Insulin replacement therapy is a common method of treatment for diabetes. There are two types of diabetes: Type 1 and Type 2. Both of these types involve the body’s inability to produce enough insulin, or not utilize insulin properly. Insulin is a hormone that is produced by cells in the pancreas. Insulin is secreted from the pancreas to regulate blood sugar (glucose) levels, and also helps cells absorb glucose, which is used for energy.
Diagnosing diabetes in an individual involves drawing blood and measuring its level of glucose. Depending on the type of test, certain levels of blood glucose confirm the presence of diabetes in the system.
After a positive diagnosis of diabetes, an individual’s doctor will be able to tell what treatments will be most beneficial for the type of diabetes the individual has. Insulin replacement therapy is a treatment utilized most commonly for Type 1 diabetes, but is sometimes necessary for the treatment of Type 2 diabetes. Diabetes is not a curable disease, therefore, insulin injections serve to minimize symptoms and slow the progression of diabetes-related complications only. Insulin replacement therapy assists the body by providing it with the insulin it cannot make or use itself.
The Insulin Types:
There are four types of manufactured insulin used as treatment for insulin replacement therapy. These types are distinguished according to these characteristics:
1. Onset: How soon the insulin type begins working after introduction to the body;
2. Peak time: The time period that the type of insulin is most effective;
3. Duration: The amount of time the insulin type works in the body.
These characteristics can vary for each individual receiving insulin replacement therapy.
The types of manufactured insulin include (onset, peak time, and duration numbers are approximate):
Rapid acting, insulin Lispro
– Onset: 5 to 15 minutes;
– Peak time: 45 to 90 minutes;
– Duration: 3 to 4 hours.
Short acting, Regular (R) insulin
– Onset: 30 minutes;
– Peak time: 2 to 5 hours;
– Duration: 5 to 8 hours.
Intermediate acting, NPH (N) or Lente (L) insulin
– Onset: 1 to 3 hours;
– Peak time: 6 to 12 hours;
– Duration: 16 to 24 hours.
Long acting, Ultralente (U) insulin
– Onset: 4 to 6 hours;
– Peak time: 8 to 20 hours;
– Duration: 24 to 28 hours.
Often times, an individual may require the use of two separate types of insulin as part of their insulin replacement therapy. When this is the case, some of these insulin’s may be mixed together and administered via injection. Other times, they may not be mixed, and each type must be administered separately.
The type of insulin treatment arranged for an individual is based on their ability to follow the associated routine, and also their preference. Other factors that may help decide what type of insulin may be right for a person can be based on:
– The patient’s inclination to regularly monitor their blood glucose levels;
– How stable the patient’s blood glucose levels are;
– Their understanding of diabetes;
– Their daily level of activity;
– The patient’s eating habits.
Administering Insulin:
For an insulin treatment to be useful in the body, it must be introduced into the bloodstream. There are a variety of tools available to patients with diabetes that can achieve this. They all involve penetrating the skin through various means and allowing the insulin to enter the blood. Insulin cannot be swallowed because it is destroyed by the digestion process.
The device chosen to assist the patient in administering insulin could be:
A syringe
A syringe for injecting insulin works much the same way as a syringe used in a doctor’s office. The needle in a syringe pierces the skin and allows the insulin to flow into the bloodstream. This is the most commonly used method for administering insulin.
An insulin pen
Appropriately named, this medical tool looks much like a writing pen, and contains a cartridge of insulin. The tip of the pen houses a small needle, activated by a plunger on the other end. A dial located on the pen can be set to allow appropriate insulin dosage to be administered.
An insulin jet injector
Unlike the syringe or insulin pen, an insulin jet injector, which looks similar to a large writing pen, sprays the insulin into the skin with the use of high-pressured air. This technique or administering insulin is a good option for patients with a low tolerance for needles.
An external insulin pump
When an insulin pump is used, a small needle is inserted into the skin of the abdomen and attached to tubing. This tubing is attached to a discreet pump which continuously pumps insulin into the bloodstream of the patient.
Injection of insulin, regardless of the chosen device used to administer it, is normally done in the fat layer of the arm, abdomen, or thigh. Each of these sights may allow the insulin to enter the bloodstream at different rates. The abdomen allows entrance of insulin the quickest and the thigh allows insulin to enter the slowest. Regardless of the type of device being used during insulin replacement therapy, the patient’s doctor will help them learn how to use and adjust to the device.
Insulin injections are carefully timed and controlled. The timing of an injection of insulin is extremely important for the patient to adhere to, especially right before they eat meal, which can introduce sugar into the blood.
A person just embarking on insulin replacement therapy will be given careful instructions and guidance by their doctor. A doctor will help the patient find the most appropriate times and instances insulin must be injected, as well as the dosage that is most appropriate for the patient.