Diabetes Treatment (cont.)
Treatment of diabetes with insulin
Insulin is the mainstay of treatment for patients with type 1 diabetes.
Insulin is also important in type 2 diabetes when blood glucose levels cannot be
controlled by diet, weight loss, exercise, and oral medications.
Ideally, insulin should be administered in a manner that mimics the natural
pattern of insulin secretion by a healthy pancreas; however, the complex pattern
of insulin secretion by the pancreas is difficult to duplicate. Still, adequate
blood glucose control can be achieved with careful attention to diet, regular
exercise, home blood glucose monitoring, and multiple insulin injections
throughout the day. For more, please see the
Diabetes and Home Care Monitoring
article.
In the past, the insulin was being derived from animal sources, particularly
cows and pigs. Not only was there a problem with enough supply of insulin to
meet the demand, but beef and pork insulin also had specific problems.
Originating from animals, these types of insulin caused immune reactions in some
people. Patients would become intolerant or resistant to animal insulin. With
the acceleration of scientific research in the latter half of the twentieth
century, beef and pork insulin were replaced by human insulin. In 1977, the gene
for human insulin was cloned, and through modern technology, manufactured human
insulin was made available. Human insulin is now widely used.
Insulin now comes in a variety of preparations that differ in the amount of
time following injection until they begin to work and the duration of their
action. Because of these differences, combinations of insulin are often used to
allow for a more tailored regimen of blood sugar control. The table below lists
the most common types of insulin currently in use in the U.S. and their specific
properties.
| Name of Insulin |
Onset of Action |
Peak Effect After Injection |
|
Humalog and Novolog//Very Short Acting
|
5-15 minutes |
30-60 minutes |
|
Regular/Short Acting
|
30 minutes |
2-5 hours |
|
NPH/Intermediate Acting
|
1-2.5 hours |
8-14 hours |
|
Lente/Intermediate Acting
|
1-2.5 hours |
8-12 hours |
|
Ultra Lente/Long Acting
|
4-6 hours |
10-18 hours |
|
Lantus
|
2-3 hours |
Stable from 2-3 hours to @20
hours |
|
Detemir |
3-4 hours |
Dose dependent (longer acting at higher doses) |
|
Combinations - 75/25, 70/30, 50/50
|
30 minutes |
7-12 hours |
For example, a patient may take an injection of Lantus in the morning and
evening to provide a baseline of insulin throughout a 24-hour period. In
addition, the same patient may take an injection of Humalog just before meals to
cover the increase in carbohydrate load after eating.
Next: Different methods of delivering insulin »
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- Diabetes - Learn about type 1 and 2 diabetes (Diabetes Mellitus) symptoms including increased urination, thirst, weight loss, fatigue, nausea, vomiting, skin infections, and blurred vision. Causes and diagnosis information is provided in the information.
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