Insulin is a hormone (a chemical substance that acts as a messenger in the human body) that is secreted by an abdominal organ called the pancreas. It controls the breakdown of carbohydrates, fats and proteins in the body. It also guides the liver and muscles to store glucose and fat that can be used during periods of increased energy requirements and fasting. Insulin is a “key” that unlocks the cell gates so that glucose from the blood enters the cells. The cells of the muscle and fat tissue are dependent solely on insulin for glucose uptake and use.
The lack of insulin in the body or inefficient insulin action at cellular levels causes blood sugar levels to spike (hyperglycemia). Hyperglycemia is the hallmark of diabetes mellitus. Insulin is the only hormone in the body that can prevent hyperglycemia.
Hyperinsulinemia: Some individuals require higher than normal amounts of insulin to maintain their blood sugar levels. This condition is called hyperinsulinemia. It is often found to co-exist with insulin resistance.
Insulin resistance is a state in which a given insulin concentration does not cause an expected dip in blood sugar levels. Insulin resistance may be caused by
- Antibodies to insulin or to the site in the cell where insulin binds (seen in autoimmune diseases such as systemic lupus erythematosus and Hashimoto’s thyroiditis).
- Suboptimal quality insulin (less effective insulin) as seen in people with certain genetic diseases.
- Genetic tendency to insulin resistance as seen in the people of Latino, African American, Native American or Asian-American heritage.
Certain conditions may cause temporary insulin resistance and resultant hyperinsulinemia, but as soon as the underlying cause is corrected, insulin resistance goes away. These conditions include long-term stress, infections, long-term sleep deprivation, obesity and pregnancy. These conditions release the stress hormones in the body. Stress hormones are a known cause of insulin resistance and high insulin levels.
The other causes of high insulin levels that may need medical intervention are as follows.
| Compensatory hyperinsulinemia |
|
| Metabolic syndrome |
Metabolic syndrome is a cluster of multiple maladies including
|
| Drugs |
|
| Genetic |
|
| Tumors of insulin-secreting cells |
|
| Hormonal disorders |
|
High insulin levels often have no clinical symptoms and may go undetected. Rarely, they may cause recurrent low blood sugar, which may be seen as palpitations, irritability, sweating and hunger pangs. Some individuals with long-standing insulin resistance may develop skin tags over the neck and armpits. Others may have dark underarms and groins (acanthosis nigricans).
What are normal insulin levels?
Insulin levels in the blood can be interpreted using a simple blood test that is performed after eight hours of fasting. This test must be performed in individuals with suspected insulin resistance or as a part of a hormonal panel in metabolic syndrome evaluation.
The normal values of insulin are as follows.
| Insulin level | Insulin level (SI units*) | Values in pmol/L |
| Fasting | <25 mIU/L | <174 pmol/L |
| 30 minutes after glucose administration | 30-230 mIU/L | 208-1,597 pmol/L |
| 1 hour after glucose administration | 18-276 mIU/L | 125-1,917 pmol/L |
| 2 hours after glucose administration | 16-166 mIU/L | 111-1,153 pmol/L |
| ≥3 hours after glucose administration | <25 mIU/L | <174 pmol/L |
What are the consequences of high insulin levels?
The following are the consequences of high insulin levels:
- High insulin levels generally translate into an overworked pancreas. This may be followed by the exhaustion of the pancreatic cells, resulting in the development of diabetes mellitus.
- Diabetes further brings on complications such as heart disease, nerve damage, eye damage and kidney damage.
- High insulin levels have been linked to the development of certain cancers such as cancer of the gut, although it is not proven conclusively.
- Non-alcoholic fatty liver disease (NAFLD) is a dysfunction of the liver due to increased fat deposition inside the organ. It is seen in individuals with insulin resistance.
- High insulin levels hasten plaque buildup in the large blood vessels causing atherosclerosis (blockages).
- High levels of insulin affect the estrogen-progesterone ratio in the ovaries and may result in polycystic ovarian syndrome (PCOS) that may cause irregular periods and infertility in young women.
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Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Diabetes Treatment: Medication, Diet, and Insulin
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with:
- insulin,
- exercise,
- and a diabetic diet.
Type 2 diabetes is first treated with:
- weight reduction,
- a diabetic diet,
- and exercise.
When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Insulin for Diabetes Treatment (Types, Side Effects, and Preparations)
There are a variety of types and preparations of insulin for the treatment of type 1 and type 2 diabetes, gestational diabetes, diabetes during pregnancy, metabolic syndrome, and insulin resistance. Human insulin preparations and regular insulin are made by recombinant DNA technology. Examples of preparations of insulin include rapid acting insulin (Apirda, Novolog, Humalog), short acting insulin (Novolin R, Humulin R), intermediate acting insulin (Humulin N, Novolin N, and long lasting insulin (Lantus, Levemir). Common side effects of insulin include hypoglycemia, headache, weight gain, rash, itching, flu-like symptoms, lipoatrophy, and reaction at the site of injection. Warnings, precautions, and drug interactions should be reviewed prior to taking insulin.insulin glargine (Lantus)
Insulin glargine (Lantus) is an injectable form of long-lasting insulin that is prescribed to regulate blood sugar levels in individuals with type 1 and type 2 diabetes. Side effects, drug interactions, dosing, storage, and pregnancy safety information should be reviewed prior to taking any medication.
Insulin Pump for Diabetes
An insulin pump is designed to deliver insulin directly to a patient with diabetes. They are about the size of a standard beeper. The pump is attached to under the skin (usually on the abdomen). The amount of insulin required will depend on lifestyle (exercise, sleep patterns, activity level, and diet).insulin regular human
Regular human insulin is a biological product used to treat type 1 and type 2 diabetes. Human insulin is a natural hormone secreted by the pancreas. Common side effects of insulin regular human include hypoglycemia, hypokalemia, injection site reactions, generalized rash, drop in blood pressure, shortness of breath, wheezing, fast pulse, sweating, peripheral edema, and weight gain. Overdose can cause hypoglycemia and hypokalemia. Insulin is the preferred treatment for type 1 and type 2 diabetes mellitus in pregnancy, as well as gestational diabetes mellitus. Consult your doctor if breastfeeding.
Insulin Resistance
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. There are no signs or symptoms of insulin resistance. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use. Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
Metabolic Syndrome
The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese. Lifestyle modification such as the Mediterranean diet, exercise, and quitting smoking are the preferred treatment of metabolic syndrome.
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