Insulin is a peptide hormone that affects the metabolism of carbohydrates, proteins, and fats. Insulin is produced by the pancreas as the body’s response to increased blood glucose levels. Measurement of insulin concentration is recommended, among other things, in the diagnosis of hypoglycaemia.
In this article, Niketrainers.com.co will tell you:
What is insulin?
Insulin is a hormone that is secreted by thepancreas, and more specifically by the B cells of the Langerhans islets. People suffering from diabetes have a problem with producing it in the right amounts, and sometimes without it.
There may also be situations where, although insulin is produced by the pancreas, it is not fully utilized by the pancreas. Then, the increase in glucose after a meal cannot be reduced by insulin and there is an accumulation of glucose in the blood, which in turn causes serious diseases of the eyes, heart, kidneys andnervous system. This hormone has many important functions in the human body, including the metabolism of fats, proteins and carbohydrates. In addition, insulin plays a significant role in the development of diabetes, which occurs as a result of disorders of insulin secretion by the pancreas.
Types of Diabetes:
Type I diabetes,also known as insulin-dependent diabetes, occurs because the body’s own immune system destroys insulin-secreting cells in the pancreas (B). With the development of the disease, the patient’s body stops producing its own insulin (endogenous). Treatment consists of injecting exogenous insulin;
type II diabetes– the cause of its formation is insufficient insulin secretion with high blood glucose levels (after a meal). Treatment includes, first of all, the implementation of an appropriate diet, exercise and preparations. Insulin injections are a last resort when medications are not bringing the expected benefits.
Types of insulin
Different types of insulin vary in duration of action, onset of action, and peak action.
1. Short-acting insulin –apart from the fact that it appears quickly in the blood, it has a short duration of action. It can be taken approximately 30 minutes before a meal. Its strongest effect lasts about 1-3 hours after application. It is effective for eight hours.
2. Intermediate-acting insulin– can be taken 0.5 to 1.5 hours before a meal. Its strongest effect is seen between 4 and 12 hours after injection. It is effective for 18-22 hours.
3. Insulin with a prolonged duration of action– its onset of action occurs after about 2 hours; its effect lasts over a day.
Insulin – history
Insulin is a hormone discovered in the 20’s of the last century. This discovery was made by Canadian physiologist Frederick Banting and his assistant Charles Best. A year after the discovery of insulin, Banting was awarded the Nobel Prize for this achievement. The financial bonus for this discovery was shared by Banting with his assistant. In 1958, the English biochemist Frederick Sanger also received the Nobel Prize for his research on insulin. He established the amino acid sequence of insulin. 5 years later, insulin was chemically synthesized, and after another 6 years, the English biochemist Dorothy Crowfoot Hodgkin, using X-ray crystallography, determined the spatial structure of insulin. The discovery of insulin turned out to be a breakthrough in the treatment of diabetes and is considered one of the most important medical discoveries of that time.
The role of insulin in the human body
Insulin plays a very important role in the human body. Its action is based on homeostatic control of hormonal mechanisms. There are several basic functions of insulin, including:
- regulation of blood glucose levels – insulin lowers blood sugar levels to the correct concentration. If your body is deficient or deficient in insulin, you may develop type II diabetes;
- participation in the processing ofcarbohydratesinto fats;
- supporting protein synthesis by accelerating the supply of amino acids.
Insulin secretion phases
The proper work of cells responsible for the production of insulin depends onthe early phase of insulin secretion(a rapid increase in insulin approximately two minutes after the increase in postprandial glucose in the blood) andthe second phase. During the second phase, insulin is released very slowly and at a constant level. Then, the production of glucose by the liver stops. The duration of the second secretory phase is proportional to the increased blood glucose level. In patients with type II diabetes, the first phase of secretion does not occur and the second phase is delayed. In addition, insulin secretion decreases over time and the synthesis of insulin precursors increases.
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What stimulates insulin secretion?
- intestinal hormones (appearing as a result of irritating the walls of the digestive tract with food),
- an increase in blood glucose after a meal,
- postprandial amino acids and fatty acids.
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Insulin production – human insulin and insulin analogues
Diabetes is treated by administering insulin. Today, two types of insulin are used for treatment:
- human insulins– these are the previously mentioned insulins, which are divided into short-acting and medium-acting insulins. Modern technologies that use genetic engineering methods are used for the production of human insulin. The amino acid composition of this insulin is identical to that of insulin produced by the pancreas. It is worth noting that pig or bovine pancreatic insulins were the basis of insulin therapy for many years. However, they are no longer used today;
- insulin analogues– these are products that are obtained using genetic engineering methods. In production, slight changes are made to the structure of human insulin. This type of insulin has new properties, and at the same time retains its physiological effect. As in the case of human insulins, analogues are divided into fast and long-acting. Fast-acting is recommended mainly for young and middle-aged people. Long-acting insulin analogues, on the other hand, are recommended for elderly, less physically active people.
Indications for insulin testing
Measurement of insulin concentration is recommended for:
- diagnosis ofhypoglycaemia(low glucose concentration);
- the presence of acute or chronic symptoms of hypoglycaemia (e.g. dizziness, excessive sweating, seizures, trouble seeing);
- assessment of the amount of endogenous (produced by the pancreas) and exogenous (injected) insulin in the blood;
- suspicion of the presence of an insulin producing tumor (insulinoma);
- assessing the severity of insulin resistance – reducing the effectiveness of insulin in peripheral tissues,
- diagnosisof liver diseases;
- assessing whether the island has been completely removed or monitoring for any recurrence;
- assessing the effectiveness of treatment after pancreatic islet cells transplantation;
- hormonal diagnosis of secreting tumors that may lead to insulin resistance – acromegaly, Cushing’s syndrome.
Fasting insulin testing is the simplest method of measuring this hormone in your serum. It is worth doing an insulin test if you want to visit a dietitian to determine the best diet for you.
Remarks:
- Insulin is a protein hormone and therefore cannot be administered orally as it would be digested in the lumen of the gastrointestinal tract by enzymes found in the stomach, duodenum and other parts of the small intestine.
- The active form of the hormone consists of two linked polypeptide chains. It is formed from the primary form of the hormone – proinsulin as a result of the separation of the protein fragment – C peptide. Determining the concentration of the C chain is important in differentiating the origin of insulin.
- In the case of exogenous origin (insulin administered in the form of preparations), there is no increase in the level of C-peptide, and in the case of excessive production of endogenous (intracorporeal) insulin, the concentration of C-peptide in the serum increases.
- In the presence of an insulin producing tumor (insulinoma), an excessive increase in insulin levels is sometimes observed after administration of tolbutamide.
Insulin sensitivity test
It is the most accurate test method, and it involves administering insulin and glucose with simultaneous blood glucose testing (every four minutes). During the diagnosis of diabetes, insulin is administered intravenously in the form of fixed doses. This test is designed to determine the amount of glucose consumed that is applied in an amount that does not pose a risk of hypoglycemia. By regulating insulin levels, you can get a close look at the insulin sensitivity of adipose tissue, muscles and liver. The insulin sensitivity test is only a scientific method that is used in specialized centers. Special computer programs and experienced personnel are required to perform it. Therefore, this test is not a routine method.
Insulin test – norms
The norms of insulin levels are as follows:
- fasting – up to 10 mU / ml;
- 1 hour after a meal – up to 50 mU / ml;
- 2 hours after a meal – up to 30 mU / ml.
Increased insulin levels are usually a symptom of type 2 diabetes, while a result below the normal range indicates type 1 diabetes. Results that are above the normal range or below the recommended values ​​require consultation with adiabetologist.
What does elevated insulin mean?
We can observe high insulin levels in:
- while taking medications such as corticosteroids, levodopa or oral contraception;
- galactose or fructose intolerance;
- Cushing’s disease;
- an islander;
- the case of obese people;
- type 2 diabetes;
- metabolic syndrome;
- acromegaly.
As for low insulin levels, it can be observed in:
- hypopituitarism;
- diabetes;
- pancreatic problems (e.g. pancreatitis, pancreatic cancer).
Natural dietary supplements will help in the proper functioning of the pancreas, for exampleFOR THE PANCREAM – the Herbapol dietary supplement in Krakow, which contains herbs that have a beneficial effect on this organ.
Indications for the use of insulin
In diabetics, insufficient insulin secretion by the pancreas is observed. Therefore, in patients with type I diabetes, insulin treatment is an essential element of therapy, because the pancreas does not produce this hormone. In type II diabetics, diet alone and an appropriate set of exercises and medications are sometimes enough. Insulin for injection is most often obtained through the use of a biotechnological method – insulin is produced by baker’s yeast or special strains of bacteria that have been previously injected with human insulin genes. Animal insulin is no longer used in developed countries.
Other indications for insulin therapy are:
- diabetes in pregnant women (insulin is introduced when the diet is ineffective),
- inhibition of glucotoxicity,
- a surgery performed in a type II diabetic, who so far has been treated only with antidiabetic preparations,
- sudden states of a patient with type II diabetes – stroke or heart attack,
- kidney or liver damage in type II diabetics (in this type of ailments taking antidiabetic drugs is contraindicated).
After injection under the skin, human insulin has the ability to crystallize. The crystals dissolve very slowly, and therefore insulin reaches its highest concentration in the bloodstream after 1.5-2 hours. 30 minutes must elapse between the injection and the meal for the insulin to start working. Unfortunately, many patients ignore these guidelines and insulin is injected too late or shortly before a meal. This situation caused scientists to convert amino acids into insulin molecules, thanks to which they obtained a new substance – an analog of human insulin. The crystals of this substance dissolve much faster, so insulin can be applied just before, during or even a quarter of an hour after a meal.
Diabetes mellitus – how to administer insulin?
The dosage of insulin is decided by a diabetologist who must first perform a series of tests. Diabetics must check their blood sugar levels before each insulin injection.
If they take a dose before a meal – take into account the amount of carbohydrates in it. Insulin is available in ampoules, the dispensers of which are similar to a regular pen. In the middle of the so-called penu is a container with insulin, which lasts for several days. The needle attached to the ampoule is very thin and coated with silicone, so that the patient does not feel pain during the injection. The injection is applied under the skin, not into the muscle! Of course, the injection into the muscle is not dangerous, but it interferes with the absorption time and the action of the hormone. It is recommended to apply insulin from the abdomen, thigh or upper arm. Do this very slowly and do not pull the needle out immediately after emptying the contents of the ampoule (wait at least 6 seconds).
Insulin can also be administered with ordinary syringes. In this case, the patient takes the appropriate amount of insulin from a special container, and then injects it under the skin. Insulin injection syringes are small and have thin needles, making injection of the preparation convenient and comfortable.SURMEDI insulin needlesare available for purchase at Medonet Market.
Another method of delivering insulin is throughan insulin pump.It consists of a small catheter inserted under the skin and a pump the size of a mobile phone. The pump contains a reservoir for insulin, which it supplies to your body at certain times.
Important! Insulin should be stored in a refrigerator at 2-8 degrees Celsius. The preparation should be kept away from sunlight, and the open vial should not be used for more than 6 weeks. Insulin that has changed its consistency or color must not be used.
Insulin – side effects
The use of insulin helps to avoid diabetes complications and has a very beneficial effect on the functioning of the eyes, kidneys, nervous system and heart. Still, taking insulin can have a variety of side effects, including:
- Hypoglycaemia or hypoglycaemia – hypoglycaemia occurs when blood glucose levels drop below 55 mg / dL. With insulin use, this may occur in the event of excessive physical exertion, alcohol consumption, or insufficient meal. Hypoglycaemia is manifested by sweating, trembling hands, feeling hungry, weakness or palpitations. A mild hypoglycemia can be quickly overcome by consuming extra sugar. If there is a significant drop in sugar and severe hypoglycaemia, it may lead to loss of consciousness and requires injection of glucagon or glucose;
- allergic reaction – insulin is a hormone that very rarely causes an allergic reaction in patients. However, a rash or reddening of the skin may occur at the injection sites. If these symptoms worsen, consult a doctor to change the preparation used;
- Lipohypertrophy and Lipoatrophy – Lipohypertrophy is a term used to describe an overgrowth of adipose tissue at the site of insulin injection. This ailment is manifested by hardening of the skin and visible elevations at the sites of insulin administration;
- weight gain – most people gain weight during the first phase of insulin therapy. The mechanisms of insulin action contribute to this;
- arterial hypertension – the use of insulin may causearterial hypertensionby stimulating the sympathetic nervous system and increasing the absorption of sodium in the kidneys.
Insulin and bodybuilding
Insulin is also used in bodybuilding as a substance that stimulates the action of anabolic steroids (mainly growth hormone). After administration, a large amount of growth hormones passes into the liver, which starts the production of insulin-like growth factor (IGF). One daily dose of insulin produced by the pancreas is insufficient to maximally produce IGF-1 in the liver, hence the need for insulin. However, it should be remembered that injecting this hormone by healthy people is very dangerous and dopinig, so it is forbidden.
There are many myths about diabetes. How is it really?
Interesting facts
- In the past, insulin had its source in the cells of the pancreas: beef or pork. Today it is synthesized biochemically and is practically no different from human insulin.
- People with diabetes can take either a mixture of insulin or a different type of insulin throughout the day.
- The insulin tolerance test is not popular today, although it is one method of determining insulin sensitivity (or resistance), especially in obese patients and women withpolycystic ovary syndrome.