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01 Nov 2016

Treating Diabetes - Understanding Insulin

"Insulin" is often used as a normal term for a great number of a variety of insulin available. When you shop for the new "car," you could go back home having an SUV, a pick-up truck, a fancy car, a sedan, or a minivan. Each one of these different "cars" possess a different function, equally as different types of insulin have different effects. Insulin

Insulin has been used since 1920s from the treatment of diabetes. Initially, purified pork and beef insulins were put to use; however, patients could develop antibodies or the signs of a hypersensitive reaction about bat roosting "foreign" substances. Consequently, human insulin originated for pharmaceutical use in the 1960s. The 1990s saw the roll-out of genetically altered "analog" insulins; these are getting to be the caliber of care today.

When it comes to insulin therapy, we have to take a look at these 3 factors:

- The start of action from the insulin, meaning how quickly will the insulin start to work?
- The duration of action from the insulin, meaning just how long will the insulin work?
- When will the insulin peak, meaning when is the insulin working its hardest?

We place insulins into four categories, based on how long they work effectively. These categories include:

- Rapid-acting insulins provide an start of action within Quarter-hour, peaking in 1 to 2 hours having a amount of 3 to 4 hours.
- Short-acting insulins come with an start of action in 30 to 60 minutes, peaking into two to 3 hours with a amount of 3 to 4 hours.
- Intermediate-acting insulins offer an beginning of action in 3 to 4 hours, peaking in 10 to 12 hours having a time period of 14 to 18 hours
- Basal (or baseline) insulins are long-acting, with an onset of action in approximately 1 hour. They may be characterized as "peakless" insulins, but truly have a very small peak at approximately 10 hours, using a amount of around Twenty four hours.

Several premixed insulins can also be found available on the market. These are mixtures of either rapid- or short-acting insulin with intermediate-acting insulin. These combinations available include:

- 25% rapid-acting insulin and 75% intermediate-acting insulin
- 30% rapid- or short-acting insulin and 70% intermediate-acting insulin
- 50% rapid-acting insulin with 50% intermediate-acting insulin

The older human insulins that are still available and used today are short-acting and intermediate-acting insulin. These human insulins vary significantly inside their day-to-day action from the same person, making a higher incidence of hypoglycemia. Their peak is really required the person be eating at the time of peak action to avoid the oncoming of hypoglycemia. I limit the use of these insulins, believing how the patients having options are "working for insulin," rather than "having their insulin help them".

The newer analog insulins have a lot less variability from day-to-day. They are usually utilized in basal-bolus therapy, or what I like to refer to as "baseline-mealtime dosing with multiple daily injections." Generally this will require four or more injections per day to be able to control before- and after-eating glucoses with a reduced incidence of hypoglycemia compared to older insulins. Insulin



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