Insulin and diabetes

Insulin is a hormone secreted by the pancreas, which when we eat is released into the circulatory system helping to move glucose from food into cells to be used as energy.

Taking it is the exclusive treatment for people with Type 1 Diabetes Mellitus, as well as one of the possible ways of treatment for people with Type 2 Diabetes Mellitus, when only diet or taking tablets is not sufficient for effective glycemic regulation.

Since insulin is classified according to how long it works in the body, there are different types with different modes of action. Each person is different and will react differently to the insulin they receive, and their needs may change over time.

To calculate the amount of insulin required by each individual with diabetes, the type and mode of action must be known, along with the individual's lifestyle and occupational requirements, the usual number and times of meals, and the its total energy needs.

There are insulins that are used mainly in the "intensive regimens" of insulin therapy, before each meal, but also in combination with mixtures, mainly to cover basic meals. The person with diabetes needs to calculate how many units of rapid insulin they need to do, having previously measured their pre-breakfast sugar.

Types of insulin include:

– Fast acting which is usually taken before a meal to cover the rise in glucose caused by food intake. This type of insulin is used in combination with a long-acting insulin. – Short acting which is usually taken about 30 minutes before a meal to cover the rise in glucose caused by food intake. This type of insulin is used in combination with a long-acting insulin. – Intermediate action which covers increases in glucose values when rapid-acting insulins stop working. This type of insulin is often combined with fast- or slow-acting insulins and is usually taken twice a day. - Long term which is often combined, when necessary, with fast-acting or slow-acting insulin. Lowers blood glucose levels when rapid-acting insulins stop working. It is taken once or twice a day. – Premixed which is mainly used in older people and mainly Type 2 Diabetes Mellitus. In most cases the mixtures are made in two doses, morning and evening and the doses increase gradually. They present a greater risk of hypoglycemia, require the adaptation of the diet to the units, require the presence of intermediate snacks, while a few units are added to the treatment regimen with a third injection before lunch.

It is noted that in the final calculation of insulin units the total consumption and quality of food, exercise, stress and the state of the disease should be taken into account.

Aggelos Klitsas Specialist pathologist-diabetologist National Resistance 74 & Aiantos, Building 1 (Votsi) www.yourdoc.gr