Type of Insulin, Side Effects of Insulin & Why Take Insulin Details
Type of Insulin, Side Effects of Insulin & Why Take Insulin Details
Insulin is an important hormone in our body. It is produced from a gland called the pancreas behind the stomach. Insulin regulates the level of glucose, i.e. sugar, in the blood.
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In case of diabetes, this process of sugar control in the body is disrupted. This disruption can occur in three ways—
- The body does not produce enough insulin than it needs
- If enough insulin is produced but it does not work properly. This is called 'insulin resistance'
- The production of insulin in the body is completely stopped
Insulin is a protein hormone. Like other proteins, it is broken down in the digestive process when taken orally. As a result, it cannot reach the bloodstream properly. So it cannot be consumed as tablets or capsules. Insulin is taken by injection to ensure that it reaches the bloodstream properly.
There are different types of insulin. The type and dose of insulin will be prescribed by the doctor according to the type of diabetes and the health condition of the patient.
Why take insulin?
Patients with type 1 diabetes are born with insufficient insulin production. On the other hand, if the body does not produce enough insulin due to a health condition after birth, lifestyle or diet, or if enough insulin is produced, it does not work properly, it is called type 2 diabetes.
In both types of diabetes, if the body lacks insulin, insulin needs to be supplied from outside the body. Therefore, all patients with type 1 diabetes and some patients with type 2 diabetes need to take insulin.
Blood sugar levels are under control when insulin balance is restored in the body. Thus it reduces the risk of various health problems in the short term as well as various serious complications in the long term.
It should be noted that in the treatment of diabetes, it is very important to follow a healthy lifestyle along with insulin use and regular check-ups as advised by the doctor.
Regular exercise and healthy eating habits can reduce the risk of diabetes complications.
Method of taking insulin
Due to not knowing the correct method, many people take insulin in the wrong place in the body, in the wrong dose while taking insulin by themselves. Therefore, on the one hand, it is not possible to control the blood sugar properly and on the other hand, various complications arise due to hardening of the skin.
Insulin is usually taken in two ways—insulin syringes and insulin pens. These two methods of taking insulin at home are discussed in the article Insulin administration rules. By following the instructions in the article, the patient can easily and correctly take insulin by himself.
Anxiety about insulin injections
Many people experience anxiety before starting insulin injections. Some may be afraid of needles, some may feel anxious, worried about pain—even many may be shy or afraid to inject in front of others. Feelings like this are not at all unusual.
But if these feelings affect diabetes control—that is, if insulin is not taken regularly—the consequences can be dire.
There are many ways to get rid of this condition. Tell your doctor if you are afraid of needles. He can choose the right size needle for you.
If you feel uncomfortable taking cold insulin, store the insulin so that the temperature is neither too cold nor too high. Follow our article on insulin storage.
Write down your concerns and questions about insulin in a notebook. You can solve several problems yourself. No worry or question is 'silly'—try to keep it in mind. Take the chart with you at the next checkup if necessary and get the solution from the doctor.
If you know a relative, friend, colleague or neighbor who uses insulin, you can also talk to them about this. Everyone's experience is different, so from these discussions you can learn some tips that will work for you.
Consequences of not taking insulin
Patients with type 1 diabetes must take insulin. In this case, if insulin is not taken regularly, life will be threatened. If you don't take insulin, the blood sugar level increases and the risk of developing 'diabetic ketoacidosis' increases.
Ketoacidosis is a complication of diabetes. It can become fatal if not treated in time. That is why it is very important to take insulin regularly in prescribed doses as per the doctor's prescription.
If the doctor has recommended the use of insulin in the treatment of type 2 diabetes patients, the use of insulin should be continued as per the prescription. If you don't take insulin, the blood sugar level will increase and various health complications may occur. If you have any questions about taking insulin, you should discuss this in detail with your doctor.
Types of Insulin
Different types of insulin are used to treat diabetes. Each of them has a slightly different mode of action in controlling diabetes. A detailed discussion should be done with the doctor to choose the most suitable insulin for the patient. Some notable types of insulin are—
- Rapid acting insulin
- Short acting insulin
- Mixed insulin
- Intermediate acting insulin
- Long acting insulin
- Ultra long acting insulin
Rapid acting insulin
This type of insulin is taken just before or after meals. These are also known as fast acting insulins. These insulins are usually taken alongside 'intermediate acting' or 'long acting' insulin.
This type of insulin works very quickly. They begin to work 15 minutes after injection and peak within one to two hours. This type of insulin works for up to four hours. The dosage will depend on how much sugary foods the patient is consuming.
Popular brands of this type of insulin in Bangladesh include Asylog, Glycet R, Insulate ASP, Mypart and Novorapid Penfill.
Short acting insulin
Their mechanism of action is similar to that of rapid-acting insulin. But they work relatively little slower. So this insulin should be taken 25 minutes before food. These insulins are also called bolus insulins.
This insulin reaches the blood stream 30 minutes after injection and reaches its peak in two to three hours. It remains effective for three to six hours. These insulins are usually taken alongside 'intermediate acting' or 'long acting' insulin.
Popular brands of this type of insulin in Bangladesh include Actrapid HM and Penfill, Insulin R, Diasulin R, Gensulin R, Maxinsulin R and Insulate R.
Mixed insulin
It is a mixture of 'short acting' and 'long acting' insulin. They should be taken during meals. However, 'intermediate acting' or 'long acting' insulin need not be taken separately with these.
These insulins start working five minutes to an hour after injection and control blood sugar for 10 to 16 hours. Usually these insulins are taken 10 to 30 minutes before breakfast and dinner.
There are some insulins, such as pre-mixed insulin, that are slightly cloudy. Before taking them, shake the vial gently until the granules inside the vial mix with the liquid to form a milky suspension or solution.
To reach this state, the vial is usually gently inverted 10 times for a total of 20 times before each injection of cloudy insulin. However, the vial should not be shaken too vigorously. This causes bubbles, which can lead to incorrect dosing.
Popular brands of this type of insulin in Bangladesh include Insulin 30/70 & 50/50, Diasulin 30/70 & 50/50, Maxinsulin 30/70 & 50/50, Insulate 30/70 & 50/50, Mixtard 30 & 50.
Intermediate acting insulin
This type of insulin is also called background insulin or basal insulin. That is, it works overnight or for half a day. These are usually taken one to two times a day.
These insulins start working two to four hours after injection and reach peak levels in four to 12 hours. They control blood sugar for 12 to 18 hours. With these, 'rapid acting' or 'short acting' insulin is often recommended.
Popular brands of this type of insulin in Bangladesh include Insulin N, Diasulin N, Gensulin N, Maxinsulin N 40 & 100, Insulate N and Insulatard.
Long acting insulin
This type of insulin is similar to intermediate insulin, but acts relatively slowly. These should be taken once a day at the same time every day. The risk of hypoglycemia has been shown to be lower with these insulins than with 'intermediate acting' insulins.
These insulins start working two hours after injection and last up to 24 hours. This type of insulin is taken once a day. They are often recommended in addition to rapid-acting or short-acting insulin when needed.
Popular brands of this type of insulin in Bangladesh include Vibranta, Semgly, Larsulin, Insulate GN, Glarin, Levemir and Abasaglar.
Ultra long acting insulin
This type of insulin injection provides the required insulin supply to the body for a long period of time. These are similar to long-acting insulin, but work a little slower and for a longer period of time.
These insulins start working six hours after injection and last for 36 hours or more.
Insulin storage rules
Insulin should always be stored below 25°C. The ideal temperature in this case is 2⁰–6⁰ Celsius. So insulin is best stored in the refrigerator. But it should never be kept in deep freeze.
Insulin can usually be stored at room temperature. But in summer or when the heater is on in the house, the temperature of the room and environment increases. If insulin is stored for a long time at temperatures above 25⁰ Celsius, it may be destroyed.
If insulin is left out of the refrigerator for more than 28 days, the insulin components break down. Then it has to be thrown away. Therefore, taking into account the temperature, the storage of insulin in the refrigerator should be taken care of.
However, insulin should never be kept in a deep freezer or freezer. It can destroy insulin.
Some insulin may need to be stored in a slightly different way. So after buying insulin, read the instructions inside the packet. If necessary, you can talk to your doctor about insulin storage.
Four important tips for storing insulin
- Store a few more insulin vials or cartridge packets than you need in the refrigerator.
- Check the expiration date printed on the packet and avoid using expired insulin.
- Insulin should not be stored in sunlight or at high temperatures. For example: next to the stove or inside the car on a hot day.
- A special type of 'cool bag' can be used for proper storage of insulin during long distance travel.
Side effects of insulin
Common side effects
As with any medication, insulin can cause some side effects. Different people may have different reactions. The following symptoms should be reported to the doctor within 72 hours of taking any new insulin:
- Headache
- Nausea
- Cold or flu-like symptoms
Hypoglycemia
The most common side effect of insulin is hypoglycemia. When the amount of glucose or sugar in the blood falls below the minimum normal level, it is called hypoglycemia. Many know it as 'Hypo' for short. Hypoglycemia occurs primarily in diabetics who require insulin.
This condition can occur when a person with diabetes takes too much insulin or skips a meal after taking insulin. One of the causes of frequent hypoglycemia is taking the wrong dose of insulin. So in such cases, talk to the doctor to know about the correct dosage and next steps.
Sore spots at the injection site
A small blood vessel under the skin is injured during an insulin injection, which can cause sore spots on the skin. People who take regular insulin can sometimes experience pain, even if there is no problem with the injection method. This is a normal occurrence.
If you are concerned about this, ask your doctor or a trained nurse how to take insulin properly. In some cases, sore spots can be reduced simply by changing the size of the needle or changing the needle used after each insulin injection.
Swelling at the injection site
Repeated injections of insulin in the same area can cause the area to become hard and swollen. This is called 'lipo-hypertrophy' or 'lipo' in medical terms. Such swelling prevents insulin from being absorbed and working properly.
So you have to choose a different place to take insulin each time. The next injection should be at least one centimeter or half an inch away from where the insulin was taken last time.
If the 'lipo' or swelling does not heal even after a few days, a doctor should be consulted.
Apart from this, due to repeated injections, itchy skin, red rash or burning problem may occur. This problem can be solved by changing the injection site. However, if you suffer from these problems for a long time, you should consult a doctor.
Weight gain and insulin
A patient may gain weight after starting insulin. There can be many reasons behind this. For example –
- Patient diet or food list
- What type of insulin is being taken
- How much insulin is being taken
How insulin affects weight depends on the type of insulin being taken. In addition to the type of insulin, the dose of insulin being taken is also very important. Taking high amounts of insulin on a regular basis can lead to hypo and weight gain. In case of 'hypo', the patient's appetite increases, resulting in weight gain.
Insulin helps the body use glucose from food to provide energy. It stores excess glucose as body fat. As a result, weight may increase. Apart from this, insulin is a type of 'growth hormone'. Any type of growth hormone can increase body weight.
However, weight can be effectively controlled by following a healthy diet and lifestyle. For this, read the articles on Diabetic Diet and Diabetic Exercise and Weight for more details.
If you don't eat according to the rules, you have to take more insulin to keep your blood sugar under control. Therefore weight may increase. Similarly, for weight loss, a healthy lifestyle and eating a balanced diet requires a relatively low amount of insulin. But if you go back to your old eating habits after a few days and increase your insulin levels accordingly, weight gain may occur again.
So, apart from making diet and lifestyle changes, consult a doctor about what kind of changes in insulin dosage should be made.
Note that weight loss may occur within a short period of time after diabetes is diagnosed. This is one of the symptoms of diabetes. In this case, weight loss can be an important part of the patient's recovery process.
Insulin Overdose
Taking more insulin than needed can lead to an insulin overdose. The consequences of insulin overdose can be fatal. In this case, blood sugar can drop dangerously and cause severe hypoglycemia. As the condition worsens, the patient may behave incoherently. Seizures can also occur—and the patient may even die.
If you accidentally take too much insulin, take sweets, sugary syrup or glucose tablets immediately. That is, you should eat sugary foods that can quickly increase blood sugar by supplying glucose.
If the insulin dose seems to be too high or if you forget to take too much insulin, contact your doctor immediately.
What you need to know about insulin
Insulin pen
There are two types of insulin pens—
- One type of insulin pen is pre-filled with insulin. When the insulin in the pen is used up, the pen must be thrown away.
- There is another type of insulin pen that can be used repeatedly by changing vials or cartridges.
Discuss with your doctor which type is right for you.
Insulin sensitivity and your dose
The body's ability to use insulin to keep blood sugar levels stable is called insulin sensitivity. People with high insulin sensitivity need to take relatively less insulin to keep their blood sugar under control.
The doctor may recommend some tests to determine the patient's insulin sensitivity. This helps determine the appropriate dose of insulin for the patient, or even whether the patient should take insulin at all.
Insulin resistance
When the body's own insulin or insulin taken from outside does not work properly in the body, the phenomenon is called 'insulin resistance'. In this condition, insulin cannot regulate blood sugar levels properly. As a result, diabetes increases.
Excess belly fat causes insulin resistance. In this case, even if the weight is correct according to the height, various health problems including insulin resistance may appear due to excess fat.
You can read the article 'What should be your weight' to know how the belly size should be for men and women to keep the body healthy.
Note that insulin resistance can be caused by other factors besides obesity or being overweight. For example, as hormone secretion is somewhat unstable during adolescence, insulin resistance is more likely to occur during this period. In this case, insulin resistance has no relationship with weight.
Treatment of insulin resistance may require taking other diabetes medications in addition to insulin injections. In this way the effectiveness of insulin can be increased. Talk to your doctor about which method is best for you to reduce insulin resistance.
Children's insulin
Only 5-10 percent of all diabetic patients suffer from type 1 diabetes. But among these patients, the number of children and adolescents is high.
The main treatment for type 1 diabetes is regular insulin injections. So if your child needs to take insulin regularly, encourage him to learn to take insulin on his own.
Insulin pump
Insulin pump is a battery operated device. It supplies insulin to the body regularly throughout the day. Insulin pumps can be used as an alternative to insulin injections. Talk to a diabetes (endocrine) specialist about using an insulin pump.
Wrote Dr. Ima Islam
Medical review done by Dr. Umme Fatima Fareen
