Diabetes once considered to be a disease of the affluent west is now emerging in developing countries. Rapid urbanisation, changes in life style and diet, mental tension and worries, are some of the many factors responsible for this increase.
Long term complications of diabetes include damage to the kidneys, eyes, nervous system, heart and peripheral vessels. These complications are delayed and minimised by optimum control of blood glucose. It is insulin that facilitates this control.
Insulin is a hormone produced by Beta cells of islets of langerhans of pancreas in the body. It regulates the glucose of the body. Deficiency of insulin is the root cause of diabetes which leads to hyperglycemia i.e. increase in blood glucose.
Diabetes has been around since ancient times, but the discovery of insulin in 1921 by Banting and colleagues revolutionised the understanding and treatment of diabetes.
Children and young adults suffering from diabetes need insulin all the time because they are Type I patients which means their bodies, or pancreases to be precise, produce no insulin.
Elderly or Type II patients can be tried on a schedule of diet restrictions, exercise and oral anti diabetic medicines. But if there is no response they are switched over to insulin for control of glucose.
Apart from this, type II patients need insulin if they develop any complication like coma due to very high blood glucose levels, significant kidney failure, retinopathy, peripheral vascular or cardiovascular disease.
Any diabetic with a serious infection or trauma of any part of the body needs insulin, even if he was on oral drugs before.
When a diabetic woman becomes pregnant, she is also put on insulin for controlling the blood glucose very well as high blood glucose levels during pregnancy are detrimental to the baby.
Major surgery is another condition where a diabetic needs insulin during and immediately after surgery to prevent any infections arising due to high blood glucose levels.
What is insulin?
Insulin is a hormone with extensive effects on both metabolism and several other body systems (e.g. vascular compliance).
When present, it causes most of the body’s cells to take up glucose from the blood (including liver, muscle, and fat tissue cells), storing it as glycogen in the liver and muscle, and stops use of fat as an energy source.
When insulin is absent (or low), glucose is not taken up by most body cells and the body begins to use fat as an energy source (i.e. transfer of lipids from adipose tissue to the liver for mobilization as an energy source).
Insulin’s structure varies slightly between species of animal. Insulin from animal sources differs somewhat in ‘strength’ (i.e. in carbohydrate metabolism control effects) in humans because of those variations. Pig insulin is especially close to the human version.
Special syringes are available for injecting insulin which are in strengths of 40 and 100 units. Ideally disposable syringes should be used. On no account should the syringe used by one person be used by another.
Vials of insulin should be placed in a cool place at about 4 to 8 degree centigrade away from direct sunlight. If facilities of refrigeration are not available, the vials can be placed in earthenware pots or any cool place of the house.
With correct use of insulin, regular diet and exercise every diabetic individual can maintain a good quality of life.