Insulin Therapy
Insulin injections are used when a patient does not produce sufficient insulin or the effects of oral treatment do not provide adequate blood sugar control. It is not given as an oral treatment because it is destroyed by the acid in the stomach and the action of enzymes in the intestine. (Several novel formulations in development are described below.) The needles used to deliver the insulin are so fine that many people claim they do not feel the injections that are administered into the subcutaneous fat lying just under the skin. Although insulin from the porcine gland is available, many diabetics are now using recombinant human insulin preparations that are produced in the lab. Some of these are identical to human insulin and others have been slightly modified. There are numerous insulin products available. A physician customizes each insulin prescription to match a person's blood glucose patterns and levels of activity. More than one type of insulin is often used to achieve the best result. Insulin comes dissolved in liquids at different strengths. Most people use U-100 insulin. This means there are 100 units of insulin per milliliter (ml) of fluid. Syringes are available with various unit markings. The syringe should match the insulin strength (ie U-100 insulin is used with a U-100 syringe).
Insulin Pens:
Insulin pens have made the use of insulin easier for many people, particularly for those who need to take insulin outside their homes The pen can be easily carried in a purse or pocket. It generally contains a dose knob for dialing in the desired amount to be injected. Some pens contain a single dose while others contain multiple doses. Many types of insulin are available in pen formulations. They are more expensive than the traditional forms available.
Insulin Pumps
The use of an insulin pump has become an effective way to provide intensive diabetes management. The pumps are frequently used by people who require multiple injections per day. Insulin pumps are also used by people who have variable schedules because it allows doses to be adjusted according to daily needs. This requires adequate knowledge of pump operation, a commitment to careful monitoring of blood glucose and the ability to adjust doses. A catheter is placed into a subcutaneous space of the abdomen or buttocks and connected to the pump that can be worn in the manner of a small pager. A limiting factor for many patients is the cost of these devices.
The Future Of Insulin Therapy
Currently, tremendous research efforts to develop an insulin inhaler are being made. Preliminary studies suggest that this form of therapy is likely to be available to patients in the near future. The inhaler sprays a mist containing insulin that is inhaled through the mouth and is carried to the lung where it is absorbed. Other areas of research include the development of insulin nose sprays, insulin patches and oral tablets that would resist acid degradation in the stomach. The future for insulin-dependent diabetics looks easier and very promising.
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