Insulin and Diabetes
Before the invention of Insulin it was difficult for Diabetic patients to survive beyond the age of 20 years. Now there. are patients who are using Insulin from the last 30 to 40 years and leading normal life.
Insulin was invented in 1926 by Dr. Fredrik Banting and Dr. Charles West, since then many changes have taken place in the structure and potency. Today various types ofInsulin are available for diabetic patients.
Insulin is hormone secreated by the pancrease.
There are three sources of Insulin% Pork Insulin- Porcine Insulin, Beef Insulin, Bovine Insulin, Human Insulin. Now-a-days purified Insulin are also available.
Insulin are of two types
Which patients need Insulin:
List of Insulins available
Different Insulin preparations are available depend.ing upon the duration of action
Fast Acting Insulins-which have short duration of Action
Even with Insulin injection one should follow strict diet control and regular Exercise Schedule.
Some Insulins are short acting, their effect starts immediately so one should take along with food. Other types of Insulins are intermediate or long acting, their action starts within 2-4 hours and lasts from 12 to 18 hours.
Types of Insulin available in India
Insulin injections are made as 40 units or/iOOunits/ml depending upon the type of Insulin.
One should be careful while filling the syringe regarding the dose of Insulin and should consult Physician about adjusting the dose.
Insulin syringes are made up of plastic material one can use the same syringe 3 to 4 times. Insulin syringes can be kept in efrigerator after using it.
Your Doctor will advise you to take one injection or two injections or more depending upon the type of Diabetes and other associated conditions.
Oral drugs are also given along with Insulin in some cases for better control of Diabetes and weight.
Complications ofInsulin Injections
These complications can be avoided by proper dosage of Insulin. Taking Insulin injections along with food and changing the site of injection frequently.
General Guidelines on Insulin Use
Insulin is mainstay of treatment in approximately 1/3rd of patients of diabetes. However, unless the patient is equipped with the knowledge and know how, the desired results cannot be obtained. Hence, the patient's education in various aspects of diabetes and its control is vital.
Insulin is ideally stored in a refrigerator at 2°-8°C. Insulin should not be kept in the freezer or exposed to extremesoftemperature. The commercially available insulin can be kept at room temperatures for 6 to 8 weeks. Insulin vials after expiry date should never be used.
Insulin are available in 40 IU/ml or 100 IU/ml strengths. It is essential to use the appropriate syringe for them.
Insulin Injection Technique
It is advisable to gently shake the suspension before use. The vial can be rolled gently upside down and sideways between the hands to ensure uniform suspension. Then vial is turned upside down and air is injected by syringe. The amount of air injected should be equivalent to the units of insulin to be withdrawn.
The Insulin vials which require mixing are usually of Plain/ Regular (clear vial) and Lente/NPH (cloudy vial). For mixing insulins first clean the rubber stopper of each bottle with spirit swab, then with the syringe, draw the air equivalent to level of desired units of Lente (cloudy) Insulin, later repeat the same for dose of Plain/Regular Insulin (clear). Ensure that there is not bubble in the syringe, (if present gently tap the syringe, to push the bubble to the top and then force it in the bottle).
Clean the site selected with the spirit swab, then skin is gently Pinched between the thumb and forefinger, hold the syringe with the other hand like a pencil and needle is pushed through the skin, plunger pushed and then released the pinch and the needle is withdrawn.
Site Selection and Rotation
Insulin should be injected into subcutaneous tissue, in any of the following areas: upper and outer area of anns, front and side areas of thigh, the buttocks, just above the waist, on the back, abdomen except the areas around the umblicus and at the waistline. The accidental intramuscular injection is painful and can cause tissue scaring. Factors like massage, increases exercise of the area where insulin injection is given can alter the absorption of insulin so they should be avoided. Rotation of the side is important to avoid problems which could occur on repeated injections at the same site. Rotation of the injection site should' be about 1-1/2" length apart within the same area. If one feels lumps, or shallow depressions or feel pain or observes change of colour of the skin at the injection site, it is better to avoid that area till that condition disappears and also consult the doctor.
Insulin should be injected 30 to 45 minutes before the meals so that its onset of action corresponds to the rise in Blood Sugar that occurs with the meals. Exercise can be associated with hypoglycemia in patients on 'nsulin. Patient should make necessary adjustments in their meal plans or insulin regimen on the days of exercise in consultation with their doctor.
Insulin and Illness
Illness can disrupt diabetic control. However, the problems can be minimised. Ifthe patients follows basic guidelines:
If the above simple precautions are observed by the patients who use insulin, many of their day to day problems can be avoided.
Here pancrease gland of other person is transplanted into Diabetic patients. There are many problems like availability of donor and rejection of graft by body.
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