Calculation and administration of insulin: causes and symptoms of diabetes, diagnostic methods and treatment 

With hormonal and metabolic diseases, patients often need maintenance therapy aimed at compensating for certain functions and restoring the constancy of the internal environment of the body.

Thus, it is important for patients with type 1 diabetes to know as much as possible about the calculation and administration of insulin. Proper drug therapy can minimize symptoms and significantly improve the patient’s quality of life.

It is important to understand that the most severe complications of diabetes are associated with improper treatment and late consultation with a doctor. A preliminary consultation with an endocrinologist will help you choose the right therapy.

What is insulin

Insulin is a peptide hormone

Insulin is a peptide hormone that is responsible for a number of metabolic functions in the body.

The general direction of action of this substance is associated with the enhancement of energy processes in all tissues of the body through the processing of carbohydrates.

Different tissues have different sensitivity to insulin, depending on the number of receptors that interact with the hormone. The largest number of receptors are located in adipose and muscle tissue.

Thanks to the interaction of insulin and tissues in the body, the functions of respiration, circulation and metabolism are maintained.

Main functions of insulin:

Information about the insulin used

Listed below are the types of insulin used at Memorial Sloan Kettering (MSK).

to come back to the beginning

Formation of matter

Insulin is produced by the pancreas

Insulin is one of the hormones produced by pancreatic cells. Stimulation of the receptors of this organ leads to the release of the hormone into the blood, resulting in the storage of glucose in the cells.

Since insulin is synthesized only in a small part of the pancreas, various diseases of the organ can affect the occurrence of insulin deficiency. In particular, these are autoimmune, inflammatory and malignant processes.

The pancreas is an organ of mixed secretion. The main part of the organ is the exocrine gland, which produces digestive enzymes necessary for the breakdown of carbohydrates, proteins and fats.

Enzymes are released from pancreatic cells into the small intestine. Also, a small part of the organ, represented by the islets of Langerhans, is an endocrine gland that transports substances directly into the blood vessels.

Deciphering the insulin test

What standards should be followed when taking an analysis? The normal insulin level will be 3-20 µU/ml. However, any result should be assessed by a doctor who will correlate the numbers with your medical history and lifestyle.

Insulin below normal may indicate:

1. Diabetes mellitus type 1.
2. Adrenal insufficiency.
3. Acute pancreatitis.
4. Pancreatic necrosis.
5. Hypopituitarism.
6. Diabetic coma.
7. Taking certain medications.

Insulin higher than normal may be a consequence of diseases:

1. Diabetes mellitus type 2.
2. Liver pathologies.
3. Acromegaly.
4. Itsenko-Cushing syndrome.
5. Dystrophic myotonia.
6. Insulinoma.
7. Obesity.
8. Impaired glucose tolerance.
9. Insulin resistance.
10. Taking certain medications.

Diabetes

Measuring blood glucose levels

Diabetes mellitus is a hormonal disease caused by impaired regulation of glucose in the body. The main clinical manifestation of the pathology is an increase in blood sugar concentration.

The pathogenesis of diabetes depends on the type of disease. If in the first type the synthesis of insulin in the human body is disrupted, then in the second type a disorder occurs at the level of interaction between the hormone and cells.

Treatment also depends on the specific form of pathology. Speaking about the calculation and administration of insulin, it is necessary to focus on the first type of disease.

Unfortunately, at the moment, type 2 diabetes is an incurable disease. Patients are prescribed supportive therapy aimed at alleviating the clinical manifestations of the disease, but doctors cannot eliminate the root cause of the disorder.

An important part of preventing severe complications of the disease is a healthy diet that excludes the consumption of sweets, alcohol and other harmful foods. Patients also need to carefully monitor their health and undergo regular examinations.

Drug concentration is also important

Insulins come in different concentrations: 40IU/ml - 40 units of insulin in 1 ml of solution; 100IU/ml - 100 units of insulin in 1 ml of solution; 300IU/ml - 300 units of insulin in 1 ml of solution. What does it mean? Let's say you need to inject 10 units of insulin. If you are using 40 IU/ml insulin, then a drop containing 10 units of the active substance will be much larger than that of insulin with a concentration of 300 IU/ml. Smaller drop means less risk of lipohypertrophy. Let us repeat: drugs cannot be tolerated when they are used thoughtlessly.
Proper use of insulin will allow you to lead an active, fulfilling life. With care, Your DiaMarka!

Causes and symptoms

Disguised insulin syringe

The main cause of type 1 diabetes is damage to the pancreatic cells that synthesize insulin.

This process can occur in autoimmune diseases, characterized by an attack of the body's defense systems on healthy tissue, or inflammation.

Infections and toxic effects while taking medications can also affect the condition of the organ. At the same time, the cells still interact with insulin, so the main etiological factor is a lack of the hormone.

Possible risk factors:

1. Complicated family history. Identifying diabetes mellitus in a patient's mother, father, brother or sister significantly increases personal susceptibility to the disease.
2. Genetics. Numerous studies have helped to identify genes responsible for a high risk of diabetes.
3. Age. Type 1 diabetes mellitus occurs in patients of any age, but the typical period of manifestation of the pathology is childhood from 4 to 14 years.

The symptoms of the disease depend on many factors, including the individual sensitivity of the patient’s body to negative influences and the degree of increase in blood sugar concentration.

Most patients have the following complaints:

• Intense thirst.
• Frequent urination.
• Involuntary urination in children after 5-7 years.
• Extreme hunger even after eating recently.
• Severe weight loss.
• Irritability and other mood changes.
• Fatigue and weakness.
• Blurred vision.

You should consult a doctor as soon as possible. Symptoms of the disease intensify as the level of glucose in the blood increases.

Preparing for analysis

Reliable research values ​​are achieved by following the list of recommendations:

1. A prerequisite for taking blood is to donate blood on an empty stomach. The duration of fasting should be at least 8-14 hours. Drinking water without gas is allowed.
2. Avoid drinking alcohol and smoking before taking blood.
3. Complex sets of physical exercises and strenuous training should be excluded.
4. Taking medications in preparation for diagnostic procedures should be agreed with the attending physician. Provided that they cannot be canceled, you need to warn the biochemical laboratory specialists about this.
5. It is not recommended to carry out blood sampling procedures immediately after physiotherapeutic procedures, ultrasound, radiographic and other examinations.
6. You should not combine a prostate biopsy and sigmoidoscopy on the same day with an insulin test.

Tests can be taken at municipal medical institutions or commercial clinics. The latter option is more often considered when the patient does not have free time or in emergency cases. The price for the study depends on the region and varies from 680 rubles and above. It should be noted that this amount does not include blood sampling, the cost of which is 199 rubles.

Diagnostic methods

To undergo diagnostics, you must contact a therapist or endocrinologist. During the appointment, the doctor will ask the patient about complaints, review medical history and conduct a physical examination.

The main way to make a diagnosis is to analyze the results of laboratory diagnostics. Prescribed examinations:

• The level of glycated hemoglobin (A1C) is a biochemical blood value that allows you to estimate the average concentration of sugar in the blood over the past 2-3 months. The test measures the percentage of blood sugar bound to the oxygen-carrying protein in red blood cells (hemoglobin). The higher the glucose level, the higher the A1C in the blood. Thus, an A1C level of 6.5% in several tests indicates the presence of diabetes in patients.
• A capillary blood sugar test is a test performed when an A1C test is not available. A specialist calculates the glucose concentration in one blood sample. It is important to understand that the accuracy of such an analysis is much lower, but not all patients are suitable for A1C protein diagnosis.
• Instrumental examination of organs to identify complications of diabetes mellitus. It is important to examine the kidneys, the organ of vision and the cardiovascular system.
• Antibody test to rule out type 2 diabetes.

After the diagnosis, the doctor will prescribe an insulin regimen. Repeated A1C monitoring helps evaluate the effectiveness of treatment.

In recent years, more and more people are coming to appointments concerned about the results of their insulin blood test. Both its pronounced decrease and excess of the upper limit of reference values ​​makes people suspect they have diabetes, go to doctors and again and again determine the level of insulin on an empty stomach and under load. The vast majority of these studies are done without indication and give rise to unfounded alarms, unnecessary follow-up examinations, and sometimes unwarranted treatment. Let's figure it out.

❓What is insulin?

Insulin is a hormone that helps glucose (in other words, sugar) get from the blood into cells (that is, lowers blood sugar levels). Glucose enters the blood from internal reserves (when we do not eat - for example, at night), as well as from food carbohydrates (that food that is broken down in the intestines into glucose and absorbed in this form into the blood), and the body's cells use it to obtain energy . The level of glucose in our blood is normally maintained within fairly narrow limits, regardless of whether we are fasting or overeating on cakes. Insulin and other hormones regulate the process so that sugar does not drop below normal (otherwise the brain will “turn off”) and does not rise above (otherwise the cells will suffer, diabetes and its complications will develop). Roughly speaking, if we are fasting or running marathons, or even just sleeping at night, then the body reduces the production of insulin, and if we eat a bun with jam, then the pancreas quickly releases into the blood the amount of insulin that is needed to absorb what comes from this bun and this glucose jam. When insulin production decreases or its action is impaired, diabetes mellitus develops. Read more about diabetes here

❓What is insulin resistance?

Insulin resistance is a decrease in the biological response to the action of insulin. That is, the tissues do not perceive it as well as normally, and more insulin is required for the penetration of glucose from the blood into the cells. If the pancreas is not able to produce this amount of insulin, then blood glucose begins to rise. This is one of the main mechanisms for the development of type 2 diabetes. Decreased sensitivity to insulin occurs very often (up to 1/3 of the adult population of the United States; there is no exact data for Russia). The vast majority of cases of insulin resistance are associated with central obesity, that is, with the accumulation of fat in the waist area. At the same time, the so-called metabolic syndrome, more about it here Insulin resistance is often found in polycystic ovary syndrome (even with normal body weight, and especially with excess weight), as well as with a history of gestational diabetes. Decreased insulin sensitivity is one of the main cardiovascular risk factors, since insulin resistance is often accompanied by increased blood pressure, the development of diabetes and atherosclerosis.

There are no accurate and readily available means of measuring insulin sensitivity, but this is usually not necessary. Measuring insulin levels is not required to make a diagnosis of metabolic syndrome. In order to give recommendations on weight loss for obesity, this is also not necessary. Sometimes we use insulin and glucose measurements with the HOMA index to determine the type of diabetes in unclear cases. The problem is that the topic of insulin resistance has now become very fashionable, especially among gynecologists, gynecologist-endocrinologists, gastroenterologists, Instagram healers and people interested in biohacking. Endocrinologists are also susceptible to this fashion. Everyone is prescribed to determine insulin levels, calculate the HOMA index, and even determine the level of glucose and insulin five times during a glucose load test (on an empty stomach and then every half hour).

As a result of such an examination, it is often possible to find a reason for fear. Here are typical questions that people ask during face-to-face meetings, on forums and in instant messengers:

❓“I (my child) have increased insulin levels! Sugar is normal. The examination was carried out regarding excess weight. Is this type 2 diabetes? Answer: No, this is not type 2 diabetes. Diabetes is a chronic increase in blood sugar levels above certain values. A normal fasting glucose level most likely indicates the absence of diabetes; additional tests can be performed using a glucose load test or determining the level of glycated hemoglobin. There is no need to look at insulin levels (many obese people will have elevated levels, and we know in advance that obese people are at risk of developing type 2 diabetes) to give weight loss advice. Next, you need to monitor not insulin, but blood sugar levels. Well, try to change your diet and physical activity, of course.

❓“I (my child) have too low insulin and C-peptide levels! The level of glucose and glycated hemoglobin is at the lower limit of normal. Is this the beginning of type 1 diabetes? Answer: normal levels of glucose and glycated hemoglobin exclude the diagnosis of diabetes mellitus (any type), and there was no reason to look at insulin and C-peptide. Low levels of insulin and C-peptide with normal glucose levels in children and young adults are the norm, and with underweight it is practically a pattern, and indicates good tissue sensitivity to insulin. In such cases, you should not do any more unnecessary examinations.

❓“My insulin levels are terribly increased after a carbohydrate load, although my glucose is normal! Is this diabetes? What to do?" Answer: calm down and understand that there are no norms for insulin levels during a test with 75 g of glucose, so the laboratory indicates “fasting” norms next to the result. A release of insulin occurs every time we drink juice or eat mashed potatoes, otherwise we would not be able to absorb the glucose that is absorbed after such a meal in the intestines. The purpose of measuring insulin after a glucose load is unclear.

❓“I have high insulin levels, and that's why I was prescribed metformin. I took a test a month later, but the insulin is still as high, why isn’t it going down?” Answer: the main indication for metformin is type 2 diabetes. You can easily verify this by reading the instructions. One of its mechanisms of action is improving insulin sensitivity; The benefits of its use have been proven mainly for patients with type 2 diabetes. It can also be used for prediabetes (when sugar is already higher than normal, but “does not reach” diabetic levels) and is sometimes used for polycystic ovary syndrome (although the basis for such recommendations is not so strong). But this is not a drug for lowering insulin levels, although often both the doctor and the patient are tempted to run tests. And this is not even a drug for the treatment of obesity, although due to its cheapness and safety, it is sometimes used for the purpose of reducing body weight under the motto “what if it helps.”

❤Don't get sick! ❤