Insulin: Potential Negative Consequences Of Early Routine Use In Patients With Type 2 Diabetes
The lack of adequate insulin secretion characterizes all hyperglycemic states. When insulin action is normal, as in type 1 diabetes, there is a near total loss of insulin secretory function. In type 2 diabetes, the abnormalities in insulin secretion are multiple. One of the initial defects is a loss of the early phase of meal-stimulated insulin secretion. This is followed by an inability of the β-cell to increase insulin secretion sufficient to overcome hepatic and peripheral insulin resistance. Type 2 diabetes is characterized by a progressive decrease in both β-cell mass and secretory function so that, in most individuals, absolute insulin deficiency occurs in the late stages of the disease. It would seem logical that the ideal treatment for type 2 diabetes should be early and continuing insulin therapy. Unfortunately, there are several characteristics of insulin treatment and insulin action in type 2 diabetes that limit the usefulness of insulin treatment and that suggest that chronic insulin therapy is best used in the later stages of diabetes when there is an absolute deficiency of insulin. In normal physiology, β-cell insulin secretion is coupled immediately with changes in the plasma glucose level (1). The secretory response is rapid (within a minute or two), and because the half-life of insulin is ~5 min, there is little lag time in the glucose regulatory system. Endogenously secreted insulin goes via the portal vein to the liver, where 30–80% of it is either metabolized or used (2). The portal vein-to-peripheral arterial insulin ratio is ~2:1. The administration of insulin exogenously eliminates the rapid regulation of plasma glucose, since the insulin must be taken up slowly and without regulation from the subcutaneous injection site. The kinetics are det Continue reading >>
Insulin Side Effects
Adverse Effects of Insulin People taking insulin are susceptible to hypoglycemia when they administer too much insulin, delay or miss a meal, exercise without first eating a snack, or drink alcohol on an empty stomach. That's why insulin treatment requires careful attention to the timing of meals, exercise, and alcohol intake. If you're taking insulin, you'll also need to test your blood glucose at home, perhaps several times a day. Your doctor will also perform periodic HbA1c tests to check your overall glucose control and to help you find the best doses of insulin that will keep your blood glucose low, but not so low that you have episodes of hypoglycemia. Other adverse effects of insulin include loss or overgrowth of fat tissue at injection sites, allergic reactions, and insulin resistance. If you inject in the same area over and over again, you may develop fat deposits there, which reduce insulin absorption. This effect is less common with the types of insulin used today, and you can prevent it by rotating injection sites. Allergic reactions are also less common with the newer insulins. If you suffer reactions, you can be treated with a desensitization procedure that involves starting with injections of small doses of insulin and gradually increasing to higher doses. Insulin resistance, which may be caused by the formation of antibodies against insulin, is usually managed by increasing the insulin dose. Publication Review By: Written by: Christopher D. Saudek, M.D.; Simeon Margolis, M.D., Ph.D. Last Modified: 03 Apr 2013 Continue reading >>
Insulin Side Effects
Applies to insulin: injectable liquid, injectable solution, subcutaneous suspension Endocrine Hypoglycemia is the most common and serious side effect of insulin, occurring in approximately 16% of type 1 and 10% of type II diabetic patients (the incidence varies greatly depending on the populations studied, types of insulin therapy, etc). Although there are counterregulatory endocrinologic responses to hypoglycemia, some responses are decreased, inefficient, or absent in some patients. Severe hypoglycemia usually presents first as confusion, sweating, or tachycardia, and can result in coma, seizures, cardiac arrhythmias, neurological deficits, and death. Blood or urine glucose monitoring is recommended in patients who are at risk of hypoglycemia or who do not recognize the signs and symptoms of hypoglycemia. The risk for developing hypoglycemia is higher in patients receiving intensive or continuous infusion insulin therapy. The association between insulin and dyslipidemia is currently being evaluated.[Ref] Permanent neuropsychological impairment has been associated with recurrent episodes of severe hypoglycemia. In one retrospective study of 600 randomly selected patients with insulin-treated diabetes mellitus, the only reliable predictors of severe hypoglycemia were a history of hypoglycemia, a history of hypoglycemia-related injury or convulsion, and the duration of insulin therapy. Those with a history of hypoglycemia had been treated with insulin for 17.4 years, which was significantly longer than the 14.3 years in the insulin-treated patients without a history of hypoglycemia. Human insulin does not appear to be associated with hypoglycemic episodes more often than animal insulin. Caution is recommended when switching from animal (either bovine or pork) to purified Continue reading >>
What Are The Side Effects Of Insulin Shots?
Insulin is at the center of the diabetes problem. In people with type 2 diabetes, the body does not use insulin effectively. The pancreas compensates by overproducing insulin, and in time, it simply cannot keep up with the demands of the body to keep glucose levels down. To provide enough insulin to the body to manage blood glucose levels, many diabetics are advised to take insulin shots. The insulin in these injections is a chemical that is produced artificially to resemble the insulin made in our pancreas. This insulin works just like natural insulin by escorting sugar from our blood into our cells. Type 2 diabetics deal with a condition known as insulin resistance. It is a phenomenon where cells aren’t sensitive to the action of insulin (escorting blood glucose into cells) and hence, do not respond to it. This leads to the accumulation of glucose in the blood and is called hyperglycemia. Supplemental insulin given to Type 2 diabetics helps the body ‘muscle’ sugar out of the bloodstream and into cells. Insulin injections are used to regulate blood sugar differently for the different diabetes-types: For people who have type 1 diabetes – Their bodies cannot make insulin and therefore they aren’t able to regulate the amount of glucose in their bloodstream. For people who have type 2 diabetes – Their bodies aren’t able to produce enough insulin, or use it effectively. The insulin shots are used because the blood sugar cannot be regulated with oral medications alone. They also stop the liver from producing more sugar. Every type of insulin available in a drug store works in this way. They, mainly, differ in two ways – How quickly they begin to work For how long they can regulate blood sugar levels Mechanism of Action Regulating the process in which glucose Continue reading >>
Insulin: Adverse Reactions
Hypoglycemias are the main problem, especially in intensified treatment. Excessive doses, insufficient calory uptake, or physical exertion are possible triggers. Early symptoms: hunger, restlessness, sweating or vertigo, unsteadiness and thought disorders. Specialists do not agree if human insulin hinders the timely recognition of severe hypoglycemias more often than animal insulins. Considerable weight gain is often observed under the intensified treatment. Generalized hypersensitive reactions also occur with human insulin. A lipodystrophy can occur at the site of injection. Transient visual disturbances are possible after readjustments. Insulin: Interactions Alcohol, beta-blockers, MAO inhibitors, oral antidiabetics and salicylates may reinforce the effect of insulin. Our Rating: Symptomatic value Our Comment: Even though only a minority of diabetes patients are insulin-dependent, the proof that an intensified treatment has long-term advantages has to be considered as an important milestone in insulin therapy. The multiplication of hypoglycemias related to the intensified treatment must not be ignored. In individual cases it is recommended to evaluate the pros and cons. As far as type II diabetes is concerned, the test results are still being expected. Insulin Tables: normal insulin (regular insulin) soluble insulin crystals 30 minutes 2 hours 8 hours crystalline insulin zinc insulin zinc crytals with acetate buffer 4 hours 8 to 24 hours 36 hours stable diabetes mellitus without ketoacidosis s.c. Two daily injections of an intermediate-acting insulin*, initially e.g. 16 U in the morning and 8 U in the evening 20 to 30 minutes before the meal intensified therapy s.c. Basic bolus principle: one nightly injection of a long-acting insulin + several daily injections of nor Continue reading >>
Insulin For Diabetes Treatment (types, Side Effects, And Preparations)
What is the dosage and how is insulin administrated? A meal should be consumed within 30 minutes after administering regular insulin Insulin usually is administered by subcutaneous injection into the abdominal wall, thigh, buttocks (gluteal region), or upper arm. Injection sites should be rotated within the same region. Some insulins (for example, regular insulin) also may be administered intravenously. The dose is individualized for each patient. A combination of short or rapid acting and intermediate or long acting insulin typically are used Some patients may develop resistance to insulin and require increasing doses. Multiple daily insulin injections or continuous subcutaneous infusions via a pump closely mimic pancreatic insulin secretion. Insulin sliding scales (doses of insulin that are based on the glucose level ) may be used for managing critically ill hospitalized patients. What are the contraindications, warnings, and precautions for insulin? Hypersensitivity to insulin or its excipients (inactive co-ingredients) Hypoglycemia may occur and is the most common side effect of insulin treatment. Severe, life-threatening allergic reactions, including anaphylaxis, may occur. Hypokalemia (low blood potassium) may occur because insulin stimulates movement of potassium from blood into cells. Combining insulin with potassium-lowering drugs may increase the risk of hypokalemia. Hepatic (liver) impairment may reduce the insulin requirement. Renal (kidney) dysfunction may reduce the insulin requirement. Illness, emotional disturbance, or other stress may alter the insulin requirement. Intravenous administration increases the risk of hypoglycemia and hypokalemia. Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
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Insulin injection is used to control blood sugar in people who have type 1 diabetes (condition in which the body does not make insulin and therefore cannot control the amount of sugar in the blood) or in people who have type 2 diabetes (condition in which the blood sugar is too high because the body does not produce or use insulin normally) that cannot be controlled with oral medications alone. Insulin injection is in a class of medications called hormones. Insulin injection is used to take the place of insulin that is normally produced by the body. It works by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Insulin comes as a solution (liquid) and a suspension (liquid with particles that will settle on standing) to be injected subcutaneousl Continue reading >>
4 Insulin Side Effects You May Not Have Known About
3 0 The earliest injections given to people with diabetes were comprised of insulin derived from pigs. Nothing against pigs – we like bacon as much as the next person – but it was a relief when other forms of synthetic insulin were developed in the 1970s, enabling us to live longer, healthier lives with fewer contributions from our porcine friends. But as terrific as the stuff is for controlling diabetes, it’s not without side effects. Whether you’ve been taking insulin for a short time – or for a couple of decades like I have – you may sometimes wonder if that rumbling in your stomach is something you ate, or if it’s just your insulin talking. Here, from people in the know, are four little-known insulin side effects that you may not know about, even if you’ve been using insulin for years. An Inability to Tolerate Unreasonable People. Since insulin allows glucose to get where it needs to be (in our cells), it affects our blood-sugar levels rapidly. In the process, it may cause us to feel irritable, anxious and jittery, and totally unwilling to deal with the guy who cut in line at the coffee shop. Don’t worry; these unpleasant sensations should quickly resolve, and you’ll return to your normal, relaxed self. (If not, of course, consult your doctor.) Unfortunately, crazy people will still be among us, even after your insulin-induced irritability disappears. Things are Looking Blurry, and You Haven’t Been Drinking. When taking insulin, your vision may sometimes be blurry, and it’s not because your eyeglasses need cleaning or the aliens are about to beam you up. It’s just another potential side effect of insulin, particularly when you first start to take it. The good news is, not only will this resolve fairly quickly, but as your body adjusts, you Continue reading >>
What Are The Side Effects Of Taking Insulin?
ANSWER The major side effects of taking insulin include: Low blood sugar Weight gain when you first start using it Lumps or scars where you've had too many insulin injections Rash at the site of injection or, rarely, over your entire body With inhaled insulin, there's a chance your lungs could tighten suddenly if you have asthma or chronic obstructive pulmonary disease Continue reading >>
Does Insulin Have Health Risks?
If your doctor has prescribed insulin as a diabetes treatment, here's what to know about avoiding low blood sugar, weight gain, and other potential complications. Faced with the prospect of daily insulin injections, you may be more worried about needles and syringes than potential health risks of this diabetes treatment. In fact, insulin has been so finely tuned that health risks, side effects, and complications from insulin therapy for people with type 2 diabetes are fewer than ever before. That doesn’t mean problems don’t exist, but most are easily overcome with proper education, close communication with your doctor, and following his or her directions. Here are some potential side effects of insulin therapy that you should know about: Low Blood Sugar (Hypoglycemia) Low blood sugar is the most serious complication associated with insulin. Also referred to as insulin reaction, it occurs when your blood sugar drops below a certain level. If your insulin dose is too high or is delivered too quickly, your blood sugar level may drop so low that it can impair brain function. In the most severe and untreated cases, low blood sugar can cause you to have a seizure, pass out, or even go into a coma. Signs and symptoms of low blood sugar include feeling weak, drowsy, or dizzy, experiencing shakiness, confusion, anxiety, nausea, or headache, blurred vision, and sometimes a loss of consciousness. Although not always possible to do, the only way to know for certain if you're experiencing low blood sugar is to test your blood sugar level — a reading under 70 mg/dl often indicates hypoglycemia. Some people can dip to that level without any signs or symptoms, especially if they've had diabetes for a long time. If you test and see low blood sugar numbers yet feel no effects, talk Continue reading >>
Insulin: It’s A Good Thing. Really!
One of my nurse educator colleagues was recently featured in a teaching video on how to inject insulin. As part of the video, we asked people who have diabetes and who take insulin to answer some questions about what it’s like to have diabetes, including following a meal plan and injecting insulin. While a few of the people (two of them were young women) boldly stated that they disliked having to take insulin (or as one woman put, “poke herself”), all of them agreed that insulin was a good thing and that, if you need it, take it. As a dietitian, I’ve dealt mostly with the “food” end of diabetes, but of course, food and insulin are so closely intertwined that you really can’t talk about one without the other (and vice versa). More and more people have diabetes, as you’re aware, and more and more people are taking insulin. Now, you know that if you have Type 1 diabetes, you have to take insulin in order to live. Right now, there are no other options for treating Type 1. With Type 2 diabetes, things are a little murkier. Some people with Type 2 can manage just fine, at least for a while, by following a meal plan, controlling their weight, and getting regular exercise. Most people, though, are started off on a medicine (usually metformin), along with a meal plan and physical activity. After a few years, one or two more medicines (usually pills) are added. And then, after that, typically comes insulin. It’s at this stage where people beg, plead, cry, or yell to do anything to stay off of the dreaded “needle.” Why is this? Well, an obvious reason is that most of us don’t like needles. They can hurt. They’re sharp. They look long. But there are other reasons for not wanting to go on insulin, besides having to “take a needle.” I’ve listed some of Continue reading >>
Insulin Side Effects
Adverse effects and allergic reactions to insulin are possible. Here's what you should know if you take insulin to control your diabetes. If you have diabetes your body has an insulin problem. In people without diabetes, insulin is a naturally-occurring hormone but in type 2s who do not use it efficiently or who have type 1 and don't produce it, insulin must be injected. Insulin is made in a variety of forms (from rapid acting to long acting, etc) using a few different methods—through genetic engineering since 1982; withdrawn from the pancreas of deceased pigs or cows prior to that. Today there are more than 20 different types of insulin available in the United States. You may think you don't need to worry about side effects with insulin as it's a "natural" substance but when used to help control diabetes and blood glucose levels it's essentially a medication. And, as with all medications, side effects (or adverse events) are possible but do not occur in everyone. (If you feel brave and want to know more, read the prescribing information that accompanies your insulin.) It's important to note that while most people who use insulin do not experience significant side effects, you should be aware of the potential complications, just in case they occur. Insulin-Related Hypoglycemia and Hypersensitivity The most common side effect is hypoglycemia; the most-rare side effect is hypersensitivity or allergy. How can injecting insulin cause hypoglycemia (low blood sugar) to happen? Insulin’s job is to essentially escort the sugar from the bloodstream into our brain, muscles, and nerves. It thinks of nothing else, even if there is not enough sugar in the bloodstream to take. Meaning that if someone injects too much insulin, it will take too much sugar from the bloodstream, lead Continue reading >>
Type 2 Diabetes And Insulin
People with type 2 diabetes do not always have to take insulin right away; that is more common in people with type 1 diabetes. The longer someone has type 2 diabetes, the more likely they will require insulin. Just as in type 1 diabetes, insulin is a way to control your blood glucose level. With type 2 diabetes, though, dietary changes, increasing physical activity, and some oral medications are usually enough to bring your blood glucose to a normal level. To learn about how the hormone insulin works, we have an article that explains the role of insulin. There are several reasons people with type 2 diabetes may want to use insulin: It can quickly bring your blood glucose level down to a healthier range. If your blood glucose level is excessively high when you are diagnosed with type 2 diabetes, the doctor may have you use insulin to lower your blood glucose level—in a way that’s much faster than diet and exercise. Insulin will give your body a respite; it (and especially the beta cells that produce insulin) has been working overtime to try to bring down your blood glucose level. In this scenario, you’d also watch what you eat and exercise, but having your blood glucose under better control may make it easier to adjust to those lifestyle changes. It has fewer side effects than some of the medications: Insulin is a synthetic version of a hormone our bodies produce. Therefore, it interacts with your body in a more natural way than medications do, leading to fewer side effects. The one side effect is hypoglycemia. It can be cheaper. Diabetes medications can be expensive, although there is an array of options that try to cater to people of all economic levels. However, insulin is generally cheaper than medications (on a monthly basis), especially if the doctor wants yo Continue reading >>
- Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Insulin, glucagon and somatostatin stores in the pancreas of subjects with type-2 diabetes and their lean and obese non-diabetic controls
Lantus Side Effects Center
Lantus (insulin glargine [rdna origin]) Injection is a man-made form of a hormone that is produced in the body used to treat type 1 (insulin-dependent) or type 2 (non insulin-dependent) diabetes. The most common side effects of Lantus is hypoglycemia, or low blood sugar. Symptoms include: hunger, sweating, irritability, trouble concentrating, rapid breathing, fast heartbeat, seizure (severe hypoglycemia can be fatal). Other common side effects of Lantus include pain, redness, swelling, itching, or thickening of the skin at the injection site. These side effects usually go away after a few days or weeks. Lantus should be administered subcutaneously (under the skin) once a day at the same time every day. Dose is determined by the individual and the desired blood glucose levels. Lantus may interact with albuterol, clonidine, reserpine, or beta-blockers. Many other medicines can increase or decrease the effects of insulin glargine on lowering your blood sugar. Tell your doctor all prescription and over-the-counter medications and supplements you use. Tell your doctor if you are pregnant before using Lantus. Discuss a plan to manage blood sugar with your doctor before becoming pregnant. Your doctor may switch the type of insulin you use during pregnancy. It is unknown if this drug passes into breast milk. Insulin needs may change while breastfeeding. Consult your doctor before breast-feeding. Our Lantus (insulin glargine [rdna origin]) Injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Continue reading >>
Insulin Regular Human Solution
Uses Insulin regular is used with a proper diet and exercise program to control high blood sugar in people with diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. This man-made insulin product is the same as human insulin. It replaces the insulin that your body would normally make. It is a short-acting insulin. It works by helping blood sugar (glucose) get into cells so your body can use it for energy. This medication is usually used in combination with a medium- or long-acting insulin product. This medication may also be used alone or with other oral diabetes drugs (such as metformin). How to use Insulin Regular Human Solution Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist. Learn all preparation and usage instructions from your health care professional and the product package. Before using, check this product visually for particles or discoloration. If either is present, do not use the insulin. Insulin regular should be clear and colorless. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin and to avoid developing problems under the skin (lipodystrophy). Insulin regular may be injected in the stomach area, the thigh, the buttocks, or the back of the upper arm. Do not inject into a vein or muscle because very low blood sugar (hypoglycemia) may occur. Do not rub the area after the injection. Do not inject into skin that is red, swollen, or itchy. Do Continue reading >>