Type 2 Diabetes: How Long Does It Take For Insulin To Work?
If you have been living with type 2 diabetes for a while, then you may be on a medication regimen that includes insulin. You’ve probably noticed that your type 2 diabetes is a bit different from other people’s. Every person’s body is different, and this is just one reason why the response to insulin treatments can vary from person to person. Read on to ease your confusion about insulin and learn how it supports blood sugar management on the individual level. How insulin works in the body Insulin is produced naturally in the body by the pancreas. The pancreas contains millions of beta cells, and these cells are responsible for making insulin. Whenever you eat food with carbohydrates, your beta cells release insulin so that other cells in the body can use the blood glucose it gets from food for energy. In a sense, insulin acts as a key, letting glucose into the cells. How insulin works without diabetes Under normal circumstances, the body produces insulin after digestion. The presence of insulin triggers cells to take in the glucose and use it as energy. The ability of your cells to respond to insulin is called insulin sensitivity. What happens to insulin when you have diabetes? If you have type 2 diabetes, your body either can’t produce any or enough insulin, or is resistant to its presence. That means glucose is not able to get into your body’s cells effectively. The inability for the cells to absorb the glucose in the blood causes elevated blood sugar levels. Blood sugar levels will be high after meals, and even between meals, since the liver makes glucose when we are between meals or sleeping. People who have type 2 diabetes often take diabetes pills or insulin shots to improve their blood sugar levels. Characteristics of insulin Insulin exists in suspension Continue reading >>
Factors Affecting The Deposition Of Aerosolized Insulin
Abstract The inhalation of insulin for absorption into the bloodstream via the lung seems to be a promising technique for the treatment of diabetes mellitus. A fundamental issue to be resolved in the development of such insulin aerosol delivery systems is their efficiency (measured, for example, in terms of the amount of insulin absorbed in the blood compared to the total amount loaded into an inhalation device). A primary factor that could cause inefficiency of insulin absorption is deposition in the nonalveolated airways with subsequent removal from the lung via mucociliary clearance. Thus, a better understanding of the spatial distribution of insulin particle deposition in the lung can give guidance to the optimization of inhalation therapy. A mathematical model was used to study factors affecting the disposition of aerosolized insulin. The model calculates the trajectories of inhaled particles in the lung and has been validated by data from human subject experiments. Computer simulations were performed describing a wide range of patient breathing maneuvers. The results indicate significant variations in particle deposition patterns within lungs for different tidal volumes, inspiratory flow rates, and breath hold times. These findings indicate that particle sizes and ventilatory parameters are significant factors determining locations of particle deposition within human lungs, and thus the absorption of insulin into the blood stream via alveloated airways. Mathematical modeling is a valuable technique to complement clinical studies in the targeted delivery of inhaled insulin. Continue reading >>
What Affects Blood Sugar Levels
Tweet Getting blood glucose levels right can prove to be difficult at times. Just when you think you've factored everything in, a high or low blood glucose level can arrive out of nowhere and really throw your confidence. These things happen to everyone with diabetes. Factoring in food, activity and medication You’ll no doubt be aware that food, activity and the medication you take play a significant role in your blood sugar levels but there can be a number of other variables at work at the same time. What can affect my blood sugar levels? Get an idea of the things that can lead to surprising sugar levels using the list below. Physical activity Exercise or just increasing exertion can lead to altering blood glucose levels: Physical activity can affect insulin sensitivity for up to 48 hours - which can lead to lower blood sugars over this time Sugar levels can initially rise following a short burst of activity. If you usually are active most days, not doing activity could lead to higher blood sugars than usual If you exercise a muscle near where you last injected, it could cause your insulin to be absorbed more quickly Food, drink and illness Food, alcohol, tiredness and stress can all impact blood glucose levels. Many people are surprised to know that protein can affect blood sugar levels, too. Proteins affect sugar levels as well as carbohydrates, but to less of an extent and more slowly than carbs Alcohol can affect sugar levels for up to several hours after stopping drinking Stress and illness can also significantly affect sugar levels Where do you inject? Where you inject can affect how quickly insulin is absorbed: Medication and conditions Taking different medications and certain health conditions can affect blood glucose levels: For women, your menstrual cycle c Continue reading >>
Factors Influencing The Absorption, Serum Insulin Concentration, And Blood Glucose Responses After Injections Of Regular Insulin And Various Insulin Mixtures
Normal fasting subjects received regular insulin and mixtures of regular with NPH or lente to assess the effects of the combinations on serum insulin concentrations (SIC) and blood glucose responses (BGR). In addition, the influence of concentration, depth, and method and site of administration was investigated. In studies of mixtures of regular with NPH and with lente, it was observed that the regular: lente ratio needed to achieve peak SIC was higher than with the regular: NPH combination. Increased SIC, including either the peak and/or the time interval required to achieve the peak, were related to the depth and site (deltoid and abdominal greater than anterior thigh or buttocks). Assuming linear kinetics of absorption, significant quantities of insulin fail to reach the serum. Marked intra- and intersubject variations in SIC and BGR to regular, NPH, and lente insulins were observed. Continue reading >>
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- KINGS Herbal | REH KINGS Herbal Official website | Ka Rey Herrera KINGS Herbal - one of leading herbal food supplement in the Philippines | Herbal supplement best for diabetes, hypertension, cancer, kidney stone and various diseases and illnesses
- Patterns of Insulin Concentration During the OGTT Predict the Risk of Type 2 Diabetes in Japanese Americans
Insulin Resistance
Insulin resistance (IR) is a pathological condition in which cells fail to respond normally to the hormone insulin. The body produces insulin when glucose starts to be released into the bloodstream from the digestion of carbohydrates in the diet. Normally this insulin response triggers glucose being taken into body cells, to be used for energy, and inhibits the body from using fat for energy. The concentration of glucose in the blood decreases as a result, staying within the normal range even when a large amount of carbohydrates is consumed. When the body produces insulin under conditions of insulin resistance, the cells are resistant to the insulin and are unable to use it as effectively, leading to high blood sugar. Beta cells in the pancreas subsequently increase their production of insulin, further contributing to a high blood insulin level. This often remains undetected and can contribute to the development of type 2 diabetes or latent autoimmune diabetes of adults.[1] Although this type of chronic insulin resistance is harmful, during acute illness it is actually a well-evolved protective mechanism. Recent investigations have revealed that insulin resistance helps to conserve the brain's glucose supply by preventing muscles from taking up excessive glucose.[2] In theory, insulin resistance should even be strengthened under harsh metabolic conditions such as pregnancy, during which the expanding fetal brain demands more glucose. People who develop type 2 diabetes usually pass through earlier stages of insulin resistance and prediabetes, although those often go undiagnosed. Insulin resistance is a syndrome (a set of signs and symptoms) resulting from reduced insulin activity; it is also part of a larger constellation of symptoms called the metabolic syndrome. Insuli Continue reading >>
Table 1factors Affecting Insulin Absorption ( [ 33 ] [ 34 ] [ 35 ] )
Factor Comment Exercise of injected area Strenuous exercise of a limb within 1 hour of injection will speed insulin absorption. Clinically significant for regular insulin analogs Local massage Vigorously rubbing or massaging the injection site will speed absorption. Temperature Heat can increase absorption rate, including use of a sauna, shower, or hot bath soon after injection. Cold has the opposite effect. Site of injection Insulin is absorbed faster from the abdomen. Less clinically relevant with rapid-acting insulins, insulin glargine and insulin detemir. Lipohypertrophy Injection into hypertrophied areas delays insulin absorption. Jet injectors Increase absorption rate. Insulin mixtures Absorption rates are unpredictable when suspension insulins are not mixed adequately (i.e., they need to be resuspended). Insulin dose Larger doses delay insulin action and prolong duration. Physical status (soluble vs. suspension) Suspension insulins must be sufficiently resuspended prior to injection to reduce variability. Continue reading >>
Pharmacokinetics And -dynamics Of Insulin Absorption
Exogenously administered insulin will never be able to exactly mimick the effects of insulin endogenously released by the pancreas. The main reason is that the pancreas releases insulin into the portal vein, so that the insulin passes the liver first. There, more than 50% of insulin is extracted, and as a result hepatic exposure to insulin is high, and peripheral (muscle, fat) exposure to insulin is low. When exogenous insulin is administered -whether i.v., s.c., i.m. or otherwise- it is distributed throughout the circulation, exposing the peripheral organs to relatively high and the liver to relatively low levels of insulin. Another problem is that the pancreas releases insulin in small bouts at short intervals, in direct response to the ambient level of glucose, whereas the dose of exogenously administered insulin thusfar is predetermined. The precise effects over time of the various exogenous insulins are however also dependent on their pharmacokinetic and pharmacodynamic characteristics and the mode of administration. Studying pharmacokinetics and -dynamics The traditional method to assess the pharmacokinetics (the plasma levels of insulin over time) and the pharmacodynamics (the resulting effects on glucose over time) of exogenous insulins is the isoglycaemic clamp study. In this, the study insulin is injected and i.v. glucose is infused to maintain a stable level of glycemia. The Glucose Infusion Rate (GIR) is considered to represent the pharmacodynamics of the insulin. When studying other subjects than those with type 1 diabetes -who do not have endogenous insulin secretion- additional steps have to be taken to make sure that (residual) endogenous insulin does not interfere with the interpretation of the results. While the technique has its disadvantages, it usua Continue reading >>
- Best insulin injection sites: Absorption time and rotation
- Strategies for Stabilizing Insulin Absorption Rates
- 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)
When Does Insulin Start Working? Many Factors Affect Absorption
A major challenge in diabetes therapy is to match the insulin with food and exercise. Changes in the amount of time that it takes for insulin to be absorbed into the bloodstream can be a critical factor in obtaining diabetes control. Both the amount of insulin and its timing are critical, and both of these can be influenced by a wide range of variables. Here is a list of factors which every person taking insulin should be aware of. Type of Insulin The type of insulin is the most obvious change that influences insulin absorption. Regular insulin is absorbed faster than NPH or Lente insulin, which are absorbed faster than Ultralente insulin. Mixing insulin can sometimes change their absorption kinetics. Regular and NPH insulin can be mixed in virtually any proportion with little or no effect on their action. The insulin of the Lente series, Lente and Ultralente insulin, are very high in zinc and can slow the absorption of regular insulin by about fifteen minutes. Species of Insulin The species of insulin can also be important. For many patients human insulin works faster than pork or beef insulin and may not last as long. For Regular insulin, this is often an advantage, as we want this insulin to work fast. But for NPH insulin, it may mean that the insulin will not last through the night, especially if you are taking only a single shot of insulin each morning. Site of Injection The site of injection can be critical. It can take up to 50% longer for insulin to be absorbed from the leg than from the abdomen (or stomach area). Not only does the time for absorption of insulin vary with the site, but so does the total amount absorbed. Regular insulin peaks in the bloodstream about 90-120 minutes after it is injected into the thigh. Because of the subcutaneous enzymes, only abo Continue reading >>
How Many Factors Actually Affect Blood Glucose?
A printable, colorful PDF version of this article can be found here. twitter summary: Adam identifies at least 22 things that affect blood glucose, including food, medication, activity, biological, & environmental factors. short summary: As patients, we tend to blame ourselves for out of range blood sugars – after all, the equation to “good diabetes management” is supposedly simple (eating, exercise, medication). But have you ever done everything right and still had a glucose that was too high or too low? In this article, I look into the wide variety of things that can actually affect blood glucose - at least 22! – including food, medication, activity, and both biological and environmental factors. The bottom line is that diabetes is very complicated, and for even the most educated and diligent patients, it’s nearly impossible to keep track of everything that affects blood glucose. So when you see an out-of-range glucose value, don’t judge yourself – use it as information to make better decisions. As a patient, I always fall into the trap of thinking I’m at fault for out of range blood sugars. By taking my medication, monitoring my blood glucose, watching what I eat, and exercising, I would like to have perfect in-range values all the time. But after 13 years of type 1 diabetes, I’ve learned it’s just not that simple. There are all kinds of factors that affect blood glucose, many of which are impossible to control, remember, or even account for. Based on personal experience, conversations with experts, and scientific research, here’s a non-exhaustive list of 22 factors that can affect blood glucose. They are separated into five areas – Food, Medication, Activity, Biological factors, and Environmental factors. I’ve provided arrows to show the ge Continue reading >>
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Patient Education: Diabetes Mellitus Type 1: Insulin Treatment (beyond The Basics)
INTRODUCTION Diabetes mellitus is a lifelong condition that can be controlled with lifestyle adjustments and medical treatments. Keeping blood sugar levels under control can prevent or minimize complications. Insulin treatment is one component of a diabetes treatment plan for people with type 1 diabetes. Insulin treatment replaces or supplements the body's own insulin with the goal of preventing ketosis and diabetic ketoacidosis and achieving normal or near-normal blood sugar levels. Many different types of insulin treatment can successfully control blood sugar levels; the best option depends upon a variety of individual factors. With a little extra planning, people with diabetes who take insulin can lead a full life and keep their blood sugar under control. Other topics that discuss type 1 diabetes are also available. (See "Patient education: Diabetes mellitus type 1: Overview (Beyond the Basics)" and "Patient education: Self-monitoring of blood glucose in diabetes mellitus (Beyond the Basics)" and "Patient education: Type 1 diabetes mellitus and diet (Beyond the Basics)" and "Patient education: Hypoglycemia (low blood sugar) in diabetes mellitus (Beyond the Basics)" and "Patient education: Care during pregnancy for women with type 1 or 2 diabetes mellitus (Beyond the Basics)".) STARTING INSULIN The pancreas produces very little or no insulin at all in people with type 1 diabetes. All patients with type 1 diabetes will eventually require insulin. Insulin is given under the skin, either as a shot or continuously with an insulin pump. Dosing — When you are first starting insulin, it will take some time to find the right dose. A doctor or nurse will help to adjust your dose over time. You will be instructed to check your blood sugar level several times per day. Insulin Continue reading >>
Factors That Affect Absorption
Insulin should be injected into the subcutaneous, or “fatty layer” of your skin where absorption is predictable and consistent. Insulin should be injected into the subcutaneous, or “fatty layer” of your skin where absorption is predictable and consistent. How you inject matters 4, 5 and 6mm needles are suitable for all people with diabetes, however, the risk of an injection into the muscle increases as the needle gets longer. If you are extremely lean, you may need to inject into a skin lift or inject at a 45° angle (6mm only). Avoid injecting into damaged skin, scars or moles as absorption may not be consistent at those sites. A structured site rotation plan can reduce your risk of developing lipohypertrophy at your injection sites. Rotate between your injection sites (ie. rotate between your abdomen, thighs and buttocks) and rotate within your injection sites (ie. your next injection within a site should be 2-3cm from your last). 1. Gibney MA, et al. Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections: implications for needle length recommendations. Curr Med Res Opin 2010;26(6):1519-30. 2. Chowdhury TA, Escudier V. Poor glycaemic control caused by insulin induced lipohypertrophy. Brit Med J 2003;327:383-4. 3 Berard L, et al. FIT Forum for Injection Technique Canada. Recommendations for Best Practice in Injection Technique. October 2011. Continue reading >>
Diabetes Monitoring
If you use insulin, a continuous glucose monitor or blood glucose meter then you should be aware of the issues of carrying insulin, injecting equipment, medical devices and glucose monitoring equipment during travel. You should consider the following points prior to departure. Insulin You should discuss your travel plans with your diabetic specialist pretravel to ensure you are confident in altering insulin doses/regimes in response to varying blood glucose levels. Twice as much insulin as required for the length of trip should be carried, to cover lost, stolen or damaged insulin and to account for extra insulin that may be required during illness. You must carry a secure means of disposing of needles and lancets. A Doctor's letter is required in order to carry Insulin and associated equipment through security/customs. Your particular brand of insulin may not be available in other countries, or may be sold under a different trade name. Pharmaceutical companies can be contacted pre travel to advise on whether their product is available at the destination, and under which name. Insulin is available in the UK as U-100, but may be sold in different strengths in some countries, U-40 or U-80. These are not directly interchangeable and will require different syringes/needles. During air travel, changes in air pressure can alter the amount of insulin delivered by prefilled devices/pumps and blood glucose should be monitored more closely on flights. Effect of Climate on Insulin Insulin is absorbed faster from injection sites in hot weather blood glucose should be checked more frequently and dosing adjusted accordingly. Insulin is absorbed slower in cold temperatures, but absorption increases as the body warms which can lead to subsequent low blood glucose levels Blood glucose sh Continue reading >>
Type 1 Diabetes Mellitus And The Use Of Flexible Insulin Regimens
The management of type 1 diabetes mellitus (formerly known as insulin-dependent diabetes) has changed dramatically over the past 30 years. In particular, new insulin strategies have improved the ability to maintain near-normal glycemia. Factors such as onset, peak and duration of action can influence the ability of a particular insulin regimen to help control glucose levels. Patient factors, including individual variations in insulin absorption, levels of exercise and types of meals consumed, also influence the effectiveness of an insulin regimen. Rapid-acting insulin lispro is an ideal mealtime insulin. The premeal dose of insulin lispro can be adjusted based on the content of the meal and the patient's blood glucose level. Intermediate-acting and long-acting insulins should not be given to account for the content of a specific meal. Long-acting insulin can be administered once daily at bedtime or, ideally, twice daily in addition to another type of insulin. Patients with type 1 diabetes typically require an insulin dosage of 0.5 to 1.0 unit per kg per day. Newly diagnosed patients may have lower initial requirements because of continued endogenous insulin production. Flexible insulin regimens are based on predetermined actions in response to self-monitoring of blood glucose levels and carbohydrate intake. Pharmacology of Insulin Several important factors affect the absorption of subcutaneously administered insulin and explain much of the unstable glycemia that occurs in patients with type 1 diabetes. The time it takes to absorb one half of an injected dose of insulin may vary by 25 to 50 percent among individual patients.5 For example, NPH insulin may have a duration of activity of 18 hours in one patient but an effective activity of only 9 or 10 hours in another pati Continue reading >>
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- Osteoporosis and Diabetes: Pros and Cons to Antidiabetic Regimens
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Factors Affecting Absorption
1 When using cloudy insulin (i.e. NPH and pre-mixed insulin) the vial, cartridge or pen device should first be gently rolled 10 times, then tipped (not shaken) 10 times, and finally visually checked to ensure the suspension has a consistently milky white appearance. 68, 60, 133, 147, 91, 22, 84, 105, 50, 92 1 Insulin injections above 50 units per dose may be more desirable to split into 2 separate injections. The larger the dose, the more delayed the action of NPH, short-acting human insulin, and rapid-acting analog insulin. 76, 68, 86, 30, 83 2 Larger doses of insulin are associated with more leakage and potentially more discomfort. 76, 68, 86, 30, 83 3 The time action profile of the long acting analogues does not appear to be affected by the volume of injection. 1 Massaging the injection site is not recommended as it increases the absorption rate, and results in an unpredictable time action profile. 76, 68, 60, 99, 48, 120 2 Increased skin temperature such as a sauna or hot bath can also increase absorption rate. 80, 75 3 Injecting into a exercising limb may hasten absorption of insulin and result in a faster action and quicker decrease of blood glucose values. 3, 52 However, Glucagon Like Peptide-1 (GLP-1), exenatide (Byetta) and liraglutide (Victoza), are absorbed equally from each of the usual injection sites (abdomen, arm and thigh). 46, 108, 25 Continue reading >>
