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Insulin Insulin Is A Hormone Central To Regulating Carbohydrate and Fat Metabolism

Insulin is a hormone produced in the pancreas that regulates carbohydrate and fat metabolism. It causes cells to absorb glucose from the blood and store it, and inhibits the release of glucagon to stop the use of fat as an energy source. When insulin levels are uncontrolled, diabetes results. There are different types of insulin categorized by their onset and duration of action: rapid-acting insulin starts working within 30 minutes and has a peak effect within 2-3 hours; intermediate-acting insulin starts working within 3-4 hours and peaks at 7-9 hours; and long-acting insulin starts working within 6 hours and provides continuous coverage for up to 36 hours.

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106 views4 pages

Insulin Insulin Is A Hormone Central To Regulating Carbohydrate and Fat Metabolism

Insulin is a hormone produced in the pancreas that regulates carbohydrate and fat metabolism. It causes cells to absorb glucose from the blood and store it, and inhibits the release of glucagon to stop the use of fat as an energy source. When insulin levels are uncontrolled, diabetes results. There are different types of insulin categorized by their onset and duration of action: rapid-acting insulin starts working within 30 minutes and has a peak effect within 2-3 hours; intermediate-acting insulin starts working within 3-4 hours and peaks at 7-9 hours; and long-acting insulin starts working within 6 hours and provides continuous coverage for up to 36 hours.

Uploaded by

maeca101
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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INSULIN

Insulin is a hormone central to regulating carbohydrate and fat metabolism


in the body. Insulin causes cells in the liver, muscle, and fat tissue to take
up glucose from the blood, storing it as glycogen in the liver and muscle.

Insulin stops the use of fat as an energy source by inhibiting the release of
glucagon. With the exception of the metabolic disorder diabetes mellitus
and Metabolic syndrome, insulin is provided within the body in a constant
proportion to remove excess glucose from the blood, which otherwise
would be toxic. When blood glucose levels fall below a certain level the
body begins to use fat as an energy source or gluconeogenesis; for
example, by transfer of lipids from adipose tissue to the liver for
mobilization as an energy source. As its level is a central metabolic control
mechanism, its status is also used as a control signal to other body
systems (such as amino acid uptake by body cells). In addition, it has
several other anabolic effects throughout the body.

When control of insulin levels fails, diabetes mellitus will result. As a


consequence, insulin is used medically to treat some forms of diabetes
mellitus. Patients with type 1 diabetes depend on external insulin (most
commonly injected subcutaneously) for their survival because the hormone
is no longer produced internally. Patients with type 2 diabetes are often
insulin resistant, and because of such resistance, may suffer from a
"relative" insulin deficiency. Some patients with type 2 diabetes may
eventually require insulin if other medications fail to control blood glucose
levels adequately. Over 40% of those with Type 2 diabetes require insulin
as part of their diabetes management plan.

Insulin also influences other body functions, such as vascular compliance


and cognition. Once insulin enters the human brain, it enhances learning
and memory and benefits verbal memory in particular. Enhancing brain
insulin signaling by means of intranasal insulin administration also
enhances the acute thermoregulatory and glucoregulatory response to food
intake, suggesting central nervous insulin contributes to the control of
whole-body energy homeostasis in humans.

Insulin is a peptide hormone composed of 51 amino acids and has a


molecular weight of 5808 Da. It is produced in the islets of Langerhans in
the pancreas. The name comes from the Latin insula for "island". Insulin's
structure varies slightly between species of animals. Insulin from animal
sources differs somewhat in "strength" (in carbohydrate metabolism control
effects) in humans because of those variations. Porcine insulin is especially
close to the human version.

TYPES OF INSULIN

Insulins are divided into rapid-acting, very rapid-acting, intermediate-acting,


and long-acting, based on the number of hours until their "peak" action.
Peak action occurs when the concentration of insulin is greatest in the
blood, and has its greatest glucose-lowering effect.

RAPID-ACTING (SHORT-ACTING) INSULINS: These include Humulin R


(HR), and Novolin Toronto (also known as regular) insulins. Rapid-acting
insulins start being absorbed in 30-60 minutes, and have their peak action
within 2 to 3 hours of injection in most individuals. Their duration of action is
approximately 6 to 8 hours but there is a great degree of variation. Short-
acting insulins are often used before eating to control the large rise of blood
glucose that often occurs after a meal. Ideally, short-acting insulin is taken
approximately 30-45 minutes before the meal, as it takes up to 2 hours to
see its main effect. However, most people take their insulin just before
eating.

Also called clear insulin, because of its transparent appearance, short-


acting insulin, begins working in the body within 30 minutes after injection.
Typically, short-acting insulin works at maximum strength for 1-3 hours and
is usually gone within 6-8 hours. As a result of its relatively short lifespan,
short-acting insulin must be injected several times during the day.

VERY RAPID-ACTING INSULIN: We are now in an age when the insulin


molecule can be manipulated in order to give it more desirable properties.
The first such "insulin analog" is Humalog (insulin Lispro), in which a
chemical change has been made to the insulin molecule. This gives the
insulin a very desirable property of extremely rapid absorption. Peak action
of Lispro insulin is about 30 minutes after injection, and insulin levels fall off
rapidly after 1 to 2 hours. This allows the insulin, if given before the meal, to
control the post-meal rise of glucose much better, and to reduce the
chance of hypoglycemia (because insulin levels drop faster). This may well
be its greatest advantage. It can essentially substitute for any short-acting
insulin.

Rapid-acting insulin begins working very quickly inside the body - usually
within 5 and 10 minutes. This type of insulin should be taken just before or
just after eating. It operates at maximum strength for one to two hours and
duration is typically up to four hours. Because the activity of rapid-acting
insulin starts and finishes so fast, it does not lead to hypoglycemia as often
as the older insulins. Extra fast-acting insulins are very convenient because
they allow diabetic patients to inject themselves just when they eat.

INTERMEDIATE-ACTING INSULINS: These insulins start being absorbed


3-4 hours after injection, and have their peak action after 7-9 hours. Again,
there is considerable variation as the duration of action may be as much as
12-16 hours after injection. Used in the morning, its greatest action would
be in the afternoon. One of the best uses is injection at bedtime to control
the morning glucose of the next day.

Characterized by a cloudy appearance, this type of insulin has a longer


lifespan than short-acting insulin but it is slower to start working and takes
longer to reach its maximum strength. Intermediate-acting insulin usually
starts working within 2-4 hours after injection, peaks somewhere between
4-14 hours and remains working for approximately 24 hours.

Types of intermediate-acting insulin include NPH (Neutral Protamine


Hagedorn) and LENTE insulin. NPH insulin contains protamine which slows
down the speed of absorption. Because of this, the insulin takes longer to
reach the bloodstream but has a longer peak and lifespan. This means that
fewer insulin injections are needed each day.

However, some diabetes patients are allergic to protamine. For these


diabetics, a better choice is LENTE insulin. This type of intermediate-acting
insulin contains added zinc which performs a similar function to the
protamine in NPH.
LONG-ACTING INSULIN: This mainly includes the UltraLente insulin.
Human UltraLente insulin has a peak effect occurring after 10-12 hours and
its duration of action may be 16-18 hours, and very occasionally longer. It is
not a popular insulin. It is mainly used in individuals in whom intermediate-
acting insulins taken at bedtime act too quickly, resulting in hypoglycemic
reactions during the night. By using a human UltraLente, one can slow
down the peak action by an hour or two, often preventing hypoglycemia at
night, but controlling the fasting sugar of the next day.

This type of insulin starts working within 6 hours and provides a continuous
level of insulin activity for up to 36 hours. Long-acting insulin operates at
maximum strength after about 8-12 hours, sometimes longer.

One commercial type of long-acting insulin is ULTRALENTE (from the Latin


ultra, meaning very; lente, meaning slow).

ULTRALENTE is designed to provide a continuous (but) low level of insulin


control using only one injection a day. That said, most diabetics who use
ULTRALENTE insulin also use short-acting insulin at meal times.

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