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Managing insulin

Function of insulin

Insulin is an essential hormone and chemical messenger produced by the pancreas. The function of insulin is to allow glucose found in the bloodstream to enter the body’s cells to provide energy. Insulin not only regulates blood sugar levels, but it also works to store excess glucose for energy, keeping blood sugar levels within a narrow range.   

If you have diabetes, your body can’t naturally regulate your blood sugar levels through insulin production. In this instance, insulin treatment is used to mimic the natural insulin response of someone without diabetes.

It is important to get your blood sugar level under control when living with diabetes. When blood sugar levels are chronically high it can damage nerves, organs, and blood vessels.8

Insulin treatment can help people with type 1 and type 2 diabetes keep a balance of the right amount of insulin to maintain balanced blood sugar levels, which is important to stay healthy and avoid further illness later in life.

Things to know before you start your insulin treatment plan

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Where insulin is produced

Insulin is produced by cells in the pancreas called the islets of Langerhans (or pancreatic islets). The pancreas contains around 1 million islets, and each islet houses four distinct cell types: alpha, beta and delta cells. The beta cells continuously release a small amount of insulin into the body and release surges of the hormone in response to a rise in the blood glucose level. 

Type 1 diabetes is caused when immune cells make their way into the pancreas and destroy insulin-producing cells. In type 2 diabetes, insulin producing cells are also affected and the amount of insulin made can be impaired.

Understand the connection between type 2 diabetes and cardiovascular disease

Having type 2 diabetes increases the risk of developing cardiovascular disease later in life. There are, however, many things you can do to reduce your risk including maintaining a healthy lifestyle with a balanced diet, exercise and by managing your diabetes.

Insulin for type 1 diabetes

People with type 1 diabetes make little or no insulin, and insulin treatment is vital to stay alive. Insulin can be self-administered through injections or insulin pumps (a small, computerised device). There’s also a variety of insulin treatment types for type 1 diabetes, including:

Basal insulin

Provides a constant, steady release of insulin

Mealtime insulin

Brings down spikes in blood sugar after eating

Premix insulins

Combines two insulins in a single injection

Insulin for type 2 diabetes

People with type 2 diabetes either produce insulin but fail to use it efficiently (insulin resistance) or don’t produce enough insulin to regulate glucose levels (insulin deficiency). Insulin isn’t the first port of call when treating type 2 diabetes, but as the disease progresses, insulin treatment is often used. 

The types of insulin used for type 2 diabetes are the same as those used for type 1 (basal, mealtime and premixed),  but it’s good to note that insulin types differ in three ways:

Onset of action 

How quickly insulin works

Time of peak action

When insulin has the greatest effect

Duration of action 

How long insulin works for

Managing type 1 diabetes

What is type 1 diabetes?

What is type 1 diabetes?

Type 1 diabetes, also known as insulin-dependent diabetes, is a chronic condition where the pancreas fails to produce insulin. Type 1 diabetes symptoms usually appear earlier in life, and daily insulin injections are mandatory for survival when living with type 1 diabetes.

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References
  1. International Diabetes Federation. IDF Atlas 10th Edition, 2021. Available from: https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf. Last accessed: January 2024.
  2. Britanica. Islets of Langerhans. Available from: https://www.britannica.com/science/islets-of-Langerhans. Last accessed: January 2024.
  3. NICE. Insulin. Available from: https://bnf.nice.org.uk/treatment-summary/insulin-2.html. Last accessed: January 2024.
  4. Almdal T, Scharling H, Jensen JS, et al. The independent effect of type 2 diabetes mellitus on ischemic heart disease, stroke, and death: a population-based study of 13,000 men and women with 20 years of follow-up. Arch Intern Med. 2004;164:1422–1426
  5. Fox CS, Coady S, Sorlie PD, et al. Trends in cardiovascular complications of diabetes. JAMA. 2004;292:2495–2499.
  6. NIDDK. Diabetes, Heart disease & Stroke. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke. Last accessed: January 2024.
  7. Holt RIG, DeVries JH, Hess-Fischl A, et al. The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2021;44:2589-2625.
  8. Diabetes Australia. Medicines for your diabetes. Available from: https://www.diabetesaustralia.com.au/managing-diabetes/medicines/ Last accessed: January 2024.
  9. Buse JB, Wexler DJ, Tsapas A, et al. 2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2020;43:487-493.
  10. Diabetes Australia. Diabetes Quick Guides: Insulin. Available from: https://www.diabetesaustralia.com.au/wp-content/uploads/220145-Diabetes-Quick-Guides_insulin.pdf Last accessed: January 2024.