- Definition : its a hormone secreted by the beta cells of the islet of langerhans in the pancreas
- The body is using feedback mechanism that will maintain blood glucose between 60 to 110 mg/dl
- the action of insulin during ****************abolism
*carbohydrate ****************abolism : conversion of glucose into glycogen for storage into the liver and skeletal muscles
* Protein ****************abolism : amino acids conversion occurs in the presence of insulin to replace muscle tissue or to provide needed
* fat ****************abolism : storage of fat in adipose tissue and conversion of fatty acids from excess glucose occurs only in the presence of insulin
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in type 1 " IDDM there are little of insulin secreted but not enough for ****************abolism , its need for injection for treatment for that condition
RAPID-ACTING (SHORT-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.
Example Humulin R (HR), and Novolin Toronto(also known as regular)
INTERMEDIATE-ACTING INSULINS: 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.
Example NPH and Lente
LONG-ACTING INSULIN: it has a peak effect occurring after 10-12 hours and its duration of action may be 16-18 hours, and very occasionally longer.
Example the UltraLente insulin
- type 2 " NIDDM " caused by combination of insulin resistance and relative insulin deficiency some individuals have predominantly insulin resistance, whereas others have predominantly deficient insulin secretion, with little insulin resistance.
- Metformin or Thiazolidinediones may be used to supplement insulin therapy if the required insulin doses are high (implying the presence of "insulin resistance"). These agents may improve blood glucose control and lessen insulin requirements.
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