Insulin Paper - TOPICS Chapter 8 Insulin T ypes and Activit...

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TOPICS: Medications (Insulin) TEACHING OBJECTIVES: 1. Describe insulin and what it does in the body. 2. Present the types of insulins to be used and their actions. 3. Discuss the schedule for insulin injections. 4. Identify who and when to call for insulin doses. LEARNING OBJECTIVES: Learners (parents, child, relative or self) will be able to: 1. State why the body needs insulin. 2. List the specific types of insulins to be used and their actions (onset, peak and duration). 3. State the schedule for insulin injections (including before or after meals). 4. Identify who and when to call for insulin doses. Chapter 8 Insulin: Types and Activity H. Peter Chase, MD Satish Garg, MD INSULIN Before insulin was discovered in 1921, there was little help for people who had type 1 diabetes. Since then, millions of people all over the world have been helped by insulin. Insulin is a hormone made in the pancreas, an organ inside the abdomen (see picture in Chapter 2). Special cells called “beta cells” make the insulin. These cells are located in a part of the pancreas called the “islets” (pronounced eye-lets). When a person has type 1 diabetes, there is a loss of the cells which make insulin. Most people with diabetes now use human insulin or insulin analogs. The human insulin does not come from humans, but has the same “make-up” as human insulin. It is produced by bacteria (Lilly) or by yeast (Novo-Nordisk) using “genetic engineering.” There are no known advantages of one brand of insulin over another brand. The analog insulins have slight changes that make their activity resemble normal insulin activity. WHAT DOES INSULIN DO? Food (carbohydrate) is converted to sugar for the body’s energy needs. The insulin allows the sugar to pass from the blood into the cells. There it is burned for energy. The body cannot turn sugar into energy without insulin (see diagram in Chapter 2). Insulin also turns off the making of sugar in the liver (see Chapter 2). If insulin is not available, the sugar builds up in the blood and spills into the urine. 65
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66 Chapter 8 – Insulin: Types and Activity People who have type 1 diabetes can’t make enough insulin. These people have to get the needed insulin through injections. Insulin cannot be taken as a pill, because the stomach acid destroys it. There are no known vitamins, herbs or other medications which can take the place of insulin injections. People who have type 2 diabetes still make insulin (although not enough to keep their sugars in a normal range, see Chapter 4). They can take pills to help them make even more insulin or to be more sensitive to their own insulin. However, these pills ar e not insulin. TYPES OF INSULIN Several companies make many different types of insulins. The three broad classes of insulin are: 1. “rapid-acting” (such as Humalog [H], NovoLog [NL], Apidra [AP]) and Regular (R) 2. “intermediate-acting” (such as NPH [N]) 3. “long-acting” such as Lantus ® (insulin glargine) and Levemir ® (insulin detemir) Insulin action (when it begins working, when
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