Diabetes treatment with insulin

Insulin is a hormone that controls the amount of glucose in the blood. When used as a medication, it is derived from either pork (porcine) insulin or is genetically made to be identical to human insulin.

People who may need insulin therapy include:

• People with type 1 diabetes (insulin is the only medication that can be used to control the increases in blood glucose that occur with the disease.)
• People with type 2 diabetes (insulin can be used alone or in combination with diabetes pills)
• Women with gestational diabetes. (Oral diabetes medications are not used in pregnant women.)

What Are the Different Types of Insulin?

There are many forms of insulin. They are classified by how fast they start to work and how long their effects last.

The types of insulin include:

• Rapid-acting
• Short-acting
• Intermediate-acting
• Long-acting
• Pre-mixed

The FDA approved the inhaled insulin drug Exubera in 2006. But in October 2007 the drug company Pfizer said it was halting sales of the drug because of financial reasons.

Your doctor will prescribe the insulin(s) that is (are) best for you. The strategy is to space your insulin doses throughout the day to enable your body to maintain your blood glucose levels within the normal range in the face of eating and activity patterns.

In addition, the FDA recently approved Symlin, an injectable medicine to control blood sugar for adults with type 1 and type 2 diabetes. Symlin is to be used in addition to insulin therapy in people who cannot achieve adequate control of their blood sugars on intensive insulin therapy alone.

In April 2005, Byetta was approved for use in adults with type 2 diabetes. Byetta is the first in a new class of drugs called incretin mimetics. It is not a substitute for insulin; it works differently. Your doctor may recommend Byetta if you have not been able to control your blood sugar with oral medicines such as metformin or a sulfonylurea. It is given as a shot 2 times a day before morning and evening meals and may be given alone, or with metformin or a sulfonylurea.

Learn more about the different types of insulin.

How Is Insulin Given?

Insulin may be taken in many ways:

• Under the skin (subcutaneously)
• Into the muscle (intramuscularly)
• Into the vein (intravenously)
• Inhaled

How Is Insulin Injected?

Insulin can be injected using a needle and syringe, cartridge or prefilled pen systems. Insulin pumps are also available.

Where On the Body Should Insulin Be Injected?

The place on the body where you inject your insulin may affect the timing of its benefit to you. The abdomen (stomach) has the fastest rate of absorption, followed by the arms, thighs, and buttocks. Absorption is also the most consistent in the abdomen.

Rotation within the selected site of insulin injection is important to prevent the breakdown and scarring of fat tissue under the skin, a condition known as lipoatrophy. By rotating within the site selected rather than between multiple sites on the body, the absorption of insulin remains relatively constant.

Of course, in the hospital setting, insulin may be given as an intravenous dose which gets more rapidly absorbed than either a dose given directly under the skin or in the muscle.