All of us produce Insulin for life and Insulin keeps us healthy by keeping Glucose in normal range. Diabetics produce less Insulin and they need Insulin supplementation when pills are unable to release adequate amount of Insulin and thus are unable to control blood glucose.Normally our pancreas secretes small amount of insulin continuously throughout the day and this is called basal insulin secretion. When a meal or snack is eaten, our Beta cells then secrete large bursts of insulin called bolus insulin.
The aim of Insulin replacement in Diabetes management, is to replace Insulin in a similar way. However, it is easier said than done.
Most patients use pen or syringes to inject Insulin and they use different types of Insulin so as to control glucose levels. But there are problems with Insulin shots, despite the availability of newer Insulin analogs and good devices.
When injections are used, two types of Insulin are needed that work at different speeds. A fast acting Insulin is used to cover meals [bolus Insulin] and it is effective for three and a half to six hours. Long-acting insulin, such as Lente, NPH or Ultralente, Glargine, Detemir etc is used to provide basal insulin requirement.
With injections, it is possible to achieve normal Glucose levels but it demands a much-regulated lifestyle, a rigid eating pattern with the same amounts of carbohydrate each time, fixed exercise plan etc. This is difficult to achieve and maintain by most people particularly young patients.
Insulin shots has four major problems:
- The action of both short and long-acting insulin is unpredictable. In clinical studies, the amount of insulin that reaches a person's blood varies by 15% to 50 % from one day to the next with injections.
- Multiple injections are often inconvenient.
- To achieve normal glucose levels, a very rigid and consistent meal plan is a must. At the same time Carbohydrate every day is needed.
- Long acting like NPH or analogs like Glargine and Detemir can provide basal Insulin but this may not necessarily match the variable background needs of an individual like Dawn Phenomenon in morning, or a different basal need in late evening.
These all problems can be better dealt with help of Insulin pumps. According to Dr. Sunil M Jain, CEO, diabeteshormone.com, Insulin pump can be considered as artificial pancreas. It provides Insulin constantly mimicking basal Insulin delivery by human pancreas as well as instantly to take care meal related Glucose rise. It is considered as gods standard for Insulin replacement.
