Diabetes Mellitus is defined as “a chronic disease caused by a relative or complete decrease in production and secretion of insulin by pancreatic beta-cells, or by the diminished effectiveness of secreted insulin in consequence of the gradual loss of insulin sensitivity of target cells” (“Types of diabetes,” n.d., para. 1). While type 2 diabetes does not induce insulin dependence and is frequently intervened through lifestyle modifications and various anti-diabetic drugs, patients with type 1 diabetes require regular insulin injections. Thus, in the given paper, pharmacological properties and effects of insulin will be described.
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Types of insulin
Insulin is a protein-peptide hormone produced by β-cells of the pancreas. It affects almost all organs and tissues, however, primarily targeting the liver, muscles, and fat tissue. There are two types of insulin − endogenous and exogenous, − and their functions are a little bit different. While endogenous insulin participates in the regulation of carbohydrate metabolism, the exogenous one performs as a sugar-reducing agent (Yetiv & Bianchine, 2013). It is the exogenous insulin that is used for the treatment of type 1 diabetes (“Types of diabetes,” n.d.).
Pharmacological properties and effects
The effect of insulin on carbohydrate metabolism becomes possible because it enhances the transport of glucose through the cell membrane and improves its utilization by tissues. Moreover, it facilitates the conversion of glucose into glycogen in the liver and inhibits the endogenous production of glucose by suppressing glycogenolysis (glycogen breakdown and transformation into glucose) and gluconeogenesis (synthesis of glucose from non-carbohydrate sources such as amino acids, etc.) (Donner, 2015). Along with this, insulin affects lipid metabolism by inhibiting lipolysis, which leads to a decrease in the absorption of free fatty acids into the bloodstream (Yetiv & Bianchine, 2013).
Pharmacokinetics (practical implications)
For the safe and effective administration of insulin in patients with diabetes, nurses should be aware of the primary pharmacokinetic properties of insulin-based drugs. The speed of insulin absorption into the blood depends on multiple factors, i.e., injection site, local blood flow rate and muscle activity, amount of insulin administered, type of insulin, etc. For instance, the fastest way insulin enters the blood is through the injection in the subcutaneous tissue of the anterior abdominal wall. When injected into the shoulder area or other sites, the absorption proceeds at a slower pace. It can be explained by the degree of vascularization of the subcutaneous fatty tissue in these bodily parts (Donner, 2015). It is also essential to pay attention to the temperature of the administered substance because, when cold, insulin is absorbed more slowly (Donner, 2015).
Types of insulin-based drugs
Nowadays, there is a great variety of insulin products that can be differentiated by the source of origin, duration of action, pH of the solution (acidic and neutral), and insulin concentrations (40, 80, 100, 200, 500 U/ml). It is possible to say that for the selection of an administration strategy, the consideration of the effect duration is especially important. Insulin can have short and ultra-short effects − such drugs mimic the normal physiological secretion of insulin by the pancreas in response to stimulation (Donner, 2015). At the same time, long-acting drugs mimic the basal secretion of insulin (Donner, 2015). Different types of drugs can also be combined. For instance, the short-acting insulin that comprises 75% of the daily dose can be administered partially before each meal intake, and then the long-acting insulin (25% of the daily dosage) is injected at night.
Overall, the quality of life of patients with type 1 diabetes largely depends on the effectiveness of the drug administration strategy and compliance with the selected treatment regimen. Both physiological features of patients, as well as the quality of daily nutritional intake, and pharmacological properties of drugs should be considered during the design of an administration strategy. Only in this way, it will be possible to achieve better treatment results.
Donner, T. (2015). Insulin – Pharmacology, therapeutic regimens and principles of intensive insulin therapy. Web.
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Types of diabetes. (n.d.). Web.
Yetiv, J. Z., & Bianchine, J. R. (2013). Hypertension, cardiovascular disease, analgesics, and endocrine disorders. Saint Louis, MO: Elsevier Science.