Alcohol And Diabetes
Are You Losing Weight
Aspirin For Diabetics
HbA1c and Mean Blood Glucose
Dental Care in Diabetes
Diabetes and Depression
Diabetes and Eyes
Diabetes and Heart Problems
Diabetes and Kidney Problems
Diabetes and Pregnancy
Diabetes and Smoking
Diabetes Care During Other Infections
Diabetes in Children
Diabetes in Old Age
Diabetes Ketoacidosis in Children
Diabetes Prevention
Diabetic Coma
Diabetes Drug Treatment
Emergency in Diabetes
Diabetes and Exercise
Foot Care in Diabetes
Insulin Pumps
Monitoring of Diabetes
Nerve Involvement in Diabetes
Obesity or Over Weight
Role of Yoga in Diabetes
Skin and Sexual Problems in Diabetes
Spontaneous Hypoglycaemia
Stress and Diabetes
Symptoms of Diabetes
Testing of Sugar
Treatment of Diabetes Mellitus
Vacations, Travel and Diabetes

Insulin and Diabetes

Before the invention of Insulin it was difficult for Diabetic patients to survive beyond the age of 20 years. Now there. are patients who are using Insulin from the last 30 to 40 years and leading normal life.

Insulin was invented in 1926 by Dr. Fredrik Banting and Dr. Charles West, since then many changes have taken place in the structure and potency. Today various types ofInsulin are available for diabetic patients.

Insulin is hormone secreated by the pancrease.

There are three sources of Insulin% Pork Insulin- Porcine Insulin, Beef Insulin, Bovine Insulin, Human Insulin. Now-a-days purified Insulin are also available.

Insulin are of two types

  • Plane-colourless-Short Acting
  • NPH or Lente-Milky colour-long Acting

Which patients need Insulin:

  1. All patients of IDDM or Type I Diabetes (Insulin Dependent Diabetes patients).
  2. Patients of NIDDM or Type II Diabetes (Non-Insulin Dependent Diabetes) who develop secondary drug failure to oral agents. In all such cases insulin is given for short period.
  3. Pregnant diabetic mothers.
  4. Diabetic patients who are undergoing major surgery like Coronary By-Pass Surgery, or Eye Surgery or other major surgery .
  5. Patients who develop Kidney failure.

List of Insulins available

Different Insulin preparations are available depend.ing upon the duration of action

Fast Acting Insulins-which have short duration of Action

  • Plane Insulin
  • Actrapid Insulin
  • Hum Insulin-R
  • Insuman Rapid, etc.
  • Long Acting Insulins-which have longer duration of action * Iletin-L
  • Lentard
  • Hum Insulin-L
  • N.P .H. Insulin
  • Insulintard
  • Iletin-N
  • Hum Insulin-N
  • Hum Insulin Mixtard 30/70,50/50
  • Insuman 25/75, 50/50
  • Mixtard Penfil
  • Monotard, etc.

Even with Insulin injection one should follow strict diet control and regular Exercise Schedule.

Some Insulins are short acting, their effect starts immediately so one should take along with food. Other types of Insulins are intermediate or long acting, their action starts within 2-4 hours and lasts from 12 to 18 hours.

Types of Insulin available in India

Insulin injections are made as 40 units or/iOOunits/ml depending upon the type of Insulin.

One should be careful while filling the syringe regarding the dose of Insulin and should consult Physician about adjusting the dose.

Insulin syringes are made up of plastic material one can use the same syringe 3 to 4 times. Insulin syringes can be kept in efrigerator after using it.

Your Doctor will advise you to take one injection or two injections or more depending upon the type of Diabetes and other associated conditions.

Oral drugs are also given along with Insulin in some cases for better control of Diabetes and weight.

Complications ofInsulin Injections

  1. Hypoglycemia (Low Blood Sugar).
  2. Atrophy or abcess at the site of injection.
  3. Itching at the site of injection.

These complications can be avoided by proper dosage of Insulin. Taking Insulin injections along with food and changing the site of injection frequently.

General Guidelines on Insulin Use

Insulin is mainstay of treatment in approximately 1/3rd of patients of diabetes. However, unless the patient is equipped with the knowledge and know how, the desired results cannot be obtained. Hence, the patient's education in various aspects of diabetes and its control is vital.


Insulin is ideally stored in a refrigerator at 2°-8°C. Insulin should not be kept in the freezer or exposed to extremesoftemperature. The commercially available insulin can be kept at room temperatures for 6 to 8 weeks. Insulin vials after expiry date should never be used.


Insulin are available in 40 IU/ml or 100 IU/ml strengths. It is essential to use the appropriate syringe for them.

Insulin Injection Technique

It is advisable to gently shake the suspension before use. The vial can be rolled gently upside down and sideways between the hands to ensure uniform suspension. Then vial is turned upside down and air is injected by syringe. The amount of air injected should be equivalent to the units of insulin to be withdrawn.

  • Draw air into the syringe in an amount corresponding to the prescribed dose of cloudy insulin.
  • Pull out the needle and put the vial aside.
  • Inject the air into the vial containing the cloudy insulin but do not draw up insulin!
  • Draw air into the syringe in an amount corresponding to the prescribed dose of clear insulin and inject the air into the vial containing clear insulin.
  • Invert the vial and draw up clear insulin a little more than prescribed.
  • Hold the vial vertically at eye level Inject the excess amount of insulin, together with any air bubbles, back into the vial.
  • Pull out the needle. Now take the vial containing cloudy insulin and air.
  • Insert the needle and draw up the accurate amount of insulin prescribed.
  • Pull out the needle. Now, the mixture is ready for use.

The Insulin vials which require mixing are usually of Plain/ Regular (clear vial) and Lente/NPH (cloudy vial). For mixing insulins first clean the rubber stopper of each bottle with spirit swab, then with the syringe, draw the air equivalent to level of desired units of Lente (cloudy) Insulin, later repeat the same for dose of Plain/Regular Insulin (clear). Ensure that there is not bubble in the syringe, (if present gently tap the syringe, to push the bubble to the top and then force it in the bottle).

Injection Technique

Clean the site selected with the spirit swab, then skin is gently Pinched between the thumb and forefinger, hold the syringe with the other hand like a pencil and needle is pushed through the skin, plunger pushed and then released the pinch and the needle is withdrawn.

Site Selection and Rotation

Insulin should be injected into subcutaneous tissue, in any of the following areas: upper and outer area of anns, front and side areas of thigh, the buttocks, just above the waist, on the back, abdomen except the areas around the umblicus and at the waistline. The accidental intramuscular injection is painful and can cause tissue scaring. Factors like massage, increases exercise of the area where insulin injection is given can alter the absorption of insulin so they should be avoided. Rotation of the side is important to avoid problems which could occur on repeated injections at the same site. Rotation of the injection site should' be about 1-1/2" length apart within the same area. If one feels lumps, or shallow depressions or feel pain or observes change of colour of the skin at the injection site, it is better to avoid that area till that condition disappears and also consult the doctor.


Insulin should be injected 30 to 45 minutes before the meals so that its onset of action corresponds to the rise in Blood Sugar that occurs with the meals. Exercise can be associated with hypoglycemia in patients on 'nsulin. Patient should make necessary adjustments in their meal plans or insulin regimen on the days of exercise in consultation with their doctor.

Insulin and Illness

Illness can disrupt diabetic control. However, the problems can be minimised. Ifthe patients follows basic guidelines:

  1. Do not stop the insulin injection,
  2. Continue testing the Blood Sugar, urine sugar, for ketones,
  3. Adapt your eating patterns to more easily tolerated foods, and
  4. Food should be taken as frequently in short intervals.

If the above simple precautions are observed by the patients who use insulin, many of their day to day problems can be avoided.

Pancrease Transplantation

Here pancrease gland of other person is transplanted into Diabetic patients. There are many problems like availability of donor and rejection of graft by body.

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