Why is insulin important?
Insulin is a hormone which plays a key role in the regulation of blood glucose levels. The lack of insulin or an inability to adequately respond to insulin leads to the development of symptoms of diabetes. Insulin is produced by the beta cells of pancreas and its main function is to regulate carbohydrate and fat metabolism. Insulin helps to absorb glucose from blood into cells of liver, skeletal muscles and fat tissue.
Glucose is stored as glycogen in liver cells and skeletal muscles and as triglycerides in fat cells. In healthy individuals, insulin is provided by pancreas in such a manner so as to maintain a steady state of normal glucose levels avoiding hyperglycemia (excess glucose) and hypoglycemia (less glucose). The failure of pancreas to produce adequate insulin or if the secreted insulin fails to perform its action, it results in a metabolic disorder called as Diabetes Mellitus. Diabetes is of two types, type I called as insulin dependent diabetes or juvenile diabetes and type II known as insulin independent diabetes which occurs mostly in adults. In both types, patients develop increased thirst, urine output and weight loss despite increased food intake.
In type I diabetes mellitus, the cells of pancreas producing insulin are destroyed due to auto-immune process (body’s antibodies destroy self’s tissues). This condition usually arises in juvenile age. In the presence of very little or no insulin, body uses fat for producing energy and hence ketone bodies rise up in the body resulting in a life threatening complication called Diabetic Ketoacidosis. These patients are fully dependant on external insulin which is nowadays prepared synthetically and available in injectable form, mostly used subcutaneously daily as per need. Dosage is individualized and depends on many factors like endogenous amount of production, calorie intake and exertion.
Type II Diabetes Mellitus usually occurs after 35yrs of age. Causes include heredity, stress, obesity, sedentary lifestyle etc. Typically these patients can get well by lifestyle modifications, exercise, weight control measures and by avoiding excess sugar intake. Type II DM patients are treated with oral hypoglycemic agents. When blood glucose level is not controlled with oral medications, insulin injections are required temporarily to normalize blood glucose levels. Diagnostic tests for Diabetes Mellitus includes random blood sugar (screening test), fasting and post prandial blood sugar. Urine examination may reveal glucose in urine. HbA1c levels provide information regarding blood glucose control in the past 3 months.
While treating Diabetes Mellitus, most dangerous adverse event is hypoglycemia (low blood sugar levels) which can be due to increased insulin levels or due to less food intake after insulin injections/ oral hypoglycemic agents and manifests with sweating, tremors, giddiness, chest pain, increased heart beat (palpitations), anxiety, fear etc. Thus all DM patients on treatment need to carry a pack of glucose biscuits with them forever.
It is very important to monitor blood sugar levels regularly to avoid emergencies. Long term complications of poorly controlled Diabetes Mellitus are diabetic retinopathy, diabetic nephropathy, gangrene development, neuropathic complications etc.
Insulin is a very important hormone which centrally regulates blood sugar levels. Diabetic patients must always try to control blood sugar levels by medications and insulin as per physician’s directions. Patients should never alter the dosage nor stop insulin doses on their own as it can have harmful effects.