PHARMACY TODAY
Ellen Campbell -GrizzleTHE INSULIN breakthrough occurred in 1920. Frederick Banting and Charles Best of the University of Toronto discovered that the pancreatic extract of the dogs had anti-diabetic properties. The life-saving component proved to be insulin which is made in the pancreas' beta cells. Since that time, several forms of the drug have been manufactured and have provided diabetics with treatment options.
Diabetes mellitus, commonly called high blood sugar, is an insulin deficiency state. It is arguably the most important disease of man. Dogs and cats can also be affected. Insulin is used primarily to treat type I or insulin-dependent diabetes. The onset of type I diabetes typically starts in childhood and is due to the destruction of pancreatic beta cells. Many of the acute effects are controlled by Insulin replacement. However, there are long-term adverse effects on blood vessels, nerves and other organ systems. Type II diabetes, which affects more people, develops at an older age and in a different way.
WHAT INSULIN DOES
You should know that high levels of glucose in the blood stimulate the release of insulin which acts on cells throughout the body in the following important ways. Insulin also:
Stimulates muscle, fatty and other tissues to take up, use and store glucose.
Stimulates the liver to store glucose in the form of glycogen so that it serves as a bank in times of excess glucose.
Promotes the synthesis of fatty acids and prevents the breakdown of fat in adipose tissues.
Stimulates the uptake of amino acids.
Increases the ease with which potassium, magnesium and phosphate ions enter many cells.
The types of insulin which are used today are manufactured in laboratories and control blood sugar levels for differing durations. Some of the newer options available include 'fast insulins'. They lower blood sugar at the same time that food is raising it and can be injected at the start of a meal rather than 30 to 45 minutes before meals. They leave the body faster. Therefore there is less residual insulin around to trigger low blood sugars in the late afternoons or at night.
EASIER TO ADJUST
These are tremendous advantages for diabetics as it is no longer necessary to engage in unpredictable timing of meals. Also, the clearly defined action times of these insulins makes it easier to adjust doses to match meals. If you have diabetes and use insulin you must:
Test your blood sugar often, before and after eating and anytime you experience unusual symptoms.
Be especially alert for low blood sugar two hours after a meal or at other unexpected times.
Follow the nutrition and exercise regime prescribed.
Fast insulins and newer delivery devices, such as pumps, offer many advantages but are also more expensive. Your physician can help you to identify the best type of insulin. Do not change doses unless you have discussed this with your physician. Store your medication in a cool place and avoid excesses of cold or heat. Use clean needles to inject your insulin. Become an expert at injecting insulin for yourself or relative. Look for bubbles in the medicine in your syringe and get rid of them before administering the injection. If you want to know more about insulin, ask your pharmacist, you have the right to know!
Ellen Campbell-Grizzle, President, Caribbean Association of Pharmacists; Director, Information & Research, National Council on Drug Abuse; e-mail: yourhealth@gleanerjm.com.
