The norm and deviation of insulin in the blood. Determination of insulin in the blood: what is the norm for a healthy person? Insulin 78 3 What May Cause

If they are elevated, then insulin indicators should be detected. In the presence of weakness, drowsiness, an increase in fat mass in the abdomen, thirst, the study should be carried out unscheduled. High levels of insulin, as well as low, are extremely dangerous for the body and indicate the presence of deviations. The maximum concentration is observed 2 hours after a meal, after which the values \u200b\u200breturn to normal. Only self-monitoring and timely examination will avoid many problems and negative health effects.

Flowing in the body.

Among other things, this substance is characterized by anabolic and anti-catabolic effects on some tissue structures of the human body. In the muscles, there is an increase in the concentration of glycogen, fatty acids, glycerol, as well as increased protein synthesis and increased consumption of amino acids.

However, minimization of glycogenolysis, gluconeogenesis, lipolysis, protein catabolism and the release of amino acids can be traced. This article describes in detail a drug that is a substitute for the pancreatic hormone called Humulin, analogues of which can also be found here.

Analogs

Humulin is an insulin preparation similar to human, which is characterized by an average duration of action.

As a rule, the onset of its effect is noted 60 minutes after direct administration. The maximum effect is achieved approximately three hours after the injection. The duration of influence is from 17 to 19 hours.

NPH

The main substance of the drug Humulin NPH is isophan protamininsulin, which is completely identical to human. It has an average duration of action. It is prescribed at.

Humulin NPH

As for the dosage of this drug, in each case it is selected by the personal attending physician. Moreover, as a rule, the amount of Humulin NPH depends on the general state of health of the patient.

It also needs to be administered in large quantities when using oral contraceptives, as well as thyroid hormones.

But as for reducing the dosage of this insulin analogue, this should be done in cases where the patient suffers from kidney or.

Also, the need for artificial pancreatic hormone decreases while taking it with MAO inhibitors, as well as beta-blockers.

Among the side effects, the most pronounced is a significant decrease in the amount of fat in the subcutaneous tissue. This phenomenon is called lipodystrophy. Also, often, patients notice insulin resistance (the complete absence of an effect on insulin administration) while using this substance.

But hypersensitivity reactions to the active ingredient of the drug are practically not traced. Sometimes patients report a severe allergy characterized by itchy skin.

Regular

Humulin Regular has a pronounced hypoglycemic effect. The active ingredient is insulin. It must be entered into the shoulder, thigh, buttocks or abdomen. Both intramuscular and intravenous administration are possible.

Humulin Regular

As for the appropriate dose of the drug, it is determined only individually by the personal attending physician. The amount of Humulin is selected depending on the glucose content in the blood.

It is important to note that the temperature of the administered agent must be comfortable. The injection sites should be alternated so that the same area is used no more than once every 30 days.

As you know, the drug in question is allowed to be administered together with Humulin NPH. But before that, you need to study in detail the instructions for mixing these two insulins.
This drug is indicated for use with an insulin-dependent one (loss of consciousness, which is characterized by a complete lack of body reactions to certain stimuli, which appeared due to the maximum), as well as in the preparation of a patient suffering from this endocrine disorder for surgical intervention.

It is also prescribed for injuries and acute infectious diseases in diabetics.

As for the pharmacological action, the drug is insulin, which is completely identical to human. It is created on the basis of recombinant DNA.

It has the exact amino acid series of the human pancreatic hormone. As a rule, the medicine is characterized by a short action. The beginning of its positive effect is observed approximately half an hour after direct administration.

M3

Humulin M3 is a strong and effective hypoglycemic agent, which is a combination of short and medium duration insulins.

The main component of the drug is a mixture of human soluble insulin and a suspension of isofan insulin. Humulin M3 is a DNA recombinant human insulin of medium duration. It is a biphasic suspension.

Humulin M3

The main influence of the drug is considered to be the regulation of carbohydrate metabolism. Among other things, this drug has a strong anabolic effect. In muscles and other tissue structures (with the exception of the brain), insulin provokes instant intracellular transport of glucose and amino acids, accelerating protein anabolism.

Pancreatic hormone helps transform glucose into liver glycogen, inhibits gluconeogenesis and stimulates the conversion of excess glucose into lipids.

Humulin M3 is indicated for use in diseases and conditions of the body, such as:

• diabetes mellitus in the presence of certain indications for immediate;
• first diagnosed diabetes mellitus;
•   with this endocrine disease of the second type (non-insulin-dependent).

Distinctive features

Distinctive features of different forms of the drug:

• Humulin NPH. It belongs to the category of medium-acting insulins. Among the prolonged drugs that act as substitutes for the human pancreatic hormone, the drug in question is prescribed for people with diabetes. As a rule, its action begins 60 minutes after direct administration. And the maximum effect is observed after about 6 hours. In addition, it lasts about 20 hours in a row. Often, patients use several injections at once because of the long delay in the action of this drug;
• Humulin M3. It is a special mixture of short-acting insulins. Such funds consist of a complex of prolonged NPH-insulin and pancreatic hormone of ultrashort and short action;
• Humulin Regular. It is used in the early stages of identifying an ailment. As you know, it can be used even by pregnant women. This drug belongs to the category of ultrashort hormones. It is this group that produces the fastest effect and instantly reduces blood sugar. Use the product before eating. This is done so that the digestion process helps to speed up the absorption of the drug in the shortest possible time. Hormones of such rapid action can be taken orally. Of course, they should first be brought to a liquid state.

It is important to note that short-acting insulin has the following distinctive features:

• it should be taken about 35 minutes before a meal;
• for a quick onset of effect, you need to enter the drug by injection;
• it is usually administered subcutaneously in the abdomen;
• injections of the drug should be followed by a subsequent meal in order to completely eliminate the likelihood of occurrence.

What is the difference between Humulin NPH insulin and Rinsulin NPH?

Humulin NPH is an analogue of human insulin. Rinsulin NPH is also identical to the human pancreatic hormone. So what is the difference between the two?

Rinsulin NPH

It is worth noting that they also both belong to the category of drugs of average duration of action. The only difference between these two drugs is that Humulin NPH is a foreign drug, and Rinsulin NPH is produced in Russia, so its cost is much lower.

Manufacturer

Humulin NPHs are produced in the Czech Republic, France, and the UK. Humulin Regular made in the USA. Humulin M3 is produced in France.

Act

As noted earlier, Humulin NPH refers to drugs of medium duration of action. Humulin Regular is classified as an ultra-short-acting drug. But Humulin M3 is classified as an insulin with a short effect.

To select the necessary analogue of the pancreatic hormone should only be a personal endocrinologist. Do not self-medicate.

Related videos

About the types of insulin used to treat diabetes in a video:

From all the information presented in this article, we can conclude that the choice of the most suitable substitute for insulin, its dosage and method of ingestion depends on an impressive number of factors. To determine the most optimal and safe method of treatment, you need to contact a qualified specialist endocrinologist.

One of the founders of the Royal Society of London, doctor T. Willis, by the way, of a very respectable age, suggested that diabetes is accompanied by an increase in blood glucose, as the urine of the patients, which he tried, turned out to be sweet. But this fact did not become public, because the doctors did not believe him, considered him a quirk of an old doctor. Subsequently, the English doctor P. Dobson discovered glucose in the urine of diabetics (it no longer tastes), and since then, elevated blood sugar and its excretion in the urine have become the main symptoms of diabetes. The disease is characterized by a chronic course, a violation of all types of metabolism and tone of blood vessels. Characteristic for it are thirst, dry mouth, weight loss (or obesity), weakness, increased urine output, dry mucous membranes and skin. The amount of urine allocated per day to patients can reach 6 liters or more; urine is found along with glucose and protein. As a result of a violation of all metabolic processes, cataracts, diabetic angiopathy, retinopathy, neuro- and nephropathy, atherosclerosis, acidosis (as a result of acidification of the internal environment of the body) and, in the most severe cases, a diabetic coma can develop. In a certain form of diabetes, which is called insulin-dependent, the only cure is insulin.

This amazing substance gave the scientists who discovered it two Nobel Prizes.

In 1916, physiologist E. Charpy-Schaefer, who worked in England, suggested that groups of cells located in the pancreas by islands produce a hormone that regulates blood sugar levels (see Figure 1.5.15, type D). These islands were first described by the German pathologist P. Langerhans in 1869 and received his name. Charpy-Schaefer proposed to call such a hormone insulin, from the Latin word insula   - islet.

Insulin activity is expressed in units of action (IU) or in international units of action (IU). 1 unit corresponds to the activity of 0.04082 mg of crystalline insulin. The human pancreas contains up to 8 mg of insulin (200 PIECES).

The degree of biosynthesis and release of insulin into the blood depends on the glucose content in the plasma: with an increase in its content, secretion increases, with a decrease it decreases (positive feedback).

The functions of insulin are not limited only to the help in the penetration of glucose into the cell. They are diverse. Insulin affects many links in the exchange of energy and substances in the human body, contributing to the creation of reserves glycogen   and fats in liver cells, skeletal muscles, adipose tissue.

Violation of insulin synthesis in the body is usually associated with self-destruction (autoimmune destruction) of the cells that produce it. It is believed that such a reaction occurs in people genetically predisposed to this under the influence of infection or the toxic effects of the environment, triggering the mechanism of self-destruction (auto-aggression). As a result, the insulin content in the blood decreases sharply (until its complete disappearance), and the cells do not receive enough glucose. Glucose accumulates in the blood and the so-called “sugaring” of the body occurs.

Such a disease, due to a deficiency or low biological activity of insulin, is called diabetes mellitus.

There are two types of diabetes - insulin-dependent (or type I diabetes) and non-insulin-dependent (or type II diabetes). In a new classification proposed by the World Health Organization in 1999, Arabic and not Roman numerals are recommended to indicate the type of diabetes mellitus and the adjectives “insulin-dependent” or non-insulin-independent are excluded from the name of the disease. In the future, we will also adhere to this classification.

In diabetes mellitus type 1, insulin is not actually produced in the body (absent in the blood). This form is also called “young and skinny diabetes” because it affects children and adolescents, as well as adults who have no signs of obesity. It occurs in approximately 15% of cases of diabetes. The main specific means of its treatment is insulin. It is necessary to inject insulin injection (and throughout life!), Since it is destroyed by digestive enzymes.

The remaining 85% of patients suffer from a milder form of type 2 diabetes, which occurs mainly in adults and, as a rule (70%), in obese people. With this form of diabetes, your own ( endogenous ) insulin is produced, but either due to insufficient quantity or due to a decrease in its biological effect (which occurs for various reasons), hyperglycemia still develops. Sometimes patients are helped by a diet and physical exercises that reduce body weight. In other cases, the use of drugs that correct hyperglycemia is required. Different approaches in the treatment of type 2 diabetes should be used for patients with or without obesity (Figure 3.3.1, Figure 3.3.2). If satisfactory control of diabetes mellitus cannot be achieved with the help of positive changes in the patient’s lifestyle within 8-12 weeks, drug therapy is prescribed. To assess the effectiveness of each step in the treatment, it is also necessary 8-12 weeks, after which they proceed to the next stage of treatment.

Figure 3.3.1. Tactics for the treatment of patients with type 2 diabetes without obesity

* drugs of the oral antidiabetic group (discussed in more detail in the next section).

Figure 3.3.2. Tactics for treating type 2 diabetes patients with obesity

* drugs of the oral antidiabetic group.

Approximately 30-40% of all patients with type 2 diabetes do not show positive dynamics during treatment with oral antidiabetic hypoglycemic agents (drugs of this group are discussed in more detail in the next section). Of those patients who initially responded well to treatment with these drugs, 5-10% per year stop responding to therapy. Insulin is the most effective hypoglycemic drug that can help such patients.

Insulin treatment should be started in the following situations:

Patients with normal or reduced body weight who have high blood glucose, ketonuria and weight loss (type 1 diabetes);

Patients who have not achieved a positive effect, despite following a diet and taking oral antidiabetic hypoglycemic agents;

Patients with concomitant diseases (for example, with severe infections, acute myocardial infarction or stroke), as well as during surgical treatment;

Patients who are contraindicated oral antidiabetic hypoglycemic agents.

In some cases, with the insufficient effect of oral hypoglycemic drugs, it may be necessary to administer insulin before bedtime in combination with tablet forms of these drugs.

Thus, insulin is effective in any type of diabetes. Of course, none of the available drugs can fully replace the hormone produced by our own pancreas, which secretes it in accordance with the need, depending on the plasma level of sugar. but replacement therapy   insulin preparations can significantly improve the quality of life of patients with diabetes, and in many cases save their lives.

However, insulin is used not only for diabetes. It is also useful in pathological processes such as general exhaustion   - as a stimulator of protein production ( anabolic agents   that promotes the absorption and accumulation of energy and fat), as well as with furunculosis , thyrotoxicosis   some diseases of the stomach ( atony , gastroptosis   - omission of the stomach) chronic hepatitis   initial forms cirrhosis of the liver   . Sometimes insulin is used in complex therapy in the treatment of acute coronary insufficiency.

Until recently, insulin for medical use was obtained from the pancreas of cattle and pigs. Given that pork insulin is closer in chemical structure to human (they differ only in two amino acids), it was he who received the greatest distribution. The insulin preparations produced by the pharmaceutical industry for therapeutic purposes differ not only in the organs of which animals they were obtained, but also in purity, concentration and solubility, speed of onset and duration of effect. Modern technology allows you to get drugs that are free from impurities. Different methods are used to purify insulin, but chromatographic separation methods give the best results.

No matter how well animal insulin has been purified, it is still “non-native” to the human body, and therefore, sometimes it can occur when it is introduced allergic reactions   related to answer the immune system to foreign protein. Of course, the use of human insulin is safer. Since the mid-80s, it has become possible to obtain human insulin, completely identical to endogenous hormone, using genetic engineering technology   . At present, various forms of human insulin are being produced, which make it possible to select the necessary dosage and duration of action for each patient. There are two main requirements: the effect should develop quickly and last long enough (to reduce the number of injections).

The variety of dosage forms is achieved by the addition of various components, allowing, mainly, to prolong (prolong) the action of insulin. As a rule, zinc is used, which forms a soluble complex with crystalline insulin, various acid-stabilizing (buffer) mixtures - phosphate or acetate buffer, and protamine (protein from trout milk), which increase the duration of action due to the slow release of insulin. Regardless of the type of feedstock and the degree of purification, all insulin preparations are released with an activity of 40 or 100 PIECES / ml. By the time of onset and duration of action, they can be divided into four groups.

1. Quick-acting insulin preparations: used 2-4 times a day, the effect manifests itself after 30 minutes, reaches a maximum after 1.5-2 hours and lasts 4-6 hours.

2. Medications of insulin of medium duration: prescribed 2 times a day, the onset of action after 1.5-2 hours, peak - in the range of 3-12 hours and duration - 8-12 hours.

3. Long-acting insulin preparations: used, as a rule, 1-2 times a day, the onset of action after 4-8 hours, a maximum in the range of 8-18 hours and a duration of 20-30 hours.

4. Mixed insulin preparations of short and medium duration of action allow you to get a quick and fairly long-lasting effect.

All insulin preparations are injected: subcutaneously, less often - intramuscularly and intravenously (solutions only). They are produced mainly in bottles with rubber stoppers and aluminum break-in. Each vial contains 10 ml of a solution or suspension for injection with an activity of 40 or 100 IU / ml.

In order to simplify insulin therapy, it is necessary to make the administration of the drug as easy as possible, convenient and, if possible, less painful. This allows you to do the so-called syringe pen: an injection system that looks like a regular fountain pen, with a replaceable container (cartridge) containing a certain type of insulin. Syringe pens NovoPen ® 3   and NovoPen ® 3 Demimanufactured by Novo Nordisk are convenient metering devices with which replaceable cartridges are used Penfill ® 3 mlfilled with appropriate insulin. The cartridge contains enough insulin for use for 1 week or more, depending on the daily requirement for insulin. Using a syringe pen, it’s very easy to administer the exact dose of insulin, and NovoPen ® 3 Demi   allows you to set the dose from 1 to 35 units with a set step of half a unit. In addition, small (8 mm) and ultra-thin needles with a silicone coating of such a syringe pen allow injections to be made almost painlessly. An additional device for introducing a needle makes this task even easier. NovoPen ® 3 PenMate ®, which allows you to make an injection quickly and painlessly.

There are a number of insulin preparations available for the treatment of patients with diabetes, including human insulin Protafan ® NM   and Mikstard ® 30 NM   Novo Nordisk companies, which are most often prescribed to patients to start insulin therapy. Protafan HM is an intermediate intermediate human insulin (Figure 3.3.3).

Figure 3.3.3. The scheme of action of insulin Protafan NM

Mikstard 30 NM (biphasic human insulin) is a mixture of 30% short-acting soluble insulin and 70% intermediate-acting insulin (Figure 3.3.4).

Figure 3.3.4. Scheme of action of insulin Mikstard 30 NM

The choice of a specific insulin preparation and the mode of its administration are determined by the doctor, taking into account the individual characteristics of the patient. For elderly patients for whom tight glycemic control is not always desirable, administration of insulin once a day is often recommended. Patients of a younger age are usually injected with insulin twice a day, this provides stricter control over night and morning hyperglycemia (Figure 3.3.5).

Figure 3.3.5. Double administration of mixed insulin

Modern drugs allow the patient to regulate the amount of insulin administered during self-monitoring of glucose levels. However, one should not forget that the level of blood glucose is subject to daily fluctuations, is closely related to the diet and psycho-emotional state of the patient. Therefore, do not rely “on chance” - the constant companions of such patients should be an additional dose of insulin (in case of abuse of sweets) and a piece of sugar (in case of an overdose of insulin). Going on a long trip, the patient should have an additional amount of insulin sufficient for use within one week. This will prevent trouble if some insulin has been lost or damaged. Patients on board the aircraft should always keep insulin as carry-on baggage in case they find themselves without baggage for some reason.

About insulin preparations, some of which are listed below, you can get detailed information on the site.

[Tradename(composition or characterization) pharmachologic effect   dosage forms firm]

Actrapid HM   (human insulin) hypoglycemic   rd d / in. Novo Nordisk   (Denmark)

Actrapid HM Penfill   (human insulin) hypoglycemic   rd d / in. Novo Nordisk   (Denmark)

Actrapid MS   (insulin neutral for injection) hypoglycemic   rd d / in. Novo Nordisk   (Denmark)

Brinsulmidi MK 40 U / ml () hypoglycemic   susp.d / in. Bryntsalov-A   (Russia)

Brinsulmidi Ch 40 IU / ml   (human insulin) hypoglycemic   susp.d / in. Bryntsalov-A   (Russia)

Brinsulmidi ChSP 40 IU / ml   (human insulin) hypoglycemic   susp.d / in. Bryntsalov-A   (Russia)

Brinsulrapi MK 40 U / ml   (insulin neutral for injection) hypoglycemic   rd d / in. Bryntsalov-A   (Russia)

Brinsulrapi Ch 40 IU / ml   (human insulin) hypoglycemic   rd d / in. Bryntsalov-A   (Russia)

Insulin LT VO-S   (insulin zinc suspension compound) hypoglycemic   susp.d / in. (Poland)

Insulin Maksirapid VO-S   (insulin neutral for injection) hypoglycemic   rd d / in. Tarchominskie Zaklady Farmaceutyczne “Polfa”   (Poland)

Insulin Long QMS hypoglycemic   susp.d / in. Belmedpreparaty   (Belarus)

Insulin Ultralong QMS hypoglycemic   susp.d / in. Belmedpreparaty   (Belarus)

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Insulin

Insulin is a hormone of protein nature, which is formed in the beta cells of the pancreatic islets of Langerhans. This substance affects almost all metabolic processes in the body. The primary goal of insulin is to lower the concentration of glucose in the blood. In addition, insulin enhances the synthesis of fats and proteins, inhibits the breakdown of glycogen and fats. The normal concentration of immunoreactive insulin in an empty stomach is from 6 to 12.5 mcU / ml. Insulin deficiency (congenital or acquired) leads to diabetes.

Increased insulin in the blood is observed with tissue insulin resistance and underlies the development of the metabolic syndrome. Insulin preparations are used as medicines for diabetes.

What do we know about insulin? If the body suddenly stopped producing it, a person is doomed to life-long injections. Indeed, artificial insulin in diabetes, instead of ceasing to develop its own, is the salvation for the sick. Modern pharmaceuticals offer quality drugs that can completely replace the natural production of insulin, and provide a high quality of life for the patient. Conventional syringes and large bottles of medication, from which it is so difficult to get the right dose, are a thing of the past. Today, the introduction of insulin is not difficult, because the medicine is available in convenient syringe pens with a dispenser, and sometimes a special pump is installed for patients at all, due to which the portions of the medicine are automatically measured and then released into the bloodstream.

Why is insulin so important? It regulates the level of glucose in the blood of a person, and it is glucose that is the main source of energy for the body. The action of insulin is very multifaceted and well studied by modern science.

Hormone insulin

Human insulin is produced by special cells (beta cells) of the pancreas, most of which are located in its tail. The accumulation of hormone-producing beta cells is called islets of Langerhans. As we have said, first of all, insulin is responsible for regulating blood glucose levels. How does this happen?

• With the help of insulin, the permeability of the cell membrane is improved, and glucose easily passes through it;
• Insulin is involved in the transition of glucose to glycogen stores in the muscles and liver;
• Blood insulin helps break down glucose;
• The hormone provides a decrease in the activity of enzymes that break down glycogen and fat.

Decreased insulin production by the body’s own cells leads to the fact that a person begins with type I diabetes. In this case, the beta cells themselves are irreversibly destroyed, where insulin must be produced during normal carbohydrate metabolism. A person with such diabetes requires continuous administration of artificially synthesized insulin. If the hormone is produced in the right amount, but the cell receptors become insensitive to it, this indicates the development of type 2 diabetes. Insulin is not used for its treatment in the early stages, but as the disease progresses, the endocrinologist can prescribe injections to reduce the load on the pancreas.

Until recently, a drug made on the basis of animal hormones or modified animal insulin, in which one amino acid was replaced, was used in the treatment of patients. The development of the pharmaceutical industry has made it possible to obtain high-quality drugs through genetic engineering. The insulins synthesized in this way do not cause allergic reactions. In addition, for successful correction of glucose levels, their lower doses are required.

Insulin production

Insulin production is a complex and multi-step process. First, an inactive substance is synthesized in the body, preceding full-fledged insulin (preproinsulin), which then takes an active form. The structure of preproinsulin is prescribed on a particular human chromosome. Simultaneously with its synthesis, a special L-peptide is formed, with the help of which preproinsulin passes through the cell membrane, turns into proinsulin and remains to mature in a special cell structure (Golgi complex).

Maturation is the longest stage in the insulin production chain. During this period, proinsulin is decomposed into insulin and C-peptide. Then the hormone joins zinc, which is in the body in ionic form.

The release of insulin from beta cells occurs after the level of glucose in the blood rises. In addition, the secretion and release of insulin into the blood depends on the presence of certain hormones, fatty acids and amino acids, calcium and potassium ions in plasma. Its production decreases in response to the release of another hormone - glucagon, which is also synthesized in the pancreas, namely in its alpha cells.

The autonomic nervous system of a person also affects insulin secretion:

• The parasympathetic part affects the increase in the synthesis of the hormone insulin;
• Under the influence of the symptomatic part, the synthesis of the substance is inhibited.

One of the most important tasks of insulin is the regulation of carbohydrate metabolism. This function is carried out by increasing the permeability of cell membranes for glucose, which allows it to quickly get inside the cell. Insulin in the body acts on insulin-dependent tissues - muscles and fat. Together, these tissues make up 2/3 of the cell mass and are responsible for the most important vital functions (respiration, blood circulation).

The action of insulin is based on the work of a protein receptor located in the cell membrane. The hormone binds to and is recognized by the receptor, triggering the work of a whole chain of enzymes. As a result of biochemical changes, protein kinase C protein is activated, which affects intracellular metabolism.

Human insulin affects a number of enzymes, but the main function of reducing the amount of blood glucose is realized by:

• Increases the ability of cells to absorb glucose;
• Activation of glucose utilization enzymes;
• Accelerating the formation of glucose stores as glycogen in liver cells;
• Reducing the intensity of glucose formation in the liver.

In addition, the action of insulin is that it:

• Increases the absorption of amino acids by cells;
• Improves the flow of potassium, phosphorus and magnesium ions into the cell;
• Increases the production of fatty acids;
• Promotes the conversion of glucose to triglycerides in the liver and adipose tissue;
• Improves DNA replication (reproduction);
• Reduces the flow of fatty acids into the bloodstream;
• Inhibits the breakdown of proteins.

Sugar and insulin

Blood insulin directly affects glucose utilization. How does this happen in a healthy person? Normally, with a long break in food, the level of glucose in the blood remains unchanged due to the fact that the pancreas produces small portions of insulin. As soon as carbohydrate-rich food enters the mouth, saliva breaks them down into simple glucose molecules that are instantly absorbed into the blood through the oral mucosa.

The pancreas receives information that a large amount of insulin is needed to dispose of incoming glucose, and it is taken from the reserves accumulated by the iron during the break in food. The release of insulin in this case is called the first phase of the insulin response.

As a result of the release of insulin, blood sugar is reduced to normal, and the hormone in the pancreas is depleted. The gland begins to synthesize additional insulin, which slowly enters the bloodstream, which is called the second phase of the insulin response. Normally, insulin continues to be produced and released into the blood as food is digested. The body stores part of the glucose in the form of glycogen in the muscles and liver. If glycogen has nowhere else to go, and not utilized carbohydrates remain in the blood, insulin helps to turn them into fats and deposited in adipose tissue. When, over time, the amount of glucose in the blood begins to decrease, pancreatic alpha cells will begin to produce glucagon, a hormone that is inverse to insulin in its action. It is glucagon that tells the muscles and liver that it is time to convert glycogen stores to glucose, which helps maintain normal blood sugar levels. The body will replenish depleted glycogen reserves during the next meal.

It turns out that maintaining a normal level of glucose in the blood is the result of hormonal regulation of the body, and there are two groups of hormones that affect glucose in different ways:

• Insulin has a hypoglycemic effect - it reduces the amount of sugar in the blood due to the deposition of glucose in the form of glycogen in the liver and muscles. When glucose levels rise above a certain number, the body begins to produce insulin for sugar utilization;
• Glucagon is a hyperglycemic hormone produced in the alpha cells of the pancreas and converts liver and muscle glycogen stores to glucose.

Insulin: the norm in women

The normal level of insulin in the blood of a woman indicates that the body copes with the processing of glucose. A good fasting glucose value is from 3.3 to 5.5 mmol / l, the insulin norm in the blood is from 3 to 26 mcED / ml. The standards for elderly and pregnant women are slightly different:

• In the elderly - 6-35 mkU / ml;
• In pregnant women - 6-28 mkU / ml.

The rate of insulin should be taken into account in the diagnosis of diabetes: along with the determination of glucose in the blood, an analysis of insulin allows you to understand whether there is a disease. In this case, both an increase and a decrease in the indicator relative to normal numbers are of importance. So, increased insulin suggests that the pancreas is idling, producing extra doses of the hormone that are not absorbed by the cells of the body. A decrease in insulin means that the pancreatic beta cells are not able to produce the right amount of hormone.

It is interesting that in pregnant women the insulin rate and glucose rate are slightly different. This is due to the fact that the placenta produces hormones that increase the amount of glucose in the blood, and it provokes the release of insulin. As a result, the sugar level rises, it crosses the placenta to the baby, forcing his pancreas to work in an enhanced mode and synthesize a lot of insulin. Glucose is absorbed and stored in the form of fat, the weight of the fetus increases, which is dangerous for the course and outcome of future births - a large baby can simply get stuck in the birth canal. To avoid this, women who have revealed an increase in the amount of insulin and glucose during pregnancy should be observed by a doctor and carry out his appointment.

Insulin: the norm in men

The norm of insulin is the same for men and women, and is 3-26 μU / ml. The reason for the decrease in hormone secretion is the destruction of pancreatic cells. Usually this happens at a young age, against the background of an acute viral infection (flu) - the disease begins acutely, often patients get to the hospital in a state of hypo- or hyperglycemic coma. The disease is autoimmune in nature (cells are destroyed by the action of their own killer cells, which are formed due to malfunctions in the immune system), and is called type 1 diabetes. Only lifelong administration of insulin and a special diet can help here.

When a man has an increased level of insulin, it is possible to suspect the presence of tumors of the pancreas, liver disease and adrenal glands. If, according to the results of the examination, nothing was revealed, and an increase in insulin level is accompanied by an increase in the concentration of glucose in the blood, diabetes mellitus of the second type can be suspected. In this case, cell receptors lose their sensitivity to insulin. Despite the fact that the pancreas produces it in large quantities, glucose cannot enter the cells through the cell membrane. Type 2 diabetes mellitus in the stronger sex appears with age, contributing to obesity, an unhealthy lifestyle, and bad habits.

What troubles does a violation of the production and absorption of insulin in men entail? A specific male problem for diabetics is impotence. Due to the fact that glucose is not being utilized correctly, its elevated level is observed in the blood, and this affects blood vessels badly, worsens their patency and impairs erection. In addition, nerve damage develops (diabetic neuropathy), and the sensitivity of nerve endings decreases.

In order not to encounter this delicate problem, male diabetics need to be observed by an endocrinologist, perform all his appointments, regularly check the level of glucose and insulin in the blood.

The norm of insulin in a child is from 3 to 20 mcU / ml. In some diseases, both its increase and decrease can be observed:

• Type 1 diabetes is characterized by a decrease in insulin levels.

This type of disease is the main one in children. Most often, the first clinical signs occur at an early age. Such a disease is characterized by a rapid onset and a severe course. Beta cells die and stop producing insulin, so only hormone injections can save a sick child. The cause of the disease lies in congenital autoimmune disorders, any childhood infection can become the trigger mechanism. The disease begins with a sharp weight loss, nausea, vomiting. Sometimes children get to the hospital already in a coma (when the body is unable to cope with a sharp decrease or increase in the level of insulin and glucose in the blood). In adolescents, the onset of the disease can be blurry, the latent period lasts up to 6 months, and at this time the child complains of headache, fatigue, an indomitable desire to eat something sweet. Pustular rashes may appear on the skin. The treatment for the first type of childhood diabetes is to prescribe insulin injections to make up for the lack of our own hormones.

• In diabetes of the second type, hyperplasia of islets of Langerhans, insulin, the level of insulin in the blood rises.

Insulinoma and hyperplasia are rare, and type 2 diabetes is very common. It differs in that with increased insulin, blood sugar is not utilized, and remains high due to a violation of the sensitivity of cell receptors. The treatment of the disease is to restore sensitivity through special medications, diet and exercise.

Elevated insulin

High insulin levels in adults

In a healthy body, everything should be in balance. This also applies to carbohydrate metabolism, part of which is the production and utilization of insulin. Sometimes people mistakenly believe that elevated insulin is even good: the body will not suffer from high numbers of blood glucose. In fact, this is not so. Exceeding insulin levels in the blood is just as harmful as lowering its concentration.

Why does such a violation occur? The reason may be a change in the structure and structure of the pancreas itself (tumors, hyperplasia), as well as diseases of other organs, due to which carbohydrate metabolism is impaired (damage to the kidneys, liver, adrenal glands, etc.). However, most often, insulin becomes high due to type 2 diabetes mellitus, when the pancreas works as usual, and the cells of the islets of Langerhans continue to synthesize the hormone normally. The reason for the increase in insulin becomes insulin resistance - a decrease in the sensitivity of cells to it. As a result, sugar from the blood cannot penetrate the cell membrane, and the body, still trying to deliver glucose to the cell, secretes more and more insulin, which is why its concentration is always high. At the same time, a violation of carbohydrate metabolism is only part of the problems: almost all type 2 diabetics have a metabolic syndrome, when, in addition to high sugar, a person has high blood cholesterol, hypertension, and heart disease. About the risk of developing type 2 diabetes can say:

• Abdominal obesity, in which fat is deposited in the waist.
• High blood pressure.
• An increase in the amount of "bad" cholesterol in comparison with the norm.

Researchers consider genetics to be the reason for the development of insulin resistance: it is assumed that resistance is a way of the body to survive in conditions of hunger, because a violation of the sensitivity of insulin receptors allows you to stock up on fat in well-fed good times. However, the evolutionary advantage in the current conditions turned into a problem: the body stores fat even when it is not needed - modern developed society has long forgotten about hunger, but people continue to eat with a reserve, which is then “deposited” on their sides.

You can diagnose an increased level of insulin (hyperinsulinism) using a blood test taken on an empty stomach - the normal value of the hormone in the blood plasma is from 3 to 28 mcU / ml. Blood is taken strictly on an empty stomach, because after eating the amount of insulin changes dramatically.

What if the analysis showed a high level of insulin? First of all, you need to understand the reason - the tactics of further treatment depend on this: for example, if the violation is associated with the presence of insulinoma, the patient is offered surgical removal of the tumor. When the amount of the hormone rises due to diseases of the adrenal glands and their cortex, liver, pituitary tumors, you need to deal with these diseases - their remission will lead to a decrease in insulin levels. Well, if the cause of the disease is a violation of carbohydrate metabolism and diabetes, a special low-carb diet and drugs aimed at improving the sensitivity of cells to insulin will help.

Elevated insulin levels are often found during pregnancy - in this case, they speak of the development of gestational diabetes. What is the danger of such diabetes for mom and baby? The child can be very large, with overly developed shoulders, and this is dangerous for future births - the baby can get stuck in the birth canal. High insulin levels often cause fetal hypoxia. Moms may subsequently develop common diabetes that is not related to pregnancy.

The risk of developing gestational diabetes increases if you have:

• Diabetes in past pregnancy;
• Excess weight;
• Polycystic ovary;
• Hereditary burden.

Why is there an increased level of insulin and a violation of carbohydrate metabolism during pregnancy?

Under normal conditions, the amount of glucose in the blood is controlled by insulin, which is formed in the pancreas. Under its influence, glucose is absorbed by cells, and its level in the blood decreases. During pregnancy, the placenta forms hormones that cause an increase in sugar levels. Glucose through the placenta enters the bloodstream of the baby, and his pancreas, trying to correct the situation, gives out more insulin. In turn, excessively secreted hormone contributes to the rapid absorption of glucose and its conversion into fatty deposits. As a result, the weight of the future baby is growing rapidly - there is a macrosomia of the fetus.

How is gestational diabetes manifested in a woman?

As a rule, he does not bother the expectant mother in any way, and is detected by chance when passing routine tests, and especially the glucose tolerance test, which is performed at 26-28 weeks of gestation. Sometimes the disease manifests itself more vividly: bouts of severe hunger, constant thirst and excessive urination.

Gestational diabetes can be suspected by ultrasound of the fetus - an advance in size and weight may indicate the development of the disease.

The normal value of the insulin level in blood plasma during pregnancy is 6-28 μU / ml, glucose - up to 5.1 mmol / l. Sometimes, in addition to these tests, a “glycated hemoglobin” study is prescribed — it shows how long a woman has developed diabetes. Glycated hemoglobin is hemoglobin glued to glucose. It is formed when blood sugar levels are elevated for a long time (up to 3 months).

How to treat gestational diabetes?

First of all, a woman is prescribed a low-carb diet and self-monitoring of blood glucose levels with portable meters on an empty stomach and after eating. Most of the disorders can be corrected by a reasonable diet with the exception of “fast carbohydrates”, uniform meals and adequate physical activity (walking, swimming). Physical education is very important - because exercises provide the body with oxygen, improve metabolism, utilize excess glucose and help normalize the amount of insulin in the blood. But if these methods did not help, the expectant mother is waiting for injections of insulin, allowed during pregnancy. As a rule, “short” insulins are prescribed before meals, and “long” ones before bedtime and in the morning. Medicines are used until the end of pregnancy, in most cases after birth gestational diabetes passes on its own, and further treatment is not required.

High insulin levels are a problem that occurs in childhood. Why can insulin be elevated in a child? More and more children are suffering from obesity, the reason for which is poor nutrition, and parents sometimes do not think how dangerous it is for the body. Of course, there are cases when the increase in insulin levels is associated with other circumstances: in children, as in adults, there may be tumors and diseases of the pituitary gland, adrenal glands and their cortex, insulinomas. But more often, a violation of carbohydrate metabolism is of a hereditary nature, on which improper nutrition, lack of exercise, and stress are superimposed.

As a result, the child develops type 2 diabetes, in which, despite the active work of the pancreas and insulin secretion, the cells lose their sensitivity to it. Unfortunately, doctors say that type 2 diabetes is now “younger” - more and more children are suffering from overweight, metabolic syndrome and carbohydrate metabolism disorders.

What should I do if a child has a high level of insulin detected by blood tests? Firstly, it is necessary to exclude diseases due to which the production of the hormone increases (insulin, hyperplasia of the islets of Langerhans, damage to the liver, pituitary and adrenal glands). If after the examination these diseases are not detected, and there are signs of type 2 diabetes, the treatment consists in restoring the sensitivity of the cell receptors to insulin and reducing the load on the pancreas so that it does not deplete from excessive hormone synthesis. This can be achieved with the help of special medicines, a low-carb diet and physical education. Violation of carbohydrate metabolism and obesity in a child is an occasion to review the menu and lifestyle of the whole family: yes - to sports and proper nutrition, no - fast food and a weekend on the couch.

Causes of Elevated Insulin Levels

High levels of insulin in humans can be for a variety of reasons. In medicine, excess hormone secretion is called "hyperinsulinism." Depending on what caused it, primary and secondary forms of the disease are distinguished:

The primary form is associated with a lack of glucagon secretion and an excess of insulin production by the beta cells of the pancreatic islets of Langerhans. This happens when:

• The pancreas is affected by a tumor that increases insulin production. As a rule, such tumors are benign and are called insulinomas;
• The islets of Langerhans in the gland grow, causing increased secretion of human insulin;
• In alpha cells, glucagon secretion decreases.

The secondary form of the disorder is not associated with pancreatic problems, and is explained by deviations in the functioning of the nervous system and impaired secretion of other hormones that affect carbohydrate metabolism. In addition, a cause of secondary (extrapanotic) hyperinsulinism may be a change in the sensitivity of insulin receptors. What disorders in the body can contribute to the development of hyperinsulinism?

• Diseases of the pituitary gland;
• Diseases (including benign and malignant tumors) of the adrenal gland, diseases of the adrenal cortex;
• Damage to the liver;
• Impaired carbohydrate metabolism. In this case, with increased insulin, blood sugar still remains high;
• Operations on the gastrointestinal tract (in particular, resection of the stomach) can lead to the fact that carbohydrates are evacuated too quickly into the small intestine and are actively absorbed there, causing a sharp increase in the amount of sugar in the blood and the release of insulin.

The most common cause of hyperinsulinism today is impaired insulin sensitivity of cellular receptors. Cells cease to perceive this hormone, and the body “does not understand” this and increases the production of insulin, which, however, does not reduce glucose in the blood - this is how type 2 diabetes is formed. As a rule, it is typical for middle-aged and older people, and accounts for more than 90% of all cases of diabetes. And if about type 1 diabetes, we can say that a person was not lucky to be born with a defective gene responsible for the development of the disease, then type 2 diabetes is a completely “merit” of the person himself: it develops in those who abuse fat and sweet, lead a sedentary life and has bad habits.

Low insulin levels

A reduced level of insulin, as a rule, indicates the development of diabetes - due to a lack of hormone glucose is not utilized, but remains in the blood. A decrease in insulin levels in diabetes leads to unpleasant symptoms:

• Increased urination, an increase in the amount of urine (especially typical for nighttime). This is due to the fact that excess glucose from the blood is excreted in the urine, and glucose “takes” water with it, increasing the amount of urination;
• A feeling of constant thirst (in this way the body tries to make up for fluid loss in the urine);
• Hyperglycemia - an increase in the amount of glucose: a low level of insulin in the blood or the complete absence of its production leads to the fact that glucose does not enter the cells, and they experience its deficiency.

You can make up for the lack of insulin by constant injections of insulin analogue drugs.

Causes of Lowered Insulin

Blood insulin levels may decrease due to many circumstances. To find out exactly why this happens, you need to contact an endocrinologist. The main reasons for reducing the production of insulin by the gland are:

• Unhealthy diet: the diet contains a large amount of high-calorie foods and animal fats, “fast” carbohydrates (sugar, flour). All this leads to the fact that the insulin produced by the pancreas is chronically insufficient for utilization of the received carbohydrates, and the body tries to increase its production by depleting beta cells;
• Failure to comply with the diet (overeating);
• Decreased immunity due to infections and chronic diseases;
• Lack of sleep, anxiety, stress help to reduce the amount of insulin produced by the body;
• Lack of active physical activity - because of them, the amount of sugar in the blood increases and the level of insulin decreases at the same time.

Diabetes Insulin

Type 1 diabetes occurs in young people. This is an incurable disease in which only regular injections of insulin that mimic its natural production will help the patient.

Scientists consider the cause of diabetes to be a hereditary predisposition to an autoimmune disorder, and the trigger may be an injury or a cold, due to which the process of destruction of beta cells by their own killer cells begins. Thus, insulin in type 1 diabetes either ceases to be synthesized at all, or is insufficient for glucose utilization.

How does the disease begin? The patient complains that he quickly weakens and gets tired, becomes irritable, often urinates and is very thirsty, and loses weight. Sometimes nausea and vomiting are added to the symptoms.

In the absence of insulin treatment, a person can die from hyper- and hypoglycemia. In addition, excess blood sugar has a toxic effect on the body: blood vessels (especially the kidneys and eyes) are damaged, blood circulation in the feet is disturbed and gangrene can occur, nerves are affected, fungal diseases appear on the skin.

The only way to treat this is to choose a dose of insulin that will replace the body's natural hormone synthesis. An interesting fact is that with the started therapy, the so-called “honeymoon” sets in, when the level of insulin is normalized to such an extent that the patient can do without injections. Unfortunately, this period does not last long (largely because people stop dieting and do not make prescribed injections). If you approach the treatment wisely, you can try to save as many of your own beta cells as possible, which will continue to synthesize insulin, and do with a small number of injections.

Type 2 diabetes

What is type 2 diabetes? In this diabetes, insulin does not cease to be produced by the body, but the sensitivity of the receptors to it changes - insulin resistance occurs. As a rule, the disease develops slowly in people aged 35-40 years and above, who are overweight. The cause of diabetes is:

• Hereditary predisposition to the development of metabolic syndrome and disorders of carbohydrate metabolism;
• Unhealthy diet with a lot of "fast" carbohydrates;
• Lack of physical activity.

In the initial stage, diabetes insulin is produced by the pancreas in a normal amount, but the tissues do not respond to it. The body increases the secretion of the hormone, and over time, the beta cells of the pancreas are depleted, and the person needs insulin injections, as in the first type of diabetes.

The disease usually does not have pronounced symptoms. Patients only complain of itching, the presence of fungal infections, and they see a doctor when diabetes is complicated by retino-, neuropathy, and kidney problems.

At the beginning of the disease, the patient can be helped by diet and physical activity. As a rule, weight loss leads to the fact that the receptors again acquire sensitivity to insulin. Despite the fact that the second type of diabetes is called non-insulin-dependent, later the patient may need the introduction of human insulin - this happens when beta cells are depleted from excessive synthesis of the hormone.

Insulin treatment

Types of insulin preparations

Insulin treatment is the main treatment for diabetics. Depending on how the preparation is synthesized, there are:

• Cattle insulin - it can give strong allergic reactions, since the protein composition is significantly different from human;
• Drugs derived from pig pancreas. They can also be allergenic, although they differ from human insulin in just one amino acid;
• Analogs of the human hormone insulin - they are obtained by replacing the amino acid in porcine insulin;
• Genetically modified drugs - the hormone is "produced" by the synthesis of Escherichia coli.

Analogs and genetically modified drugs are the best choice for insulin treatment, because they do not cause allergies and provide a stable therapeutic effect. You can see the composition of the medicine on the package: MS - monocomponent, NM - analogue or genetically modified. Labeling with numbers shows how many units of the hormone are contained in 1 ml of the drug.

In 2016, the results of the work of scientists from the Endocrinological Scientific Center of the Ministry of Health of Russia in Moscow were published. The aim of the study was a retrospective comparison of the efficacy of glycemic control and the incidence of microvascular complications (nephropathy and retinopathy) in patients with type 1 diabetes who had been treated with genetically engineered human insulin (GIC) or human insulin analogs (AIC) for 10 years. As a result, it was possible to establish that patients receiving AICH had less likely to develop diabetic nephropathy, in comparison with patients receiving GICH.

Insulins differ not only in origin, but also in duration of action:

• "Fast", or ultrashort - begin to work immediately after administration.

The maximum effect is observed after 1-1.5 hours, the validity is 3-4 hours. They are administered either before meals, or immediately after. The ultra-short type of insulin includes Novorapid and Insulin Humalog.

• "Short" - effective half an hour after administration, peak activity - after 2-3 hours, all in all, they last up to 6 hours.

Such drugs are administered 10-20 minutes before a meal. At the peak of activity, you need to plan an additional snack. An example of short insulin is Insulin Actrapid, Insuman Rapid.

• "Medium" - act within 12-16 hours, begin to work 2-3 hours after administration, peak - after 6-8 hours.

Such drugs are administered 2-3 times a day. An example of drugs – Protafan, Insulin Humulin NPH.

• "Long" - has a prolonged effect and is an analogue of basal (background) production of insulin.

It is administered 1-2 times a day. Some drugs are called “peakless” because they do not have a pronounced peak in activity and completely mimic the hormone production of healthy people. The peakless type of insulin includes Levemir and Lantus.

• Combined, or mixed.

In such a preparation, doses of long and short acting insulin are already mixed in one syringe, so the patient needs to be given fewer injections. Medicines differ in proportions in which two types of insulin are mixed. The specific type of drug, depending on the proportion, should be selected by the endocrinologist. An example of a combined type of insulin is Novomix.

Insulin injections are an integral part of the life of a patient with type 1 diabetes. How well a person makes them depends on his well-being and the degree of compensation for the disease. The medicine is usually introduced into the subcutaneous fat - this ensures its uniform absorption in the blood. The most convenient places for injections are the abdomen (except for the navel), buttocks, the front surface of the thigh and the outer surface of the shoulder. On each part of the body, insulin enters the bloodstream at different speeds: the slowest way is if it is inserted into the front of the thigh, the fastest from the abdomen. In this regard, “short” drugs need to be injected into the abdomen and shoulder, and extended-dose insulin doses should be injected into the upper lateral part of the buttock or thigh. If you use the drug Novorapid or Lantus, injections can be done in any of these areas.

You can not inject insulin in the same place and at a distance of less than 2 cm from the previous injection. Otherwise, fatty seals may appear, due to which the medicine is worse absorbed into the blood. The injection procedure consists of several stages:

• Need to wash your hands with soap;
• Wipe the skin with an alcohol towel (if you do not take a daily shower);
• The insulin syringe needs to be turned over several times, but not shaken - for better mixing;
• Then you should dial the desired dose of insulin by scrolling the dial in a circle to the left to the desired number;
• Make a skin fold and insert the needle at an angle of 45-90º, press on the piston and wait 15 seconds;
• Slowly and gently pull out the needle to prevent the medicine from leaking out of the puncture.

To ensure the optimal level of insulin in the blood, the dose of drugs and the number of injections must be selected together with the endocrinologist. As a rule, the following schemes are used:

• Three injections (breakfast, lunch, dinner) of "short", and one or two (morning and evening) - of "long" insulin. This treatment method best mimics the natural production of insulin by the gland, but requires frequent measurement of glucose levels to determine the right dose of medication.
• Two introductions (“short” and “long” insulin) before breakfast and dinner. In this case, strict diet and clockwise nutrition are required.

If a patient develops acute respiratory viral infections or the flu, frequent administration of “short” insulin may be necessary, since hormone production is inhibited during viral infection.

Insulin administration rules

The introduction of insulin must be carried out in accordance with certain rules:

• Syringes with medicine should be stored at room temperature. If long-acting insulin is used, it must be mixed by turning the syringe pen.
• The choice of injection site depends on what type of insulin is injected (“short” must be injected into places where it is absorbed quickly, “long” - where it is slow).
• You can not make injections at the same point - this leads to the formation of seals in the subcutaneous fat and impairs the absorption of the drug.
• After removing the cap, you need to attach the needle to the syringe pen in accordance with the instructions. It is advisable to use a new needle with each new injection.
• If there is a large vial of air in the syringe, tap on the body pointing up with the needle so that the vial pops up, and then release several units of the medicine into the air. Small bubbles do not need to be removed.
• The dose of the drug is set by turning the regulator of the syringe in accordance with the instructions.
• For the correct administration of insulin, you need to make a skin fold in the desired area, and then insert the needle at an angle of 45 to 90 degrees. After that, gently and slowly press the syringe button, count to 20, and carefully pull it out, after releasing the skin fold.

Insulin treatment is the main way to ensure a normal life for a diabetes patient. In order for the therapy to bring the desired effect, it must be prescribed by the endocrinologist. Self-selection of drugs and dosages can threaten health!

The goal of insulin treatment is to completely replace the lost production of the hormone with artificial administration of drugs. For this, the doctor selects medications that will best act on the patient's body. The patient, in turn, must responsibly treat the treatment: follow a diet, diet and insulin.

Fortunately, the current level of development of medicine allows the patient to lead a full life: combined and long-acting drugs are available, pumps can be used. At the same time, the idea was rooted in the minds of many: if you start injecting insulin, it means recognizing yourself as disabled. In fact, proper insulin therapy is a guarantee that a person will not develop serious diabetes complications that lead to disability. Adequate treatment makes it possible to “unload” the remaining beta cells and relieve them of the harmful effects of chronically elevated blood glucose. Over time, the patient may need smaller doses of insulin.

Low insulin diet

A low level of insulin in the human body is typical for diabetes. Diabetes treatment requires a low-carb diet (Pevzner table 9). What are the basic nutritional guidelines?

• The diet should be balanced, and its calorie content should be reduced.
• With a lack of insulin, sugar does not have time to be utilized in the blood, therefore it is necessary to limit the amount of digestible carbohydrates, and some of them to be completely eliminated: diabetic semolina, potatoes, white rice, sugar and honey will not benefit.
• According to the doctor’s prescription, instead of sugar, you can use xylitol, sorbitol, fructose and other sweeteners. As a rule, they are absorbed more slowly than glucose, and allow better control of blood sugar.
• Food should be fractional and frequent, and portions should be small. The optimal number of meals is at least five times, and each time you need to try to eat an approximately equal amount of carbohydrates.
• It is necessary to include a large amount of fiber in the diet, which gives a feeling of fullness and promotes better utilization of fats and carbohydrates. Fiber is found mainly in raw vegetables: cucumbers, cabbage, tomatoes, zucchini.
• Since the violation of the production and absorption of the hormone insulin is usually accompanied by impaired fat metabolism, the menu should contain products that have a lipotropic (fat-splitting) effect: cottage cheese, low-fat fish, beef, oatmeal.
• It is necessary to abandon dishes with a high content of animal fat, fried, rich broths.

High insulin diet

An increased level of insulin in the blood suggests that the pancreas produces it in excess. Moreover, the sensitivity of cellular receptors to it can be impaired - this happens with the metabolic syndrome, when a person has diabetes mellitus, obesity, impaired lipid metabolism, heart and vascular disease, and hypertension. The body produces insulin in vain, unnecessarily boosting the pancreas. How to correct such a violation? Usually, doctors prescribe medication, exercise, and diet. The main principles of the diet are as follows:

• Limitation of “fast” carbohydrates, which cause increased production of insulin in the body. It is best to completely exclude them, giving preference to “slow” carbohydrates: brown rice, durum wheat pasta, buckwheat, whole grain bread;
• Control portion sizes - the amount of food at one meal should be small, you need to eat often (4-6 times a day);
• If possible, it is better to use sweeteners instead of sugar;
• Give up alcohol;
• Drink plenty of ordinary water, completely quench your thirst;
• Reduce the amount of salt eaten (both in dishes and in pure form);
• Refuse foods high in sodium (salted nuts, sausages, canned goods).

What foods should be in the diet of a person who has high insulin?

• Low-fat meat (preferably beef);
• Low-fat dairy and sour-milk products, cottage cheese;
• Eggs in a small amount;
• Whole grains and cereals;
• Vegetables that do not contain starch: cabbage, pumpkin, broccoli, tomatoes, etc.
• Greens;
• Fruits with a low glycemic index.

If the insulin in the body is produced in insufficient or, conversely, in excess quantities, this leads to a change in the level of glucose in the blood. Although high and low sugar have different symptoms, the regulation of carbohydrate metabolism requires compliance with certain rules:

• If you suffer from a violation of the production and absorption of insulin, get a bracelet or put a note in your wallet so that others can quickly respond and help;
• Observe regularly with an endocrinologist and follow the prescribed treatment;
• Do not drink alcohol, as it causes a sharp change in blood sugar;
• Try to lead a calm, measured lifestyle - because, as you know, the production of the hormone insulin is suppressed during stress. In addition, people in a state of stress can disregard their own health on the basis of the principle “there will be no worse anyway”, causing great damage to this;
• Regularly check your blood sugar with portable devices (glucometers) - this is how you can assess whether your body can handle the load or if you need to change the current dose of medication. Monitoring glucose levels will prevent life-threatening conditions such as hypoglycemic and hyperglycemic coma;
• Be wise of physical activity. Do not set sports records, because insulin production does not change at the time of exercise, but glucose utilization is accelerated, and blood sugar levels can drop to unacceptably low levels. You can deal with this by eating a small amount of carbohydrate food before starting classes, or by injecting less insulin with meals (if you are prescribed insulin therapy);
• Do not neglect preventive vaccinations, the purpose of which is to protect the body from influenza and pneumococcal infection, because during the disease hormones are produced that block the production and absorption of insulin in the body, and this has a bad effect on the state of health and exacerbates the course of diabetes.

The insulin produced by the pancreas is perhaps the most popular hormone. Literally every schoolchild knows that with lower insulin, blood sugar increases, and type 1 diabetes occurs. An increase in insulin levels can also be the initial sign of diabetes, when the pancreas accepts poor absorption of the hormone by the tissues as its absolute lack, and begins to produce it even in excess - this is how type 2 diabetes appears.

The treatment of diseases associated with a deficiency or excess of insulin is different, and depends on the specific cause:

• With a lack of hormone, insulin therapy is prescribed;
• With excessive secretion of insulin and the lack of tissue sensitivity to it, drugs that reduce insulin resistance are used.

It is important to remember: violation of insulin production in itself is not a sentence, but an occasion to turn to an endocrinologist for qualified help and change your habits to healthier ones. It is unacceptable to self-medicate and experiment with dosages and drugs - the doctor should prescribe all the therapy depending on the medical history and the characteristics of the health condition.

Used sources

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2. Balabolkin M.I. // Diabetology // M .: Medicine, 2000.
3. Dedov I.I., Shestakova M.V., Maksimova M.A. // Federal target program "Diabetes": Method. recommendations // M., 2002.
4. Starostina EG. // Insulin and insulin therapy: “dark forest” or harmonious system? // In the world of medicines // 1998 // No. 2.
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