How Is Type 2 Diabetes Treated
People with type 2 diabetes have to pay a little more attention to what they’re eating and doing than people who don’t have diabetes. They may need to:
- Eat a healthy diet, as determined by the care team.
- Get regular physical activity to achieve a healthy weight and allow insulin to work more effectively.
- Check their blood sugar levels on a regular basis.
- Get treatment for other health problems that can happen more often in people with type 2 diabetes, like high blood pressure or problems with the levels of fats in their blood.
- Have regular checkups with doctors and other people on their diabetes health care team so they can stay healthy and get treatment for any diabetes problems.
People with type 2 diabetes might have to eat smaller food portions and less salt or fat, too. Those who eat healthy foods, stay active, and get to a healthy weight may bring their blood sugar levels into a healthier range. Their doctors may even say they don’t need to take any medicines at all.
Why Is Insulin Important
Insulin, which is secreted from our pancreas, regulates our metabolism and provides the bodys cells with the energy it needs it does this based on blood sugar levels and other hormones in the body.
The hormone is responsible for allowing cells in the muscles, fat and liver to absorb sugar from our blood. These cells need sugar or glucose in order to have energy or it can be converted into fat, if required.
You probably are aware that insulin is connected with diabetes whether its type 1 or type 2 diabetes or gestational diabetes, which occurs during pregnancies. Apart from some differences in symptoms, all forms of diabetes are caused by the body not being able to secrete enough insulin or the body not being able to effectively use the insulin it produces.
This causes the sugar to remain in the bloodstream and overall blood sugar levels to rise. The rise in this long-term blood sugar level triggers many health problems, such as deafness or impaired vision. At the same time, kidneys can be affected, and the risk of strokes increases. The good news is that you can test your long-term blood sugar levels with a health test either at your doctors or at home.
Regulator Of Endocannabinoid Metabolism
Insulin is a major regulator of endocannabinoid metabolism and insulin treatment has been shown to reduce intracellular ECs, the 2-arachidonoylglycerol and anandamide , which correspond with insulin-sensitive expression changes in enzymes of EC metabolism. In insulin-resistant adipocytes, patterns of insulin-induced enzyme expression is disturbed in a manner consistent with elevated EC synthesis and reduced EC degradation. Findings suggest that insulin-resistant adipocytes fail to regulate EC metabolism and decrease intracellular EC levels in response to insulin stimulation, whereby obese insulin-resistant individuals exhibit increased concentrations of ECs. This dysregulation contributes to excessive visceral fat accumulation and reduced adiponectin release from abdominal adipose tissue, and further to the onset of several cardiometabolic risk factors that are associated with obesity and type 2 diabetes.
Hypoglycemia, also known as “low blood sugar”, is when blood sugar decreases to below normal levels. This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures or death. A feeling of hunger, sweating, shakiness and weakness may also be present. Symptoms typically come on quickly.
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For many years scientists believed that some kind of internal secretion of the pancreas was the key to preventing diabetes and controlling normal metabolism. No one couldfind it, until in the summer of 1921 a team at the University of Toronto began trying a new experimental approach suggested by Dr. Frederick Banting.By the spring of 1922, the Toronto researchers Banting, Charles Best, J.B. Collip andtheir supervisor, J.J.R. Macleod, were able to announce the discovery of insulin. In 1923, Banting and Macleod received the Nobel Prize for one of the most important,and most controversial, breakthroughs in modern medical history.
How Is Type 2 Diabetes Diagnosed
Doctors can say for sure if a person has diabetes by testing blood samples for glucose. Even if someone doesn’t have any symptoms of type 2 diabetes, doctors may order blood tests to check for it if the person has certain risk factors .
Some kids and teens with diabetes may go to a pediatric endocrinologist â a doctor who specializes in diagnosing and treating children and teens living with diseases of the endocrine system, such as diabetes and growth problems.
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Benefits And Disadvantages Of Animal Insulin
There is some controversy over the benefits and disadvantages of animal insulin compared with human insulin. There is reported evidence to suggest that human insulins may cause behavioural changes, lethargy, often feeling unwell and loss of hypo symptoms that are not recognised when using animal insulin.
However, no research has been carried out to provide conclusive evidence to either back up or dismiss the claim.
A disadvantage of animal insulin is in the peak activity time. The peak activity period for short acting insulin occurs up to 3 to 4 hours after injecting which can make timing of meals in relation to injections more difficult than with human and particularly analogue insulins.
B Interchangeability Of Biosimilar And Follow
A further regulatory barrier to biosimilar insulin competition is interchangeability. Unlike generics, biosimilars are not automatically substitutable with the biologic. To be interchangeable, a manufacturer must demonstrate that the product is âbiosimilarâ to the reference product, âcan be expected to produce the same clinical result as the reference productâ, and does not pose a greater risk âin terms of safety or diminished efficacyâ compared to the reference product if a patient were to switch or alternate use. The FDA to date has only approved 19 biosimilar products of any kind, and no biosimilar has yet received interchangeability status. This outlook is not supportive of seeking approval of an interchangeable biologic, which may be necessary for effective market entry and competition.
While the FDA has released some guidance on interchangeability approval, additional disclosures and support could help fast-track such approvals, such as limited disclosure of manufacturing techniques. Professors Price and Rai, for example, have suggested various potential disclosure mechanisms, including through the patent and FDA approval systems. These would likely be strongly opposed by the industry, as the trade secret protection is extremely advantageous for them. But given the continued unaffordability of insulin and limited competition, exploring such regulatory reforms may be warranted.
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How Do You Choose The Right Syringe For Injecting Insulin
Just as there are different sizes of syringes for administering insulin, there are also varying sizes of insulin needles. Shorter needles usually mean less sting when injecting. The downside is that the shallower the injection is, the longer it takes for the insulin to work. Your doctor will help you find the balance thats best for you.
Type I Diabetes And Making Insulin
One of the questions I am asked most often is how to deal with Type 1 diabetics in a long-term survival scenario. There is a story about how home-made Insulin was produced in Japanese-occupied Singapore during WWII. I have been unable to find the specific process used there, but I have come upon a lecture by one of the scientists who first produced Insulin in the lab. This occurred in 1922, and the lecture is from that era. The material used was the pancreatic organs of cows and pigs. I will add some comments below the transcript of the lecture.
Here it is:
The present method of preparation is as follows. The beef or pork pancreas is finely minced in a larger grinder and the minced material is then treated with 5 c.c. of concentrated sulphuric acid, appropriately diluted, per pound of glands. The mixture is stirred for a period of three or four hours and 95% alcohol is added until the concentration of alcohol is 60% to 70%. Two extractions of the glands are made. The solid material is then partially removed by centrifuging the mixture and the solution is further clarified by filtering through paper. The filtrate is practically neutralized with Sodium Hydroxide. The clear filtrate is concentrated in vacuo to about 1/15 of its original volume.
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The History Of A Wonderful Thing We Call Insulin
Since the dawn of time, we have searched for ways to make life easier for us. The modern age has given us some amazing technological advanceswhat we would do without the internet, our iPhones or high-speed travel?
For many people, surviving life without these things sounds rough. However, if you have diabetes, no doubt youre also a big fan of one particular 20th-century discovery: insulin.
Before insulin was discovered in 1921, people with diabetes didnt live for long there wasnt much doctors could do for them. The most effective treatment was to put patients with diabetes on very strict diets with minimal carbohydrate intake. This could buy patients a few extra years but couldnt save them. Harsh diets sometimes even caused patients to die of starvation.
So how did this wonderful breakthrough blossom? Lets travel back a little more than 100 years ago.
In 1889, two German researchers, Oskar Minkowski and Joseph von Mering, found that when the pancreas gland was removed from dogs, the animals developed symptoms of diabetes and died soon afterward. This led to the idea that the pancreas was the site where pancreatic substances were produced.
Later experimenters narrowed this search to the islets of Langerhans . In 1910, Sir Edward Albert Sharpey-Shafer suggested only one chemical was missing from the pancreas in people with diabetes. He decided to call this chemical insulin, which comes for the Latin word insula, meaning island.
Last edited: August 31, 2020
A Reciprocal Approval Of Existing Insulins
Taking advantage of existing companies with the capacity to increase their supply and enter the United States insulin market could be a fast and effective way to increase access, affordability, and competition. This could be done with reciprocal approval of products already approved in other countries. Such a reciprocal approval policy would allow the FDA to approve drugs based on approvals by certain other comparable medicines regulatory authorities.
While there are only three manufacturers supplying insulin in the United States, there are an estimated 34 insulin manufacturers globally. These manufacturers only make up about 10 per cent of the global market and none supply the United States market. An early review identified over 40 companies providing insulin in other countries and additional investigation and meetings with manufacturers suggest that approximately 10 of these companies are independent of the other companies .
If interchangeability could be achieved and the system were effective and trusted, this could eventually be a means to increase competition in the insulin market. Even so, other local reforms would need to be instituted to increase supply and affordability as well as address the failures in the biosimilar market and approval process.
Insulin And Type 2 Diabetes
Type 2 diabetes is characterised by the body not responding effectively to insulin. This is termed insulin resistance. As a result the body is less able to take up glucose from the blood. In the earlier stages of type 2 diabetes, the body responds by producing more insulin than it would normally need to.
If type 2 diabetes develops over a number of years, the extra demands on the pancreas to produce insulin can lead to a loss of insulin producing cells as they wear out.
Depending on their level of insulin resistance, people with type 2 diabetes may also need to take insulin injections to manage their blood sugar levels.
What Severe Complications Can Occur Because Of Rationing Or Running Out Of Insulin
Diabetic ketoacidosis is an emergency condition that results if you dont have enough insulin to regulate your blood sugar. DKA causes your body to break down fat for energy in the absence of insulin. This leads to a dangerous accumulation of acids known as ketones in your blood that can cause your brain to swell and your body to go into shock.
Signs of diabetic ketoacidosis include:
- Thirst or a very dry mouth
- Frequent urination
- High levels of ketones in your urine
- Nausea, vomiting, or stomach pain
- Difficulty breathing
- A fruity or acetone odor on your breath
- Confusion or acting drunk while sober
DKA is so common and can come on so quickly that it is the first sign of Type 1 diabetes in 20% of cases, and the way many type 1 diabetics are first diagnosed with the condition. If you go into diabetic ketoacidosis, dont try to hide it or make light of it. Treat it as the emergency it is and get to a hospital as soon as possible to recover. Ive had people tell me theyre tired of taking insulin, or that theyre rationing it due to cost. In type 1 diabetes, thats all it takes to end up in a life-threatening situation, says Dr. Zilbermint.
Another complication facing diabetics who use insulin is the potential for hyperglycemia, also known as insulin shock, which involves using too much insulin and causing your blood sugar to drop extremely low. This can cause coma, seizures, and heart attacks, says Dr. Powers.
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What Is The Function Of Cortisol
When people talk about stress, they often talk about cortisol. Because this hormone is released by your body as soon as you find yourself in a stressful situation. Affected glands include the adrenal glands, hypothalamus and pituitary gland. By secreting cortisol, various bodily reactions are triggered, for example:
- Blood sugar levels are controlled
- Immune system inflammation improves
- Energy is supplied
- Metabolism is regulated
Stress and also the short-term release of cortisol can be very helpful in dangerous situations, for example, so that the body can react quickly. However, if your body is exposed to chronic stress, this can have many possible harmful effects on your health.
What Are Some Effects Of Thyroid Hormones
There are several hormones that are produced in the thyroid gland and secreted from there. In particular, the two hormones thyroxine and triiodothyronine influence processes that regulate the development, growth and metabolism of our body. More specifically, the thyroid gland and its hormones are involved in the following processes:
- Energy regulation and body temperature
- Muscle, nerve, heart, circulatory and digestive activity
- Emotional well-being
- Physical and psychological development
- Skin health, hair health and nail growth
Your thyroid gland can either be overactive or underactive. If you suffer from hypothyroidism, you may experience a lack of interest or energy, weight gain, cold sensations, constipation and an overall lower level of performance. Hypothyroidism usually runs in families and is more common in adults especially in women. Symptoms of hyperthyroidism include nervousness, weight loss, heat and diarrhoea.
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Why Is Insulin So Expensive In The Us
A nurse in 1938 checks the amount of insulin in a needle. For many decades, the only insulin available to people with diabetes came from the pancreases of cattle or pigs. Insulin from animals is still available outside the U.S. and cheaper than a recombinant DNA version. Bettmann/Corbishide caption
A nurse in 1938 checks the amount of insulin in a needle. For many decades, the only insulin available to people with diabetes came from the pancreases of cattle or pigs. Insulin from animals is still available outside the U.S. and cheaper than a recombinant DNA version.
Dr. Jeremy Greene sees a lot of patients with diabetes that’s out of control.
In fact, he says, sometimes their blood sugar is “so high that you can’t even record the number on their glucometer.”
Greene, a professor of medicine and history of medicine at Johns Hopkins University, started asking patients at his clinic in Baltimore why they had so much trouble keeping their blood sugar stable. He was shocked by their answer: the high cost of insulin.
Greene decided to call some local pharmacies, to ask about low-cost options. He was told no such options existed.
Insulin Gets An Upgrade
After the discovery of insulin in 1921 , the use of porcine or bovine insulin to control blood glucose levels in individuals with diabetes became widespread and saved many lives. However, insulin derived from animal pancreases had several limitations, including erratic effects on glucose levels and allergic reactions, both resulting from the production of insulin antibodies by the patients immune system. This immunogenicity was thought to be the result of contamination of insulin with other pancreatic substances and small differences in amino acid composition between human and animal insulin. Purified animal insulins were developed and reduced the occurrence of allergic reactions, but further improvement was needed.
Nevertheless, just 2 years later, Goeddel et al. reported the first successful generation of fully synthetic human insulin. Native human insulin consists of two amino acid chains the A chain and the B chain that are linked by two disulphide bonds. The team chemically synthesized the DNA fragments encoding the two chains and used plasmids to express the A-chain gene in one strain of E. coli and the B-chain gene in another.
The generation of fully synthetic human insulin was a major step forwards in the diabetes field and an important breakthrough in medical biotechnology, paving the way for the FDA approval of many more therapeutic recombinant proteins more than 100 to date.
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