Which Type Of Diabetes May Involve Injections Of Insulin

How Is The Diabetes Drug Insulin Administered

Insulin must be injected for most patients, though there is a new inhaled form. Injections are done with a disposable fine needle and syringe or the use of a pump.

• People with diabetes generally rotate injection sites to prevent tissueinjury and for the best insulin absorption.
• Insulin is absorbed most quickly when it is injected into the abdomen; the thighs and buttocks are other common injection sites.
• Some people with diabetes find it more convenient and comfortable to use newer insulin delivery systems, such as prefilled or cartridge pen insulin dispensers.
• While these eliminate the need to draw up insulin from a bottle, they may limit dosing flexibility. Still, others benefit from the use of insulin pumps, which deliver a continuous dose over 24 hours through an implanted catheter.
• Insulin pumps are more commonly used by people with type 1 diabetes.

Twice Daily Insulin Regimen

Twice daily insulin regimens may be suitable for people with type 1 and type 2 diabetes.

It is important that people on a twice daily regimen keep to a consistent daily routine that includes three meals a day.

A twice daily insulin regimen is described as being biphasic because it has two phases of activity.

At each injection you will take a mixture of short acting and intermediate acting insulin.

The insulin will either need to be manually mixed via syringe or, alternatively, you may take pre-mixed insulin. In type 1 diabetes, a twice daily regimen is suitable in people who have a consistent day to day routine.

A twice daily regimen may allow some flexibility for adjusting doses but not as much as a basal-bolus regimen.

In type 2 diabetes, a twice daily insulin regimen can be useful for people who experience high blood glucose levels after meals.

• Twice daily

Recognizing The Differences Between Young Children And Teens

Since the impact of diabetes or other endocrine issues is different in teenagers than in younger children, we take a slightly different approach with older patients. For example, teens blood sugar can have wider swings for a variety of reasons, including hormonal changes or less parental involvement in monitoring and medicating. We partner with you and your teen to develop practical strategies for controlling their endocrine disorder.

Dealing with diabetes medication and equipment during adolescence can be frustrating or lead to anxiety and depression in some cases. Our pediatric endocrine psychologists work with adolescent and teen patients to help them navigate work with adolescent and teen diabetic patients to help them navigate this challenging time. We also offer group sessions where teenagers with diabetes gather together to receive education, training and group support that includes the ability to network and share experiences.

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Avoiding Injection Bruises And Lumps

Bruising can happen when you catch a tiny capillary under the skin where you have injected. It is quite normal for this to happen occasionally when you are injecting regularly and youre not doing anything wrong.;

If you are concerned, you could make an appointment with your diabetes specialist nurse who will be able to do a review of your injection technique. In some cases, bleeding and bruising can be reduced by something as simple as using a different sized needle or changing your needle after each injection.;

Some people notice hard lumps that can form if you inject in the same place too often. This might be lipohypertrophy ,;or could be something called cutaneous amyloidosis. These lumps can stop the insulin from working properly, so make sure you rotate where you inject and choose a different spot each time. If you notice any lumps, especially if they’re not going away, speak to your healthcare professional for more advice.

Other side effects from injecting a lot can be itching, rashes and other skin irritations. Changing where you inject helps with this too. You can also get treatments from your local pharmacy that can will help with the irritation.

Drugs That Increase Insulin Production

Numerous classes of medications can be used to increase insulin production in people with diabetes.

Most of these medications are effective in treating type 2 diabetes. People with this form of diabetes still have the ability to produce insulin, so they often respond better to treatment.

Some of these medications may be used along with insulin injections to manage blood glucose levels in people with type 1 diabetes.

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Addisons Disease/primary Adrenal Insufficiency

Primary adrenal insufficiency is mediated most commonly by autoimmune mechanisms and is commonly referred to as Addisons disease. Among children, it represents 15% of cases of primary adrenal insufficiency . Addisons disease can exist as an isolated condition or as a component of the autoimmune polyglandular syndromes . Workup of this disorder entails demonstration of inappropriately low cortisol secretion, determination of ACTH status to distinguish primary versus secondary adrenal insufficiency, and imaging of the adrenal glands . Common laboratory derangements in Addisons disease include hyponatremia, hyperkalemia, and hyperchloremic metabolic acidosis.

Pathophysiology

Mucocutaneous manifestations of Addisons disease

Treatment

The treatment of Addisons disease involves replacement of glucocorticoids and mineralocorticoids that the adrenal gland is unable to produce. The dosage of glucocorticoids is adjusted based on clinical context.

What Other Injectable Medicines Treat Type 2 Diabetes

Besides insulin, other types of injected medicines are available. These medicines help keep your blood glucose level from going too high after you eat. They may make you feel less hungry and help you lose some weight. Other injectable medicines are not substitutes for insulin. Learn more about noninsulin injectable medicines.

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How Is Diabetes Mellitus Treated

The aim of treatment in diabetes is to

• reduce circulating glucose to as normal a level as possible
• avoid the acute symptoms of diabetes such as thirst, and
• avoid the long-term complications of diabetes such as eye, nerve and kidney damage. ;

While glucose control is the prime aim of treatment, other factors such as blood pressure and blood cholesterol levels are also very important in the management of diabetes and the prevention of long-term health consequences.;

Type 1 diabetes is always treated with insulin, a life-saving treatment.;Patients will need to take insulin several times a day for the rest of their lives. They will usually learn how to self-administer this.;Insulin is usually given through injections under the skin, normally two to four times a day. An increasing number of patients with type 1 diabetes are being treated with insulin pumps, which provide a continuous supply of insulin.;

Patients need to ensure that their blood glucose levels are kept as normal as possible so that delicate tissues in the body are not damaged by high glucose levels over a long period of time. To achieve this, patients need to measure their glucose regularly and learn how to adjust their insulin doses in order to optimise their glucose levels . Good diabetes control helps to minimise the risk of long-term diabetes complications, as well as short-term symptoms .

What Are The Symptoms Of Diabetes

The symptoms of type 1 diabetes often occur suddenly and can be severe. They include:

• Increased thirst

• Blurred vision

Pregnancy makes most women have to urinate more often and feel hungrier, so these symptoms donââ¬â¢t always mean you have gestational diabetes. But it is important to get tested, because high blood sugar can cause problems for both you and your baby.Ã

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Studies Specific To Insulin Adherence

A 2015 study by Cani et al. showed a decrease in A1C by 0.57% in insulin-treated patients with type 2 diabetes. These patients were provided with an individualized pharmacotherapeutic care plan from a clinical pharmacist, as well as a diabetes education protocol. The education protocol covered topics such as complications , lifestyle changes, foot monitoring, and glucose monitoring. This study showed improved adherence as measured by both the Morisky-Green questionnaire and the Adherence to Medicines Questionnaire .

Farsaei et al. found that patients with type 1 or type 2 diabetes who were classified as having low adherence via the Morisky Medication Adherence scale reported injections being time-consuming, embarrassment, feeling worse afteran injection, forgetfulness, hypoglycemia, cost, weight gain, insulinshortage, and difficulties with in-jection preparation as factors significantly associated with adherence.

Another study published in 2013 by Guo et al. showed a 0.16% greater A1C reduction in patients with type 2 diabetes treated with insulin therapy who were entered into the OPENING education program compared to those with no educational intervention. The OPENING program has seven modules: 1) taking medication, 2) insulin injection technique, 3) blood glucose monitoring, 4) diet, 5) exercise, 6) hypoglycemia prevention, and 7) prevention of complications. Adherence according to the Morisky Medication Adherence Scale improved more in the intervention group .

The Pineal Gland And Gonads

The pineal body, also called the pineal gland, is located in the middle of the brain. It secretes melatonin, a hormone that may help regulate the wake-sleep cycle.

The gonads are the main source of sex hormones. In males, they are located in the scrotum. Male gonads, or testes, secrete hormones called androgens, the most important of which is testosterone. These hormones regulate body changes associated with sexual development, including enlargement of the penis, the growth spurt that occurs during puberty, and the appearance of other male secondary sex characteristics such as deepening of the voice, growth of facial and pubic hair, and the increase in muscle growth and strength. Working with hormones from the pituitary gland, testosterone also supports the production of sperm by the testes.

The female gonads, the ovaries, are located in the pelvis. They produce eggs and secrete the female hormones estrogen and progesterone. Estrogen is involved in the development of female sexual features such as breast growth, the accumulation of body fat around the hips and thighs, and the growth spurt that occurs during puberty. Both estrogen and progesterone are also involved in pregnancy and the regulation of the menstrual cycle.

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Types Of Insulin Administration With Needles Pumps Pens And Why Insulin Is So Expensive

What does insulin do? Help your body turn food into energy, for starters. When youre diabetic, and youre either not producing insulin, or your insulin function is off, all sorts of things can go wrong. From needles, to pens, to pumps, to types of insulin, were here to empower you with clear answers to all your pressing Qs.

In This Article:;

Alvin Powers MD,;Mihail Zilbermint MD, and;Irl Hirsch MD

How Common Is Diabetes Mellitus

Diabetes mellitus is a public health problem around the world.;In 1980, 108 million adults worldwide had diabetes . By 2014 this had risen to 422 million adults . By 2040, the number is expected to be 642 million adults. In the UK, there is estimated to be between;3 and;4 million people with diabetes.;Type 2 diabetes accounts for more than 90% of all patients with diabetes.;

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What Else Can I Do To Control My Blood Glucose Levels

Food, sleep, and exercise are all of vital importance for regulating your blood sugar when you have diabetes.

Problems With The Endocrine System

Too much or too little of any hormone can be harmful to the body. For example, if the pituitary gland produces too much growth hormone, a child may grow excessively tall. If it produces too little, a child may be abnormally short.

Controlling the production of or replacing specific hormones can treat many endocrine disorders in children and adolescents, some of which include:

Adrenal insufficiency. This condition is characterized by decreased function of the adrenal cortex and the consequent underproduction of adrenal corticosteroid hormones. The symptoms of adrenal insufficiency may include weakness, fatigue, abdominal pain, nausea, dehydration, and skin changes. Doctors treat adrenal insufficiency by giving replacement corticosteroid hormones.

Cushing syndrome. Excessive amounts of glucocorticoid hormones in the body can lead to Cushing syndrome. In children, it most often results when a child takes large doses of synthetic corticosteroid drugs to treat autoimmune diseases such as lupus. If the condition is due to a tumor in the pituitary gland that produces excessive amounts of corticotropin and stimulates the adrenals to overproduce corticosteroids, its known as Cushing disease.

Type 1 diabetes can cause long-term complications, including kidney problems, nerve damage, blindness, and early coronary heart disease and stroke. To control their blood sugar levels and reduce the risk of developing diabetes complications, kids need regular injections of insulin.

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Treatment Of Type 1 Diabetes

• taking insulin daily by injections or by insulin pump
• self-monitoring of blood sugar levels by regularly testing droplets of blood in a glucose meter
• self-testing of urine with a test strip for high levels of ketones not routinely, but when problems are suspected
• regulating diet so intake is matched to insulin and exercise
• increasing the amount of slow carbohydrates in the diet, such as beans and fruit, which take longer to be absorbed by the body
• regular exercise
• maintaining regular checks for diabetes complications.

Animal Models In Dm Type 1 Research

Animal models are used in autoimmune diabetes research to understand the pathogenesis and etiology of this disease, and to find and test predictive biomarkers and therapeutic interventions. Currently available models of T1D can be divided into spontaneously autoimmune, chemically induced, virus induced and genetically induced.

Spontaneous autoimmune

• Non-obese diabetic mouse

The NOD mouse is the best known and most widely used animal model for type 1 DM research. It is an inbred, genetically well characterized mouse strain that spontaneously develops T1D. The onset of insulitis occurs at 3â4 weeks of age. The islets of Langerhans are infiltrated by CD4+, CD8+ T lymphocytes, NK cells, B lymphocytes, dendritic cells, macrophages and neutrophils, similar to the disease process in humans. Insulitis leads to destruction of β-cells, resulting in the apparent occurrence of T1D, which varies by sex. The incidence is about 60-80% in females and 10-30% in males. In addition to sex, breeding conditions, gut microbiome composition or diet also influence the onset of T1D. NOD Mice are used to understand the pathogenesis and etiology of the disease, to identify novel autoantigens and biomarkers or to test new intervention strategies.

• BioBreeding Diabetes-Prone rat

• LEW -1AR1 / -iddm rat

Chemically induced

Genetically induced

Virally induced

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Continuous Subcutaneous Insulin Infusion / Insulin Pump Therapy

Continuous subcutaneous insulin infusion , also known as insulin pump therapy, involves having an insulin pump connected to your body.

The pump is not much larger than a mobile phone and delivers a constant feed of insulin into the body via a cannula which stays inserted into the fat under your skin.

At meal times, an increased burst of insulin can be delivered to keep blood glucose levels under control.

Insulin pump therapy is generally offered, by the NHS, to people with type 1 diabetes that have struggled to keep blood glucose levels under control on a multiple daily injection regimen.

Availability of insulin pumps in the UK can vary from one NHS trust to another.

Insulin pump therapy can be particularly beneficial in people that have varied daily routines, are more susceptible to hypoglycemia or have trouble with high blood glucose levels before breakfast.

How Well Does Insulin Treat Diabetes

Efficacy of insulin

• In a 24 week study of patients with type 1 diabetes, regular human subcutaneous insulin before breakfast and dinner plus human insulin isophane suspension twice daily reduced HbA1c by 0.4% from baseline and fasting glucose by -6 mg/dl.
• In a 24 week study of patients with type 2 diabetes, regular human subcutaneous insulin before breakfast and dinner plus human insulin isophane suspension twice daily reduced HbA1c by 0.6% from baseline and fasting glucose by -6 mg/dl.

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Diabetes Sick Day Rules

If you need to take insulin to control your diabetes, you should have received instructions about looking after yourself when you’re ill known as your “sick day rules”.

Contact your diabetes care team or GP for advice if you haven’t received these.

The advice you’re given will be specific to you, but some general measures that your sick day rules may include could be to:

• keep taking your insulin it’s very important;not;to stop treatment when you’re ill; your treatment plan may state whether you need to temporarily increase your dose
• test your blood glucose level more often than usual most people are advised to check the level at least four times a day
• keep yourself well hydrated make sure you drink plenty of sugar-free drinks
• keep eating eat solid food if you feel well enough to, or liquid carbohydrates such as milk, soup and yoghurt if this is easier
• check your ketone levels if your blood glucose level is high

Seek advice from your diabetes care team or GP if your blood glucose or ketone level remains high after taking insulin, if:

• you’re not sure whether to make any changes to your treatment
• you develop symptoms of diabetic ketoacidosis
• you have any other concerns

Read more about;sick day rules