How insulin is introduced into the human body. Insulin: what is it and what types are there? Substances added to insulin

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There are many misconceptions about insulin. The inability to explain such a situation as why some people maintain their weight of 90 kg on 250 g of carbohydrates per day, while others have difficulty maintaining their 80 kg on 400 g of carbohydrates, gives rise to many questions. It's time to figure this all out.

General information about insulin

Insulin is a hormone that regulates blood glucose levels. When a person eats a portion of carbohydrates, blood glucose levels rise. The pancreas begins to produce the hormone insulin, which begins to utilize glucose (after stopping the liver’s own processes of glucose production) distributing it to the cells of the whole body. In a healthy person, when the level of glucose in the blood decreases, insulin ceases to be produced. The relationship between insulin and cells is healthy.

When insulin sensitivity is impaired, the pancreas produces too much insulin. The process of penetration of glucose into cells becomes more difficult, the presence of insulin in the blood becomes very long, which leads to bad consequences for (it slows down).

However, insulin is not only a blood sugar regulator. It also stimulates protein synthesis in muscles. It also suppresses lipolysis (fat breakdown) and stimulates lipogenesis (accumulation of fat reserves).

Insulin helps transport glucose to cells and penetrate cell membranes into the interior.

It is this last function that gives it its bad reputation. So, some argue that a diet rich in foods that stimulate increased insulin production will certainly lead to excess weight. This is nothing more than a myth, which will be dispelled below.

The physiological effect of insulin on various processes in the body:

Ensuring the entry of glucose into cells. Insulin increases the permeability of cell membranes by 20 times to glucose, thereby supplying it with fuel.
Stimulates synthesis, inhibits breakdown in the liver and muscles.
Causes hypoglycemia (low blood sugar).
Stimulates the synthesis and inhibits the breakdown of fats.
Stimulates fat deposits in adipose tissue.
Stimulates the synthesis and inhibits the breakdown of proteins.
Increases the permeability of cell membranes to amino acids.
Stimulates the synthesis of mRNA (information key to anabolic processes).
Stimulates the production and enhances the effect of growth hormone.

A complete list of functions can be found in the reference book V.K. Verin, V.V. Ivanov, “HORMONES AND THEIR EFFECTS” (St. Petersburg, FOLIANT, 2012).

Is insulin friend or foe?

The sensitivity of cells to insulin in a healthy person is very dependent on body composition (percentage of muscle and fat). The more muscles there are in the body, the more energy you need to get to feed them. The muscle cells of a muscular person are more willing to consume nutrients.

The figure below shows a graph of insulin levels in people with a low percentage of fat and people who are obese. As you can see, even during periods of fasting, insulin levels in obese people are higher. People with a low percentage of fat have a higher rate of absorption of nutrients, so the presence of insulin in the blood is shorter than in obese people, whose absorption of nutrients occurs much more slowly.

I'm sure you've all heard of insulin. It is injected into diabetics. You may also know that for those who do not suffer from diabetes, insulin in the human body is produced by the pancreas. However, you most likely do not know what role insulin plays in the human body, and it is very simple. Its purpose is to take glucose (sugar) from the blood and transfer it to the cells.

What happens when there is too much sugar in the blood?

When there is a lot of sugar in the blood, it is very bad for the body. And the thing is, if the glucose level is too high and does not decrease for a long time, then the person develops a disease called “diabetes”. It destroys blood vessels and kills you little by little. Glucose sticks to proteins, which in turn stick to each other, causing them to become denser. This phenomenon is called protein glycosylation. It has now become the subject of increased research in the field of antiaging. Diabetics have such high blood sugar levels that the rapid glycosylation of proteins causes tissue destruction throughout the body.

So, when the body senses that blood glucose levels are high, it releases insulin to bring the sugar back to normal. In this case, blood sugar levels. Here's what happened to me (and what's most likely happening to you): I used to eat a lot of foods that contained carbohydrates in a concentrated form - cereal, pasta, juice or something else - and my blood sugar levels were I was rapidly flying up. One thing to always remember is that all carbohydrates are actually sugar in one form or another. Simple carbohydrates are sweet sugar, that is, ordinary glucose, sucrose or fructose. Complex carbohydrates, another name for starch, are “a combination of several forms of sugar.” However, in terms of their chemical composition, different types of sugar are substances of the same order.

Why do blood sugar levels rise?

So, every time I ate foods containing concentrated carbohydrates, my blood sugar levels spiked. Have you forgotten that the human body is not adapted to the gradual absorption of substances? Seeing such an amount of sugar in the blood, my pancreas said to itself, “Hey, there’s a lot of sugar here! We need to get rid of it,” and immediately sent a large portion of insulin into the blood. Glucose was sent straight to the fat storage, where, turning into fat, it settled. Blood sugar levels dropped significantly.

Thus, two things were happening to me at the same time: firstly, fat was being stored, and secondly, there were no calories left in the blood to support energy, as a result of which I experienced hunger and fatigue. Of course, I again absorbed foods containing carbohydrates - they are low in fat and are not harmful to health! - and everything to the beginning. It turned out to be a vicious circle: I eat foods that contain concentrated carbohydrates. When I started farming, humanity was limited in receiving those foods that contained carbohydrates in a concentrated form. In prehistoric times, fruits were the main source of carbohydrates. A person received most of his carbohydrates in the summer and autumn during their ripening period. People consumed carbohydrate-containing foods, their bodies stored fat, and then they spent it throughout the long, cold winter.

But now the lack of food in winter is no longer a problem for us. In fact, the majority of the population is provided with fruit all year round, and all year round we consume huge quantities of foods with a high concentration of carbohydrates, store fat all year round and, in the end... yes, we get fat!

The Other Side of the Coin: Without Insulin You Can't Preserve Fat

People who have had diabetes since childhood know this. One of the signs of juvenile diabetes is significant weight loss. I know one young man who, according to him, lost nine kilograms in two days after his pancreas stopped producing insulin! Without insulin, fat cannot be stored.

Insulin cycle

Knowledge of these mechanisms provides us with a powerful weapon in the fight against fat deposits. If we can control insulin levels in the body, we can control fat storage. When does insulin enter the blood?

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Why does a person need a pancreas?

The pancreas is the most important organ of the digestive system. It is customary to distinguish two functions of the pancreas:

Exocrine;
Endocrine.

The exocrine function (internal) is the secretion of pancreatic juice, which contains enzymes required for the digestion process. Scientists have calculated that on average, from half a liter to a liter of such juice is released per day. When food is absorbed, a number of hormones are produced, acting as an activator of a whole chain of chemical reactions and a stimulator of pancreatic juice enzymes. The substances and microelements that make up this juice are required in order to neutralize the acidic component. They help absorb carbohydrates and promote digestion.

The endocrine function (internal) realizes the synthesis of necessary hormones and the regulation of carbohydrate, fat and protein metabolic processes. The gland releases insulin and glucagon into the blood. These hormones are synthesized by the islets of Langerhans, consisting of 1-2 million alpha and beta cells.

Alpha cells produce glucagon, which is essentially an insulin antagonist. It provides an increase in glucose levels. Alpha cells are involved in the production of lipocaine, the role of which is to prevent fatty degeneration of the liver. Alpha cells account for about 20%.

Beta cells produce insulin. Their tasks include regulating fat and carbohydrate metabolic processes in the body. Under the influence of insulin, glucose enters tissues and cells from the blood, causing a decrease in sugar. The number of beta cells is dominant, about 80%. Disorders in beta cells lead to disruptions in the production of insulin, which threatens the development of diabetes mellitus.

What is insulin and why is it needed?

Insulin is a protein hormone. It is synthesized by the pancreas, namely by the beta cells of the islets of Langerhans. The purpose of insulin is to regulate metabolic processes. Surprisingly, insulin is the only hormone of its kind whose ability is to lower glucose levels. No human hormone has such an effect. It is this uniqueness that requires special attention, since its activity and condition immediately affect the functioning of the body.

Without insulin, liver and muscle cells refuse to work at all. The hormone influences the metabolism of nucleic acids, fat and protein. It is difficult to overestimate the importance of this vital hormone. It implements functions such as:

stimulation of the formation of glycogen and fatty acids in the liver and glycerol in adipose tissue;
activation of protein and glycogen synthesis in muscles after absorption of amino acids;
provokes inhibition of: glycogen breakdown and glucose production through the body’s internal reserve stores:
inhibits the synthesis of ketone bodies, the breakdown of lipids and muscle proteins.

Why does diabetes appear?

Diabetes mellitus is a disease caused by a deficiency of insulin and a failure in the production of this hormone by the pancreas. This disease entails disruption of all metabolic processes, especially carbohydrate ones. It is problems with carbohydrate metabolism that stimulate pathological changes in all human systems and organs.

The disease is characterized by an inability to extract energy from food, which is converted into glucose. As soon as glucose enters the bloodstream, its level begins to steadily increase. When working properly, this looks like a signal addressed to the pancreas, which activates the release of insulin, which suppresses sugar. The hormone ensures the penetration of glucose from the blood into cells, which is an energy source for normal life.

If there are disturbances in the functioning of this mechanism, then glucose does not penetrate into the cells, but accumulates in the blood. The amount of sugar increases even with a missed meal or with a lack of insulin. This leads to the fact that the body begins to intensively release an additional portion of sugar into the blood. Conventionally, insulin can be described as a key that opens access for glucose into cells and maintains the required amount of sugar in the blood.

Among the causes of diabetes mellitus, doctors name the following:

Genetic predisposition plays a leading role. Mostly, this disease is inherited.
Overweight (relative to BMI - body mass index);
Diseases of the pancreas (cancer, pancreatitis) and endocrine glands;
Viral infections (chickenpox, rubella, hepatitis, influenza);
Age (approximately every 10 years the risk of getting the disease doubles);

Definition of illness

There are a number of symptoms associated with diabetes mellitus. Patients note that they constantly experience dry mouth and a feeling of thirst. Exceeding the daily fluid intake by several times, the frequency of urination and diuresis increases accordingly.

A characteristic symptom is a sudden change in weight, both up and down. Dryness and itching are also observed on the skin. Increased sweating, muscle weakness, prolonged healing of wounds and cuts.

A progressive disease leads to complications. Vision is impaired and frequent headaches appear. Pain in the heart and limbs may occur. Usually the liver becomes enlarged. There is a decrease in the sensitivity of the feet and an increase in pressure. Swelling is a common complication. You can smell the acetone exuded by the patient.

ogormonah.ru

Insulin is...

Insulin is a hormone produced by the pancreas. It is produced by special endocrine cells called islets of Langerhans (beta cells). There are about a million islets in the adult human pancreas, whose function is to produce insulin.

Insulin - what is it from a medical point of view? This is a protein hormone that performs extremely important necessary functions in the body. It cannot enter the gastrointestinal tract from the outside, since it will be digested, like any other protein substance. Every day the pancreas produces a small amount of background (basal) insulin. After eating, the body supplies it in the amount that our body requires to digest the incoming proteins, fats and carbohydrates. Let us dwell on the question of what is the effect of insulin on the body.

Functions of insulin

Insulin is responsible for maintaining and regulating carbohydrate metabolism. That is, this hormone has a complex, multifaceted effect on all tissues of the body, largely due to its activating effect on many enzymes.

One of the main and best known functions of this hormone is to regulate blood glucose levels. The body needs it constantly, because it is one of the nutrients that are needed for the growth and development of cells. Insulin breaks it down into a simpler substance, facilitating its absorption into the blood. If the pancreas produces it in insufficient quantities, glucose does not nourish the cells, but accumulates in the blood. This can lead to increased blood sugar levels (hyperglycemia), which has serious consequences.

Insulin also transports amino acids and potassium.
Few people know the anabolic properties of insulin, which are superior even to the effect of steroids (the latter, however, act more selectively).

Types of insulin

There are different types of insulin based on their origin and action.

Fast-acting has an ultra-short effect on the body. This type of insulin begins its work immediately after administration, and its peak is reached after 1-1.5. Duration of action - 3-4 hours. It is administered immediately before or before meals. Drugs that have a similar effect include Novo-Rapid, Insulin Apidra and Insulin Humalog.

Short-term insulin has an effect within 20-30 minutes after use. After 2-3 hours, the concentration of the drug in the blood reaches its maximum point. In total, it lasts about 5-6 hours. The injection is given 15-20 minutes before meals. In this case, approximately 2-3 hours after the administration of insulin, it is recommended to have “snacks”. The time of eating should coincide with the time of maximum effect of the drug. Short-acting medications - drugs “Humulin Regulya”, “Insulin Actrapid”, “Monodar Humodar”.

Intermediate-acting insulins act on the body much longer - from 12 to 16 hours. It is necessary to make 2-3 injections per day, often with an interval of 8-12 hours, since they do not begin to act immediately, but 2-3 hours after administration. Their maximum effect is achieved after 6-8 hours. Medium-acting insulins - drugs "Protafan" (human insulin), "Humudar BR", "Insulin Novomix".

And finally, long-acting insulin, the maximum concentration of which is reached 2-3 days after administration, despite the fact that it begins to act after 4-6 hours. Apply it 1-2 times a day. These are drugs such as Insulin Lantus, Monodar Long, Ultralente. This group also includes the so-called “peakless” insulin. What it is? This is insulin, which does not have a pronounced effect, acts gently and unobtrusively, therefore it practically replaces the “native” one produced by the pancreas.

Human insulin — this is an analogue of the hormone produced by our pancreas. This insulin and its genetically engineered “brothers” are considered more advanced than other types of animal-derived insulin.

Porcine hormone is similar to the above, with the exception of one amino acid in the composition. May cause allergic reactions.

Cattle insulin is the least similar to human insulin. It often causes allergies because it contains a protein foreign to our body. The level of insulin in the blood of a healthy person has strict limits. Let's take a closer look at them.

What should be the level of insulin in the blood?

On average, a healthy person has a normal fasting blood insulin level that ranges from 2 to 28 µU/mol. In children it is slightly lower - from 3 to 20 units, and in pregnant women, on the contrary, it is higher - the norm is from 6 to 27 µU / mol. In the event of an unreasonable deviation of insulin from the norm (the level of insulin in the blood is increased or decreased), it is recommended to pay attention to your diet and lifestyle.

Increased insulin entails the loss of almost all of its positive qualities, which negatively affects health. It increases blood pressure, promotes obesity (due to improperly transported glucose), has a carcinogenic effect and increases the risk of diabetes. If you have high insulin, you should pay attention to your diet, trying to eat as many foods with a low hypoglycemic index as possible (low-fat dairy products, vegetables, sweet and sour fruits, bran bread).

There are also cases when insulin levels in the blood are low. What is it and how to treat it? Excessively low blood sugar leads to brain problems. In this case, it is recommended to pay attention to foods that stimulate the pancreas - kefir, fresh blueberries, boiled lean meat, apples, cabbage and parsley roots (the decoction is especially effective when taken on an empty stomach).

Thanks to proper nutrition, you can normalize insulin levels and avoid complications, in particular diabetes.

Insulin and diabetes

There are two types of diabetes - 1 and 2. The first is a congenital disease and is characterized by the gradual destruction of beta cells of the pancreas. If there are less than 20% of them left, the body can no longer cope and replacement therapy becomes necessary. But when there are more than 20% of islets, you may not even notice any changes in your health. Often, short and ultra-short insulin, as well as background (extended) insulin, are used in treatment.

The second type of diabetes is acquired. Beta cells with this diagnosis work “conscientiously”, but the action of insulin is impaired - it can no longer perform its functions, as a result of which sugar again accumulates in the blood and can cause serious complications, including hypoglycemic coma. To treat it, drugs are used that help restore the lost function of the hormone.

Patients with type 1 diabetes mellitus desperately need insulin injections, but type 2 diabetics often rely on medications for a long time (years or even decades). True, over time you still have to “sit down” on insulin.

Insulin treatment helps get rid of complications that develop when the body ignores the body's need to receive it from the outside, and also helps reduce the load on the pancreas and even contribute to the partial restoration of its beta cells.

It is believed that once you start insulin therapy, you can no longer go back to medications (pills). However, you will agree that it is better to start injecting insulin earlier, if necessary, than to refuse it - in this case, serious complications cannot be avoided. Doctors say that there is a chance in the future to refuse injections for type 2 diabetes if insulin treatment was started on time. Therefore, carefully monitor your well-being, do not forget to adhere to diets - they are an integral factor in good health. Remember that diabetes is not a death sentence, but a way of life.

Scientists continue to persistently search for a way to make life easier for people with diabetes. In 2015, the United States introduced a new development - a device for insulin inhalation, which will replace syringes, making the life of diabetics easier. This device can already be purchased in American pharmacies with a doctor's prescription.

In the same year (and again in the USA), the so-called “smart insulin” was introduced, which is injected into the body once a day, activating independently when necessary. Despite the fact that it has so far only been tested on animals and has not yet been tested on humans, it is clear that scientists made very important discoveries in early 2015. Let's hope that in the future they will delight diabetics with their discoveries.

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Production of insulin in the body

The pancreas is responsible for the production of insulin - for this it has special beta cells. In the human body, this hormone regulates carbohydrate metabolism, and therefore its secretion is vital. How does this happen? The process of insulin production is multi-stage:

First, the pancreas produces preproinsulin (a precursor to insulin).
At the same time, a signal peptide (L-peptide) is produced, whose task is to help preproinsulin enter the beta cell and turn into proinsulin.
Further, proinsulin remains in a special structure of the beta cell - the Golgi complex, where its maturation occurs over a long period of time. At this stage, proinsulin is broken down into C-peptide and insulin.
The produced insulin reacts with zinc ions and remains in this form inside the beta cells. In order for it to enter the blood, glucose in it must have a high concentration. Glucagon is responsible for suppressing insulin secretion; it is produced by the alpha cells of the pancreas.

The most important task of insulin is to regulate carbohydrate metabolism by affecting insulin-dependent tissues of the body. How does this happen? Insulin binds to the receptor of the cell membrane (membrane), and this triggers the work of the necessary enzymes. The result is the activation of protein kinase C, which is involved in metabolism inside the cell.

Insulin is needed in the body to ensure constant blood sugar levels. This is achieved due to the fact that the hormone:

Helps improve glucose absorption by tissues.
Reduces the activity of glucose production in the liver.
Triggers the work of enzymes responsible for the breakdown of blood sugar.
Accelerates the transition of excess glucose into glycogen.

The level of insulin in the blood also affects other body processes:

Assimilation of amino acids, potassium, phosphorus and magnesium ions by cells.
Conversion of glucose in the liver and fat cells into triglycerides.
Production of fatty acids.
Correct DNA reproduction.
Suppression of protein breakdown.
Reducing the amount of fatty acids entering the blood.

Insulin and blood glucose levels

How are blood glucose levels regulated by insulin? In a person who does not have diabetes, blood sugar remains approximately the same even when he has not eaten for a long time, since the pancreas produces insulin in the background. After eating, carbohydrate foods are broken down in the mouth into glucose molecules, and they enter the bloodstream. Glucose levels increase and the pancreas releases stored insulin into the blood, normalizing the amount of blood sugar - this is the first phase of the insulin response.

Then the gland again produces the hormone to replace the spent one, and slowly sends new portions to the breakdown of sugars absorbed in the intestines - the second phase of the response. The remaining unspent excess glucose is partially converted into glycogen and stored in the liver and muscles, and partially becomes fat.

When some time passes after eating, the amount of glucose in the blood decreases and glucagon is released. Due to this, glycogen accumulated in the liver and muscles is broken down into glucose, and blood sugar levels become normal. The liver and muscles left without glycogen supply receive a new portion of it in the next meal.

Norm

The level of insulin in the blood shows how the body processes glucose. The insulin norm for a healthy person is from 3 to 28 µU/ml. But if high sugar is combined with high insulin, this may mean that tissue cells are resistant (insensitive) to the hormone that the gland produces in normal quantities. A high level of blood glucose and a low level of insulin indicates that the body does not have enough hormone produced, and blood sugar does not have time to break down.

Increased level

Sometimes people mistakenly believe that increased insulin production is a favorable sign: in their opinion, in this case you are protected from hyperglycemia. But in fact, excessive release of the hormone is not beneficial. Why does it happen?

Sometimes this is due to a tumor or hyperplasia of the pancreas, diseases of the liver, kidneys and adrenal glands. But most often, increased insulin production occurs in type 2 diabetes, when the hormone is produced in normal quantities, but tissue cells “do not see it” - insulin resistance occurs. The body continues to secrete the hormone and even increases its amount, trying in vain to deliver carbohydrates inside the cells. Therefore, with type 2 diabetes mellitus, the level of insulin in the blood is constantly higher than normal.

Scientists believe that the reason why a cell stops accepting insulin is genetics: nature provides that insulin resistance helps the body survive hunger, allowing it to store fat in prosperous times. For modern society in developed countries, hunger has not been relevant for a long time, but the body, out of habit, gives a signal to eat more. Fat accumulations are deposited on the sides, and obesity becomes a trigger for metabolic disorders in the body.

Reduced level

Low insulin may indicate type 1 diabetes, when a lack of the hormone leads to incomplete utilization of glucose. Symptoms of the disease are:

Frequent urination.
Intense constant thirst.
Hyperglycemia - glucose is in the blood, but due to a lack of insulin it is not able to cross the cell membrane.

An endocrinologist must understand the reasons for a decrease or increase in insulin production - you need to contact him with blood tests.

The main reasons for decreased insulin production are:

Improper nutrition, when a person gives preference to fatty, carbohydrate, high-calorie foods. Therefore, the insulin produced by the pancreas is not enough to break down incoming carbohydrates. The production of the hormone increases, and the beta cells responsible for this are depleted.
Chronic overeating.
Stress and lack of sleep inhibit insulin production.
Deterioration of immunity as a result of chronic diseases and as a consequence of past infections.
Physical inactivity - due to a sedentary lifestyle, blood glucose increases, and the amount of insulin produced by the body decreases.

medaboutme.ru

“> Insulin is an essential hormone; without it, the normal process of cellular nutrition in the body is impossible. It helps transport glucose, potassium and amino acids. The effect is the maintenance and regulation of carbohydrate balance in the body. Being a peptide (protein) hormone, it cannot enter the body from the outside through the gastrointestinal tract - its molecule will be digested, like any protein substance in the intestines.

Insulin in the human body is responsible for metabolism and energy, that is, it has a multifaceted and complex effect on metabolism in all tissues. Many effects are realized due to its ability to act on the activity of a number of enzymes.

Insulin is the only hormone that helps reduce blood glucose.

In type 1 diabetes mellitus, the level of insulin in the blood is disrupted, in other words, due to its insufficient production, the level of glucose (sugar) in the blood increases, urination increases and sugar appears in the urine, and therefore this disease is called diabetes mellitus. In type 2 diabetes, the action of insulin is impaired. For such purposes, it is necessary to monitor IRI in the blood serum, that is, a blood test for immunoreactive insulin. Analysis of the content of this indicator is necessary in order to identify the type of diabetes mellitus, as well as to determine the correct functioning of the pancreas for further prescription of therapeutic treatment with the help of medications.

An analysis of the level of this hormone in the blood makes it possible not only to detect any disturbance in the functioning of the pancreas, but also to accurately distinguish between diabetes mellitus and another similar disease. This is why this study is considered very important.

In diabetes mellitus, not only carbohydrate metabolism is disrupted, fat and protein metabolism also suffers. The presence of severe forms of diabetes mellitus in the absence of timely treatment can lead to death.

“> The human body's need for insulin can be measured in carbohydrate units (CU). The dosage always depends on the type of medication being administered. If we talk about functional insufficiency of pancreatic cells, in which there is a reduced level of insulin in the blood, a drug that stimulates the activity of these cells, for example, butamide, is indicated for the therapeutic treatment of diabetes mellitus.

According to its mechanism of action, this drug (as well as its analogs) improves the absorption of insulin present in the blood by organs and tissues, which is why it is sometimes said to be insulin in tablets. The search for it for oral administration is indeed underway, but to date not a single manufacturer has introduced such a drug onto the pharmaceutical market that can save millions of people from daily injections.

Insulin drugs are usually administered subcutaneously. Their action on average begins after 15-30 minutes, the maximum level in the blood is observed after 2-3 hours, the duration of action is 6 hours. In the presence of severe diabetes, insulin is administered 3 times a day - on an empty stomach in the morning, at lunch and in the evening.

In order to increase the duration of action of insulin, long-acting drugs are used. These medications include a zinc-insulin suspension (duration of action is from 10 to 36 hours) or a protamine-zinc suspension (duration of action 24 to 36 hours). The above drugs are designed for subcutaneous or intramuscular administration.

Drug overdose

In cases of overdose of insulin drugs, a sharp drop in blood glucose may occur, this condition is called hypoglycemia. Among the characteristic signs, aggressiveness, sweating, irritability, a strong feeling of hunger should be noted, in some cases hypoglycemic shock occurs (convulsions, loss of consciousness, cardiac dysfunction). At the first symptoms of hypoglycemia, the patient urgently needs to eat a piece of sugar, a cookie, or a piece of white bread. In the presence of hypoglycemic shock, intravenous administration of a 40% glucose solution is necessary.

The use of insulin can cause a number of allergic reactions, for example, redness at the injection site, hives and others. In such cases, it is advisable to switch to another drug, for example, insulin, after consulting with your doctor. You cannot refuse the prescribed administration of the substance on your own - the patient may quickly develop signs of hormone deficiency and coma, which are caused by high levels of glucose in the blood.

tvoelechenie.ru

Insulin is a hormone that plays a key role in regulating blood glucose levels. A lack of insulin, or an inability to respond adequately to insulin, can lead to the development of diabetes symptoms. In addition to its role in controlling blood sugar levels, insulin is also involved in fat storage.

The role of insulin in the body

Insulin is a hormone that plays several roles in the body's metabolism. Many of the body's cells require insulin because insulin transports glucose, which will be converted into energy inside the cells. Insulin helps control blood glucose levels through signaling in the liver, muscles and fat cells. Insulin therefore allows cells to allow glucose into themselves, which will be used for conversion into energy. If the body has enough energy, insulin will signal the liver to store it. The liver can store up to about 5% of it by weight in the form of glycogen.

Insulin and type 1 diabetes (http://telaviv-clinic.ru/sakharnyi-diabet)

In type 1 diabetes, the body does not produce enough insulin to regulate blood glucose levels. Without the presence of insulin, many of the body's cells will not be able to take up glucose from the blood and, therefore, the body will need to use other sources of energy. People with type 1 diabetes need insulin to compensate for the lack of insulin in the body.

Insulin and type 2 diabetes

Type 2 diabetes is characterized by an ineffective response to insulin. This is called insulin resistance. As a result, the body will be less able to transport glucose from the blood. Depending on the level of insulin resistance, people with type 2 diabetes may also need to take insulin injections to manage their blood sugar levels.

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Diabetes

Insulin- a hormone produced by the internal secretion of the pancreas in response to increased blood sugar levels. The main function of this hormone is to normalize or reduce excess amounts of glucose in the blood to normal and deliver glucose to tissue cells, which contributes to the production of energy in the body.

Insulin is considered a fat-producing hormone because it provides sugar reserves in cells, and when it accumulates excessively, it begins to convert it into fat, which is deposited in the subcutaneous fatty tissue. From all of the above, it is not difficult to conclude that foods containing sugar affect the rise of glucose in the blood and provoke the production of this hormone. This increases fat reserves in the body.

Insulin completes its work a day after production, but not everyone knows about the significance of this hormone and its effect on health. For example, with type 1 diabetes, the hormone stops being produced in the body, and with type 2 diabetes, insulin resistance develops when organs and cells do not respond to its effects. Meanwhile, a lack of the hormone is dangerous for the body, since its deficiency disrupts certain mechanisms. This can manifest itself in a constant feeling of hunger, even after eating a large meal. This is why people with type 1 diabetes should replenish it with regular injections. In type 2 diabetes, as already noted, insulin resistance develops, so there is often an increased level of this hormone in the blood of patients. Despite this, the cells practically do not respond to insulin, or give a weak reaction, so glucose is not absorbed. To normalize blood sugar, different types of insulin are used.

Insulin preparations

Ultra-short-acting insulins are absorbed along with food. They begin to act immediately or after 15 minutes. They are administered immediately before a meal, when the volume of a single serving is determined. The dose is calculated taking into account the amount of food. This insulin is effective for 4 hours. Peak action is 1 – 1.5 hours after administration.

Ultra-short-acting insulins include the following drugs: Humalog, Novorapid.

Short-acting insulins, or simple insulins, are slow-acting. Introduced in 20 – 40 minutes. before meals. It is important that the peak of its effect coincides with the peak of the increase in blood sugar, so you need to eat a strictly defined amount of food for which the dose of this drug is calculated. Between meals you need to have snacks, such as a second breakfast and a second dinner. Peak action is 2 – 4 hours after administration.

Short-acting insulins include the following drugs: “Actrapid NM”, “Humulin Regular”, “Insuman Rapid GT”.

Long-acting insulins are used to maintain optimal blood glucose levels between meals and at night. They act 1 – 3 hours after administration. Duration of action – 10 – 14 hours. They are administered 2 times a day: in the morning before breakfast and in the evening before dinner. The time of its effect directly depends on the dose. If you give a large dose, it will last longer than a small dose. The peak of action occurs 6–8 hours after administration.

Long-acting insulins include the following drugs: “Humulin NPH”, “Protafan NM”, “Insuman Basal”

Non-peak or extended-release insulins are administered once a day at any time. These include drugs: Lantus, Lemevir.

All of the drugs listed are a pre-formulated combination of insulins in strictly defined proportions and different durations of action.

Classification of insulins

According to their classification, insulins can be single-type or combined. Single-species contain an extract of the pancreas of one type of animal, for example, a bull or a pig. Combined insulins consist of extracts of the pancreas of several types of animals, but today such insulins are not in demand.

Based on species, insulins are distinguished: human, cattle, pork and whale insulins.

According to the degree of purification, they can be traditional, monopeak and monocomponent.

How insulin works

When insulin enters the liver, the work of the cells of this organ is activated and the processing of the hormone begins. When insulin reacts with cells, sugar processing is activated. The hormone converts it into fats and glycogens. Thus, insulin reduces the production of sugar in liver cells, which means it helps lower blood sugar levels.

Insulin pumps, syringes, and pen syringes are used to deliver insulin into the body. Disposable syringes for insulin administration can come in different dosages. The patient can independently inject the drug into the blood through a needle. Pen syringes are designed for repeated use. A special regulator on the pen syringe helps determine the required dose of insulin. The patient places it on the handle and inserts it into the blood through a needle. Insulin pumps with a catheter are inserted into a vein, and the pump is attached to the belt. The patient programs the device for the required amount of insulin, which gradually enters the body throughout the day.

What else you need to know about insulin

There is a certain list of foods that sharply raise blood sugar and cause a strong insulin reaction:

All products containing sugar, as well as pure sugar;

Flour (baked goods, pasta and others);

Potato;

White polished rice.

An alternative to sweet foods will be berries, fruits, except citrus fruits, grapes and bananas. Flour products will replace porridge. White rice should be replaced with brown or black (wild) rice. Instead of potatoes, you should eat cauliflower.

Chromium, a mineral found in large quantities in broccoli, will help normalize blood glucose levels. In addition, meat, legumes, cereals, bran, and liver are rich in chromium.

Athletes call insulin an anabolic hormone. In practice, it is an indiscriminate anabolic that can both store fat and increase muscle mass. However, it should not be blamed for the cause of obesity, since it is just doing its job, maintaining a safe, stable blood sugar level of 80 - 100 mg / deciliter. When the sugar level exceeds the specified norm, the hormone “removes” excess glucose from the blood and transforms it into adipose tissue, liver glycogen or muscle glycogen.

What kind of substance is this - insulin, which is so often written and talked about in connection with the now widespread diabetes mellitus? Why at some point does it cease to be produced in the required quantities or, conversely, is synthesized in excess?

Insulin is a biologically active substance (BAS), a protein hormone that controls blood glucose levels. This hormone is synthesized by beta cells belonging to the islet apparatus (islets of Langerhans) of the pancreas, which explains the risk of developing diabetes mellitus when its functional abilities are impaired. In addition to insulin, other hormones are synthesized in the pancreas, in particular, the hyperglycemic factor (glucagon), produced by the alpha cells of the islet apparatus and also involved in maintaining a constant glucose concentration in the body.

The normal levels of insulin in the blood (plasma, serum) of an adult are in the range from 3 to 30 µU/ml (or up to 240 pmol/l).

In children under 12 years of age, indicators should not exceed 10 µU/ml(or 69 pmol/l).

Although somewhere the reader will encounter a norm of up to 20 µU/ml, somewhere up to 25 µU/ml - in different laboratories the norm may differ slightly, so always, when donating blood for analysis, you need to focus on the exact data (reference values) of that laboratory, which conducts research and not on the values given in various sources.

Increased insulin may indicate a pathology, for example, the development of a pancreatic tumor (insulinoma), and physiological state(pregnancy).

Decreased insulin levels may indicate development or simply physical fatigue.

The main role of the hormone is hypoglycemic

The action of insulin in the human body (and not only the human body, in this regard, all mammals are similar) lies in its participation in metabolic processes:

This hormone allows sugar obtained from food to freely penetrate into the cells of muscle and fat tissue, increasing the permeability of their membranes:
It is an inducer of glucogen production from glucose in liver and muscle cells:
Insulin promotes the accumulation of proteins, increasing their synthesis and preventing the breakdown, and fatty products (it helps adipose tissue to capture glucose and convert it into fat (this is where excess fat reserves come from and why excessive love of carbohydrates leads to obesity);
Increasing the activity of enzymes that enhance the breakdown of glucose ( anabolic effect), this hormone interferes with the work of other enzymes seeking to break down fats and glycogen ( anti-catabolic effect of insulin).

Insulin is everywhere, it is involved in all metabolic processes occurring in the human body, but the main purpose of this substance is to ensure carbohydrate metabolism, since it is the only hypoglycemic hormone, while its “opponents,” hyperglycemic hormones that strive to increase blood sugar, are noticeably more numerous (adrenaline, growth hormone, glucagon).

First of all, the mechanism for the formation of insulin by β-cells of the islets of Langerhans is triggered by an increased concentration of carbohydrates in the blood, but before this the hormone begins to be produced as soon as a person, having chewed a piece of something edible, swallows it and delivers it to the stomach (and it is not at all necessary that the food product was carbohydrate). Thus, food (any) causes an increase in the level of insulin in the blood, and hunger without food, on the contrary, reduces its content.

In addition, the process of insulin formation is stimulated by other hormones, increased concentrations of certain microelements in the blood, for example, potassium and calcium, and increased amounts of fatty acids. The growth hormone somatotropin (GH) inhibits insulin production to the greatest extent. Other hormones also reduce insulin production to some extent, for example, somatostatin, synthesized by the delta cells of the islet apparatus of the pancreas, but its effect still does not have the effect of somatotropin.

It is obvious that fluctuations in the level of insulin in the blood depend on changes in the glucose content in the body, so it is understandable why, when studying insulin using laboratory methods, they also carry out a determination.

Video: insulin and its functions - medical animation

Insulin and sugar sickness of both types

Most often, the secretion and functional activity of the described hormone changes in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus - NIDDM), which often develops in middle-aged and elderly people who are overweight. Patients often wonder why excess weight is a risk factor for developing diabetes. And this happens as follows: the accumulation of fat reserves in excess quantities is accompanied by an increase in the blood, which, in turn, contribute to a reduction in the number of receptors for the hormone and a change in affinity for it. The result of such disorders is a decrease in insulin production and, accordingly, a decrease in its level in the blood, which leads to an increase in the concentration of glucose, which cannot be utilized in a timely manner due to insulin deficiency.

By the way, some people, having learned the results of their tests (hyperglycemia, ), upset for a while about this, begin to actively look for ways to prevent a terrible disease - they urgently “go on” a diet that reduces body weight. And they do it very right! Such experience can be very useful for all patients at risk for diabetes: timely measures can delay the development of the disease itself and its consequences, as well as dependence on drugs that lower blood sugar in the blood serum (plasma) for an indefinite period.

A slightly different picture is observed in type 1 diabetes mellitus, which is called insulin-dependent diabetes mellitus (IDDM). In this case, there is more than enough glucose around the cells; they simply bathe in a sugar environment, but they cannot absorb important energy material due to an absolute deficiency of the conductor - there is no insulin. Cells cannot take in glucose, and as a result of such circumstances, disruption of other processes in the body begins to occur:

Reserve fat, without being completely burned in the Krebs cycle, is sent to the liver and participates in the formation of ketone bodies;
A significant increase in blood sugar leads to incredible thirst, a large amount of glucose begins to be excreted in the urine;
Carbohydrate metabolism is directed along an alternative pathway (sorbitol), forming an excess of sorbitol, which begins to be deposited in various places, forming pathological conditions: cataracts (in the eye lens), polyneuritis (in nerve conductors), (in the vascular wall).

The body, trying to compensate for these disorders, stimulates the breakdown of fats, as a result of which the content of cholesterol in the blood increases, but the level of the beneficial fraction of cholesterol decreases. Atherogenic dysproteinemia reduces the body's defenses, which is manifested by changes in other laboratory parameters (fructosamine and glycosylated hemoglobin increase, the electrolyte composition of the blood is disrupted). In this state of absolute insulin deficiency, patients become weaker, constantly thirsty, and produce large amounts of urine.

In diabetes mellitus, a lack of insulin ultimately affects almost all organs and systems, that is, its deficiency contributes to the development of many other symptoms that enrich the clinical picture of the “sweet” disease.

What excesses and deficiencies “tell”

Increased insulin, that is, an increase in its level in blood plasma (serum), can be expected in the case of certain pathological conditions:

Insulinomas are tumors of the tissue of the islets of Langerhans that produce hypoglycemic hormone uncontrollably and in large quantities. This neoplasm produces a fairly high level of insulin, while the fasting glucose level is reduced. To diagnose this type of pancreatic adenoma, the ratio of insulin and glucose (I/G) is calculated using the formula: quantitative value of the hormone in the blood, µU/ml: (sugar content determined in the morning on an empty stomach, mmol/l - 1.70).
The initial stage of the formation of non-insulin-dependent diabetes mellitus, later insulin levels will begin to fall, and sugar will rise.
Obesity. Meanwhile, here and in the case of some other diseases, it is necessary to distinguish between cause and effect: in the first stages, it is not obesity that causes increased insulin, but, on the contrary, a high level of the hormone increases appetite and promotes the rapid transformation of glucose supplied with food into fat. However, everything is so interconnected that it is not always possible to clearly trace the root cause.
Liver diseases.
Acromegaly. In healthy people, high insulin levels quickly reduce blood glucose, which significantly stimulates the synthesis of somatotropin; in patients with acromegaly, an increase in insulin levels and subsequent hypoglycemia does not cause any particular reaction from growth hormone. This feature is used as a stimulation test when monitoring hormonal balance (intravenous injection of insulin does not cause a significant increase in growth hormone either one hour or 2 hours after insulin administration).
Itsenko-Cushing syndrome. Impaired carbohydrate metabolism in this disease is caused by increased secretion of glucocorticoids, which suppress the process of glucose utilization, which, despite the high level of insulin, remains in the blood in high concentrations.
Insulin is elevated in muscular dystrophy, which is the result of various metabolic disorders.
Pregnancy proceeding normally, but with increased appetite.
Hereditary intolerance to fructose and galactose.

Injecting insulin (fast-acting) under the skin causes a sharp jump in the hormone in the patient's blood, which is used to bring the patient out of a hyperglycemic coma. The use of the hormone and glucose-lowering drugs to treat diabetes mellitus also leads to an increase in insulin in the blood.

It should be noted that although many people already know that there is no cure for elevated insulin levels, there is a treatment for a specific disease in which a similar “disorder” occurs in the hormonal status and disruption of various metabolic processes.

A decrease in insulin levels is observed in both type 1 and type 2 diabetes mellitus. The only difference is that in NIDDM the hormone deficiency is relative and is caused by factors other than the absolute deficiency in IDDM. In addition, stressful situations, intense physical activity or exposure to other unfavorable factors lead to a drop in the quantitative values of the hormone in the blood.

Why is it important to know your insulin levels?

Absolute insulin levels obtained in laboratory tests do not in themselves have much diagnostic value, since without quantitative values of glucose concentration they do not say much. That is, before judging any disorders in the body associated with the behavior of insulin, its relationship to glucose should be studied.

For this purpose (to increase the diagnostic significance of the analysis), glucose stimulation test for insulin production(stress test), which shows that in people with latent diabetes mellitus, the hypoglycemic hormone produced by the beta cells of the pancreas is delayed, its concentration grows more slowly, but reaches higher values than in healthy people.

In addition to the glucose loading test, the diagnostic search uses provocative test or, as it is called, a fasting test. The essence of the test is to determine the quantitative values of glucose, insulin and C-peptide (the protein part of the proinsulin molecule) in the patient’s blood on an empty stomach, after which the patient is limited in food and drink for a day or more (up to 27 hours), conducting a study of the indicators every 6 hours, of interest (glucose, insulin, C-peptide).

So, if insulin is elevated mainly in pathological conditions, with the exception of normal pregnancy, where an increase in its level is considered a physiological phenomenon, then identifying a high concentration of the hormone, along with a decrease in blood sugar, plays an important role in diagnosis:

Tumor processes localized in the tissue of the islet apparatus of the pancreas;
Hyperplasia of islet tissue;
Glucocorticoid deficiency;
Severe liver pathology;
Diabetes mellitus at the initial stage of its development.

Meanwhile, the presence of such pathological conditions as Itsenko-Cushing syndrome, acromegaly, muscular dystrophy, and liver diseases require a study of insulin levels, not so much for diagnostic purposes, but to monitor the functioning and preservation of the functionality of organs and systems.

How do they take and pass the test?

Before the study, the patient is explained the significance of the analysis and its features. The reaction of the pancreas to food, drinks, medications, and physical activity is such that the patient should fast for 12 hours before the study, not engage in heavy physical work, and avoid taking hormonal medications. If the latter is impossible, that is, the medications cannot be ignored, then an entry is made on the analysis form that the test is being carried out against the background of hormone therapy.

Half an hour before venipuncture (blood is taken from a vein), the person waiting in line for the test is asked to lie down on the couch and relax as much as possible. The patient should be warned that failure to comply with the rules may affect the results and then a return to the laboratory, and, therefore, repeated restrictions will be inevitable.

Insulin injection: only the first injection is scary, then it becomes a habit

Since so much attention has been paid to the hypoglycemic hormone produced by the pancreas, it would be useful to briefly dwell on insulin as a drug prescribed for various pathological conditions and, first of all, for diabetes mellitus.

The administration of insulin by patients themselves has become commonplace; even children can cope with it of school age, whom the attending physician teaches all the intricacies (to use a device for administering insulin, observe the rules of asepsis, navigate the properties of the drug and know the effect of each type). Almost all patients with type 1 diabetes and patients with severe non-insulin-dependent diabetes mellitus are on insulin injections. In addition, some emergency conditions or complications of diabetes, in the absence of effect from other medications, are treated with insulin. True, in cases of type 2 diabetes, after stabilization of the patient’s condition, the hypoglycemic hormone in injection form is replaced by other drugs used orally, so as not to bother with syringes, make calculations and depend on an injection, which can be quite difficult to give to yourself without habit, even if there are some skills in performing simple medical procedures.

The best medicine with a minimum of side effects and without serious contraindications is recognized as an insulin solution, which is based on human insulin substance.

In its structure, the hypoglycemic hormone of the pig pancreas is most similar to human insulin; in most cases, it saved humanity for many years before semi-synthetic or DNA-recombinant forms of insulin were obtained (using genetic engineering). Currently, only human insulin is used to treat diabetes mellitus in children.

Insulin injections have the task of maintaining normal blood glucose concentrations, preventing extremes: jumps up (hyperglycemia) and falling levels below acceptable values (hypoglycemia).

Prescribing types of insulin, calculating their dose in accordance with the characteristics of the body, age, and concomitant pathology performed only by a doctor on a strictly individual basis. He also teaches the patient how to inject insulin on his own, without resorting to outside help, designates areas for insulin administration, gives advice on nutrition (food intake should be consistent with the flow of the hypoglycemic hormone into the blood), lifestyle, daily routine, and physical activity. In general, in the endocrinologist’s office, the patient receives all the necessary knowledge on which the quality of his life depends; the patient himself can only use it correctly and strictly follow all the doctor’s recommendations.

Video: about administering an insulin injection

Types of insulins

Patients receiving hypoglycemic hormone in injection form will have to find out what types of insulins there are, at what time of day (and why) they are prescribed:

Long-acting and extra-long-acting insulins are administered once a day; they are not suitable for emergency situations (until they reach the blood). Of course, in case of coma, ultra-short-acting insulins are used, which quickly restore insulin and glucose levels, bringing them closer to normal values.

When prescribing different types of insulin to a patient, the doctor calculates the dose of each, the method of administration (under the skin or into the muscle), indicates the mixing rules (if necessary) and the hours of administration in accordance with food intake. Probably, the reader has already realized that treatment of diabetes (with insulin, in particular) will not tolerate a frivolous attitude towards diet. Meals (main) and “snacks” are very closely related to the level of insulin at the time of the meal, therefore they must be strictly controlled by the patient himself - his health depends on this.

Video: about the action of insulin and its types

The course of such a multi-stage and complex process as metabolism is influenced by various biologically active substances and hormones, including, which is produced by special islets of Langerhans-Sobolev, which are located in the thickness of the pancreas. It takes part in almost all metabolic processes in the body.

What is insulin?

Insulin is a peptide hormone, very important for normal nutrition and cell function; it is a transporter of glucose, potassium and amino acids. It is designed to regulate. Therefore, after eating, an increase in the amount of this substance in the blood serum is recorded in response to the production of glucose.

The process of normal cellular nutrition without insulin is impossible, and this hormone is essential. Insulin is a protein hormone, so it cannot penetrate the body through the gastrointestinal tract, since it will immediately be digested, like any protein.

How does insulin work?

Insulin is responsible for energy and has a complex effect on metabolism in all tissues. It is able to influence the activity of many enzymes.

Insulin is the only hormone that can reduce blood glucose levels.