WHAT IT IS AND HOW IT IS USED

Transcription

1 ABC of insulin WHAT IT IS AND HOW IT IS USED ABC of insulin

2 Why do I have to take insulin? In most cases, type 2 diabetes is treated with oral antidiabetics, as well as with diet and exercise. These medications help your pancreas to produce more insulin or make it work better, therefore they are able to control blood glucose levels. However, in time the pancreas provides lower and lower amounts of insulin, until it becomes insufficient. At this point it may be necessary to treat diabetes with insulin. Insulin is administered by subcutaneous injection. Your doctor will give you explanations on insulin treatment

3 What is insulin and how does it work? Insulin is a substance produced by the beta cells of your pancreas; its task is to enable the entry of glucose into the cells. Insulin behaves like a key that unlocks a door, allowing glucose to enter the cells. In this way, insulin helps to lower the blood glucose level. In other words, insulin makes the right fuel (glucose) available to our body.

4 The pancreas releases insulin into the bloodstream in two different ways: 1 In amounts adequate to the presence of sugar in the blood, as soon as the pancreas beta cells detect that blood glucose is high after a meal rich in sugar. The richer the meal, the more insulin is released. 2 During fasting periods, e.g. between meals or at night while we sleep, the liver releases sugar into the bloodstream, to make sure that the brain is always supplied with food. For this food to be used by our body, even while we are not eating, the pancreas releases insulin in small amounts, but continuously, to prevent blood glucose from rising. This also happens at night, as we need insulin to keep blood glucose under control until morning.

5 If you have diabetes, it may be necessary to treat it with insulin. When? Generally after many years of treatment with oral medications, especially if blood glucose levels are not kept under control. Insulin may also be necessary every time your diabetes is not well controlled, i.e. when blood sugar levels are too high and medications are not enough. Your doctor may prescribe fast acting insulin every time you eat, or basal insulin, also known as slow acting insulin, to control your blood glucose between meals and at night. BREAKFAST LUNCH DINNER Insulin at meals Basal insulin Blood glucose The duration of insulin may vary significantly between individuals or in the same individual. For example, as regards fast acting insulins, the effect starts after a few minutes, peaks after 1-2 hours, then drops until it disappears entirely after 4-5 hours.

6 How is insulin used? Insulin is a natural hormone that is only effective if injected subcutaneously, using appropriate insulin syringes or pens. The amount of insulin to be injected is prescribed by your doctor and is called insulin dose. The dose varies according to needs and is measured in insulin units (insulin IUs) Insulin is injected after disinfecting and slightly lifting a small skin fold in certain areas of the body. WHERE TO INJECT IT? Around the navel n the front of the thigh In the side of the arm In the side of the buttock It is recommended to rotate the injection site to prevent the swelling and bruises that appear if you repeat the injection too many times in the same site. Front Back

7 SYRINGES Since it was discovered, insulin has been injected using syringes. Over the years, the syringes have become increasingly small and the needles increasingly thin. PENS In addition to syringes, insulin pens have been available for over 10 years. There are two types of insulin pens: Pre-filled or disposable, which are sold with the insulin already inside. Rechargeable; these are used with insulin cartridges. Pre-filled injection pens facilitate insulin therapy because: They are discrete: they look like normal pens and are handy and light. They don t have to be stored in the refrigerator after the first use. They facilitate dosage control. Insulin, like other hormones, must be handled with care. The vials containing insulin are sensitive to heat, so they must be stored in a cool place or in the lower part of the refrigerator (never in the freezer!).

8 How to store and dispose of pre-filled injection pens Pre-filled injection pens can be taken anywhere. As explained below, these are some steps to be followed to ensure proper functioning of the pen Keep all pens not in use in the refrigerator. Do not freeze. After the first use, do not keep in the refrigerator but at room temperature. Do not use the pen after the expiry date on the label and the packaging. Protect it from excessive heat, humidity and light. Remove the needle after each use; do not store the pen with the needle still inside. Dispose of the pen after 28 days from the first use, even if there is still insulin inside. Dispose of the pen correctly, in accordance with applicable regulations.

9 Can insulin be harmful? What are the risks? Insulin is necessary for the functioning of your body. We cannot live without insulin. The main function of insulin is to lower blood glucose. People who take insulin may face certain risks, in particular low blood glucose levels, lipodistrophy, and weight gains. LOW BLOOD GLUCOSE Insulin administered in excessive amounts can cause an excessive decline in blood glucose, causing what is known as low blood glucose or hypoglycemia, i.e. blood glucose below 70 mg/dl. Low blood glucose can occur even if you delay a meal or burn too much glucose (e.g. after running). For more information on low blood glucose and how to manage it, please refer to the specific guide brochure at WEIGHT INCREASE Insulin can cause weight increase (2-4 Kg), mainly because it facilitates the entry of glucose into the body, particularly if combined with a wrong diet and an inactive lifestyle life. To control weight gains, it is important to follow a healthy lifestyle through correct nutrition and exercise. For more detailed information please refer to the specific guide brochure at LIPODYSTROPHY In a small percentage of cases, if injected always in the same site, insulin may cause an alteration of subcutaneous fat, like a sinking of the skin, which may also involve the muscle. To prevent it, remember to rotate the injection site.

10 Is insulin therapy always Insulin is not always necessary to treat diabetes. However, if you have had diabetes for many years and the pancreas is no longer able to produce insulin, then you will have to start and continue insulin therapy. Sometimes, however, insulin may only be necessary for short periods of time and in special situations. When these periods are over, you can resume treatment with oral antidiabetics only. IN WHAT SITUATIONS IS INSULIN TAKEN FOR A LIMITED PERIOD? During long-term cortisone therapy Before a surgical procedure During a heart attack or stroke Before and during an instrumental exam: e.g. a particular radiographic examination. When diabetes is uncompensated, and therefore hemoglobin (HbA1c) is very high.

11 necessary? Is it for life? WHY? Cortisone opposes the action of insulin. It protects from possible side effects of other medications administered orally before, during and immediately after the procedure. Insulin protects the vessels and the heart. Optimal blood glucose levels help to overcome the acute phase of myocardial infarction. Some oral antidiabetic medications may cause side effects. Insulin is the safest medication to prevent possible problem (e.g. kidney problems) during certain radiological examinations. In case of uncompensated diabetes, and sometimes also when the condition is first diagnosed, insulin is prescribed, usually for short periods.

12 The complete line of brochures dedicated to Diabetes is available for download from What Is Diabetes CAUSES AND CONSEQUENCES Low blood glucose HOW TO RECOGNIZE IT AND WHAT DO TO Complications WHICH COMPLICATIONS, WHY THEY OCCUR, AND HOW TO PREVENT THEM Le complicanze Diabetes and special situations ILLNESS, TRAVEL AND HOLIDAYS Diabete e situazioni particolari Correct lifestyle NUTRITION AND EXERCISE RECOMMENDATIONS ABC of insulin WHAT IT IS AND HOW IT IS USED L ipoglicemia Il corretto stile di vita Che cos è il diabete ABC of insulin What Is Diabetes Low blood glucose Complications Diabetes and special situations Correct lifestyle ABC of insulin Also available in the following languages: Italian French Spanish German Russian Romanian Albanian Filipino Hindi Arabic Chinese For more information please contact your doctor or call toll-free Every day from 8:30 a.m. to 9:30 p.m. Copyright 2012, Eli Lilly Italia SpA. Tutti i diritti riservati. ITDBT00284i