Insulin is a hormone released from the pancreas that allows the intake and use of sugar in tissues that use blood sugar such as muscle, fat and liver.
What are the Effects of Insulin Resistance?
If there is insulin resistance in the tissues, sugar is a hormone released. It is difficult to get into tissues, use and burn. This causes more insulin to be released. By releasing more insulin, the pancreas almost works "double time" for the use of sugar by the tissues. Excess insulin causes hunger, eating more and snacking, creating a vicious circle. This situation both reduces the insulin reserve and the excess amount of insulin circulating in the blood prepares a suitable environment for the formation of chronic diseases such as obesity, hypertension and atherosclerosis.
How Does Our Body Use Insulin?
Normally between meals and a small amount of insulin is secreted from the pancreas at night, we call it basal insulin. When we eat, our body quickly releases large amounts of insulin. This insulin, which is secreted at mealtime together with basal insulin secretion, ensures that blood sugar is kept under control throughout the day. When our body cannot control sugar levels, sugar accumulates in the blood and comes out in the urine.
People with type 1 diabetes have to have insulin injections for the rest of their lives and take the insulin they can't make from outside. In type 2 diabetes, although the body produces enough insulin, it cannot use the insulin produced well due to insulin resistance. In type 2 diabetes, the insulin produced in the body decreases over time and the need for insulin may arise. There is a type of insulin. Most patients with diabetes use at least two different types of insulin to simulate the body's normal insulin production. The main types of insulin used as medicine today are human insulins obtained through genetic engineering and insulin analogues, which are a modified form of human insulin. lasts around. A meal is eaten 15-30 minutes after short-acting insulin is administered. short acting insulin They are available in transparent bottles. In general, it starts to take effect within 1-3 hours after it is applied under the skin and its effects last for 18-24 hours.
In addition, there are human insulin mixtures consisting of short and medium-acting insulins. These are taken 10-30 minutes before a meal.
Because the recently emerging insulin analogues are used just before the meal or in the first 15 minutes after starting the meal, they are especially preferred in school-age children and younger children who cannot wait for the meal.
Fast-acting insulin analogues start to lower blood sugar in about 15 minutes and their effects last 3-5 hours after injection. It is used just before a meal or within the first 15 minutes.
Long-acting insulin analogues are absorbed slowly and pass into the bloodstream quickly. They start to take effect within a couple of hours and their effects last for at least 24 hours. In addition, insulin analogs have ready-made mixtures as in human insulin.
Insulins can be stored in the refrigerator at 2-8 degrees. Unopened cartridges can be used for up to 30 days.
Insulin cannot be taken orally in tablet form, because the stomach perceives insulin as a nutrient and digests it before it enters the blood to show its effect. For this reason, insulin is used as an injection under the skin with a needle. There have been studies of insulin spray recently, but the use of short-acting insulin by nasal spray has not yet become routine. Today, insulin pens are used to facilitate the use of insulin. These are devices that are both easy to use and easy to carry, and their needles are very small.
How to Adjust the Insulin Dose?
The dose is calculated and adjusted by the physician according to the body's needs. The total daily insulin dose is calculated between 0.5 and 1 unit per kilogram of body weight. The daily requirement of a person is 0.8 mg/kg. After the dose is calculated, the exact dose requirement is calculated according to the blood sugar controls made by the patient. For this, it is necessary to inject insulin several times a day. A lot A person makes short-acting insulin before three main meals, that is, before breakfast, before lunch and before dinner, and before going to bed to control blood sugar while asleep, he makes an intermediate or long-acting insulin at 21 or 22 o'clock.
This method has shown that Diabetes control is better. Less frequently, mixtures of short- and intermediate-acting insulin can be used twice a day, morning and evening. In this case, while short-acting insulin controls the meal to be eaten soon, for example breakfast and dinner; Intermediate-acting insulin controls blood sugar at lunch or at midnight. Some type 2 diabetes patients, on the other hand, need only a small amount of insulin, so they can meet their needs with only one or two medium or long-acting insulins per day. Of course, all these are calculated by the physician and given to the patient.
Some patients may need instant insulin adjustments. These instantaneous adjustments only apply to short-acting insulin and its analogues. If blood sugar is high, if there is ketone in the urine or if a heavy meal is to be eaten, the dose of short-acting insulin is increased by 2 units. If the blood sugar falls below 60 mg/dl or if a heavy physical activity is planned, the insulin dose is reduced by 2 units.
Where and How Insulin Injections Are Made?
Diabetes education nurses in diabetes centers inform the patient about this. Now all insulin treatments are done with insulin pens. Making insulin with plastic injectors plus vials is out of use because there are no insulins. Of course, this is also a great convenience for the patient because the needles of insulin pens are very small.
Insulin injection is very easy with an insulin pen. After washing the hands and cleaning the injection site with alcohol, the insulin cartridge is shaken to make it homogeneous. The cartridge is inserted into the pen and the needle is attached. Air bubbles are eliminated. The dose is adjusted and injected. The needle must be held under the skin for a few seconds to deliver the entire dose. After the injection is completed, the needles should be disposed of in their protected containers.
Insulin is injected under the skin, not into a vein or muscle. Subcutaneous application is the most convenient way in terms of insulin absorption. In general, the most suitable areas are the abdomen, calves � The upper parts are the hip and outer-upper part of the arm. The most important point here is not to use the same place all the time. Otherwise, there may be swellings or muscle meltdowns, absorption disorders may occur. Since insulin needles are quite thin, they usually do not leave scars. There is little to no pain. Some people say that rubbing the skin with ice for a few minutes relieves the pain.
Sometimes a small amount of bleeding or a small wound may occur after the injection, this is nothing to worry about. Probably the needle came across a thin vein under the skin. It is almost impossible for insulin to mix directly with the blood in subcutaneous application, so it is unnecessary to worry about minor bleeding.
What is the Cause of Insulin Resistance?
Insulin resistance, genetic predisposition, sedentary lifestyle, unhealthy diet result occurs. Although we often see insulin resistance on the basis of genetic predisposition, we have been feeling the weight of environmental factors more recently, with people leading a more sedentary life, increased consumption of refined foods, and the demand for "fast food" style nutrition.
This is why sometimes our patients say, "My mother and father were fed with butter, honey and cream, nothing happened to them, why is it happening to me?" We are faced with questions such as: What we forget here is the place of movement in the lifestyle of the ancients, which cannot be ignored.
What are the Symptoms of the Disease?
Feeling hungry 2-3 hours after meals, trembling in the hand standing up Insulin resistance should be suspected in cases of cold sweats and fainting sensations, the desire to eat sweets, the presence of obese and diabetic people in the family of the person who gradually gains weight.
Can we say that everyone who says "I can't lose weight, I'm fat" has high insulin resistance?
100% although often yes. Sometimes, apart from insulin resistance, hypothyroidism, some endocrine diseases (cushing's disease, etc.) can also cause obesity. However, in the presence of obese and diabetic individuals in the family, people who complain about not being able to lose weight should definitely look for insulin resistance and related diseases. There are many studies identified dr. It has been observed in many scientific studies that it increases the risk of Esophageal, Large Intestine, Bile ducts, Pancreas, Breast, Uterus, Ovary, Prostate, Kidney, Bladder, Thyroid and Lymph cancers.
Also, insulin resistance, diabetes, stroke, cardiovascular diseases. It is the culprit for many diseases such as atherosclerosis, hypertension, fatty liver, lipid elevations, polycystic ovary disease and infertility. It has also been determined that there is a link between Alzheimer's (dementia) and insulin resistance.
How to Treat the Disease
The treatment of insulin resistance, first of all, is to reveal the factors that make up the picture in the patient. and requires recognition. With lifestyle changes and regular exercise, calories consumed should be increased, body fat ratio should be decreased, and healthy eating habits should be gained. Only with exercise and healthy nutrition, 60% of insulin resistance can be corrected. These factors can be supported with drugs that break insulin resistance in patients when necessary, but it should be known that drugs alone cannot cope with insulin resistance.
How Does Sugar Harm Our Body?
Sugar It is the primary energy source for cells. The fact that sugar cannot be taken up and used by the tissues and that it rises above a certain level in the blood acts like a poison in the body. When glucose (sugar) to be used as fuel cannot be taken into the cell, they cannot be fed adequately, cells and tissues cannot perform their basic functions. In addition, the high level of sugar in the environment directly contributes to the destruction. Thus, a chronic damage process begins in almost all tissues.
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