The creation of insulin is a great illustration of what may be done in healthcare when science encounters clinical engineering. Diabetes management’s primary objective is to prevent long-term issues of the ailment. Improving and maintaining glycemic levels over time is a key tool towards this objective. Diabetes is a complex disorder, and it is expected that most individuals will receive insulin injections at a certain point throughout their medication. However, despite the multiple benefits of insulin and its immense influence on the overall well-being of diabetic individuals, the topic remains debatable. On the one hand, insulin contributes to the normal functioning of a patient’s organs. On the other hand, insulin might contribute to severe complications, for example, hypoglycemia, cardiovascular diseases, or weight gain. Nevertheless, insulin should remain one of the treatments for diabetes due to its simplicity and ubiquity.
The primary function of insulin is to maintain the body’s supply of energy by regulating macronutrient amounts. Insulin is required for internal glucose distribution to “insulin-dependent cells/tissues” such as the liver, muscle, and tissues (Rahman et al., 2021, p.5). Therefore, the area of impact of insulin is unlimited, starting with proper liver function. The liver is the major organ responsible for insulin activity. Among the numerous vital actions of insulin, the most significant is nutritional regulation, which involves the formation of glycogen from glucose and the breakdown of stored glycogen into fatty acids (Rahman et al., 2021). According to a review of the research, insulin increases glucose-utilizing activity by accelerating increased glucose consumption while decreasing glucose production (Rahman et al., 2021). Therefore, insulin aids the liver in removing excess glucose from circulation.
In other words, if a patient has adequate energy, the liver reserves any glucose that they do not consume immediately so that it may be utilized for energy afterward. As a result, the liver generates less glucose on its own. In order to keep blood sugar levels within a safe level, the liver releases little quantities of glucose into their circulation amid mealtimes. This regulates the blood sugar levels of an individual and contributes to well-being.
Insulin serves various critical roles throughout all body parts, including muscle tissue. Muscle tissue is “one of the most dynamic tissues in the human body,” accounting for over half of its mass and two-thirds of its protein (Rahman et al., 2021, p.5). According to both observational and clinical findings, people with type 2 diabetes have worse muscular movement and endurance (Rahman et al., 2021, p.5). Since muscle tissue is a primary location for glucose disposal, quantitative reductions in muscle volume in type 2 diabetes patients may have a detrimental effect on total glucose metabolism; consequently, insulin treatment may increase optimum glucose goals.
Like other sections of the body, the muscle requires a constant amount of energy to function properly, and carbs and lipids are the primary energy sources required by muscle cells. Cells are “starved for energy” in the absence of insulin and, therefore, must find an alternative provider (Rahman et al., 2021, p.5). This can result in potentially fatal consequences. In other words, insulin responsiveness is raised, and the patient’s muscle tissue may utilize any available insulin to take up sugar during and after exercise. When their muscles contract during exercise, the cells may absorb sugar and employ it for energy whether or not insulin is present. Thus, insulin is essential on an everyday basis since it facilitates the activities of a person, alleviating difficulties with their implementation.
There is another advantage of insulin which is focused on the variety of approaches to diabetes. Unlike many other illnesses, which only include several methods of treatment, insulin can be consumed through syringe injections, insulin pens, pumps, or even inhalation. This is very helpful since there are several hurdles to insulin therapy, which include reported discomfort, injection fear, and gadget mobility. Patients have traditionally utilized a vial and syringe delivery device to deliver a single dosage of insulin (Kjeldsen & Kurtzhals, 2021). On the other hand, recent treatments offer a variety of delivery systems to practitioners and individuals, allowing therapy to be adjusted to most patient needs and concerns. Insulin-delivery technologies supplement medication research and have the potential to significantly enhance patients’ experiences with insulin administration.
The first method of insulin intake involves advanced insulin pens, which provide several improvements over old vials and syringes, including increased mobility, simplicity, and convenience. Insulin pens also have advanced capabilities such as a big dosage selection and dial, as well as an audible click while administering insulin doses. These may be useful for individuals suffering from diabetes-related problems such as neuropathy and retinopathy, as well as those who are physically, visually, or aurally handicapped.
External insulin pumps are very successful methods that give regular insulin infusion. The pumps employ only accelerated insulin analogs (aspart, glulisine, lispro) or regular human insulins, and dosages can be regulated by the user to offer bolus release with a meal or a low insulin level between meals (Senior & Hramiak, 2019). Additionally, there are fewer risks connected with needle sticks, and a pump is more precise than injections, allowing an individual to better regulate their blood sugar levels. Insulin pumps, therefore, contribute to the convenient intake of insulin without concerns for mobility or doses.
Another successful way of consuming insulin is with the help of the lungs. Due to their enormous surface region for absorption, propensity for fast intake, and the start of effect caused by inhalation, the airways are an efficient route for insulin administration (Mohanti & Das, 2017). Breakthroughs in bronchial therapy have resulted in the creation of more potent nasal sprays that can transport insulin deeper into the lung, as well as the ability to make smaller aerosol particles, both of which aid to maximize distribution. Since inhaled insulins are intended to give a “bolus” or mealtime dosage, oral diabetes medications or basal insulin injections are still required for intense therapy.
Nevertheless, despite such success of insulin and methods of intake which contribute to the overall satisfaction and comfort, insulin imposes several risks and threats to the well-being of a patient. Despite substantial advancements in insulin technologies and therapeutic approaches, medical challenges remain the same. Although there have been numerous gains in effectiveness, security, and even user customization and comfort based on pharmacokinetics and methods of delivery since the first insulins were accessible, further progress is required.
The most serious and prevalent detrimental impact of insulin treatment is hypoglycemia. It is also the rate-limiting element in establishing great glucose control in a sensible way. Both types of diabetes with strict glycemic control have a threefold higher risk of serious hypoglycemia (Strachan & Frier, 2013). This necessitates the need to personalize treatment and glycemic objectives in order to reduce this risk. Severe hypoglycemia typically begins with disorientation, perspiration, or hypertension and can progress to coma, convulsions, cardiac failure, neurological impairments, and death (Strachan & Frier, 2013). People undergoing intense or continuous injection insulin treatment are at an increased risk of experiencing hypoglycemia.
Weight gain is another severe issue that is frequently related to insulin therapy, especially among physicians. When an individual’s blood sugar level is high, their body seems unable to convert sugar into energy (Strachan & Frier, 2013). The kidneys excrete the additional sugar in the form of urine. This results in the classic signs of high blood glucose levels: frequent urination, excessive thirst, and fatigue (Strachan & Frier, 2013). This can dehydrate an individual and consequently cause a person to lose weight in an unhealthy way. However, when a patient begins insulin therapy, their body becomes more capable of converting the glucose in their meals and drinks into energy. This leads to the patient gaining weight in the near term.
Another source of worry among physicians is that insulin may raise the risk of cardiovascular disease. Insulin has major vascular functions via stimulating blood vessels to widen and the release of certain hormones. This causes capillary activation, vasodilation, higher blood circulation, and, as a result, an increase in glucose absorption in conventional insulin target tissues (Dongerkery et al., 2017). Under ordinary circumstances, these and other circulatory effects of insulin aid the connection of metabolic balance. In insulin-resistant people, cardiovascular disease is the primary cause of cause of death and disability. Insulin resistance is commonly described as diminished sensitivity and reactivity to insulin’s metabolic activities (Dongerkery et al., 2017). This key aspect of diabetes and obesity is also a part of high blood pressure, heart disease, and atherosclerosis, all of which are defined by heart dysfunction.
However, it is of utmost importance to understand that there are limits to the provided risks. For example, hypoglycemia linked with insulin treatment may indeed cause anxiety in both patients and physicians. Even though insulin therapy has been linked to a higher rate of insulin resistance than oral medication in research of type 1 diabetes patients, the rate of severe insulin resistance in type 2 diabetes patients is fairly low, approximately 2.5 percent (Strachan & Frier, 2013). Since hypoglycemia is a huge impediment to insulin usage, the introduction of novel insulin variants with enhanced 24-hour time-action patterns could help relieve worries (Home et al., 2014). While hypoglycemia is a known danger of insulin treatment, individuals should realize that incidents can be prevented with mindful awareness and frequent self-monitoring of blood sugar.
When it comes to cardiovascular diseases, the topic proves to be quite dubious. On the one hand, some studies might indicate that insulin impacts the cardiovascular system, leading to heart diseases. Evidence from the primary health care services, on the other hand, clearly suggests that rigorous blood sugar level management with insulin reduced substantially the incidence of cardiovascular problems (Dongerkery et al., 2017). There was a significant decrease in death rates in people with diabetes who had an increased risk of heart disease and received concentrated insulin therapy compared to those who had an intense problem and did not receive aggressive therapy in the study. Van den Bergh’s colleagues discovered that continuous insulin therapy in severely ill patients in the intensive care unit lowered both intensive care fatality and increased mortality (Dongerkery et al., 2017). Thus, there is no data suggesting that insulin is cardiotoxic.
As for substantial weight gain – this is a temporary situation with the start of insulin therapy. Though the increase of body is detrimental to the health of a diabetic person, leading to struggles with liver production, intensive attention to the occurring changes is important. For example, an individual might consult with their physical, deciding upon the dosage of insulin and proper nutrition. Additionally, there are certain physical exercises that can contribute to maintaining the appropriate weight level. As a result, the problem of weight gain is relatively small than other problems connected with insulin intake.
Hence, insulin is a vital medication for people who struggle with diabetes. Insulin regulates blood sugar levels by enabling it to leave the circulation and enter cells and, therefore, decreases pressure on the pancreas to produce these elements. Most diabetic patients rely on insulin on an everyday basis, either opting for insulin pens or pumps. Nevertheless, there are multiple concerns in the medical field and among patients that insulin might contribute to the development of severe complications. For example, the ongoing use of insulin might cause cardiovascular diseases, weight gain, or even hypoglycemia. However, though some of the points have been proven to be either temporary or rare, there is no evidence corroborating the link between hypoglycemia and insulin intake. Therefore, insulin remains to be an important part of the treatment and alleviation of the difficulties.
Dongerkery, S. P., Schroeder, P. R., & Shomali, M. E. (2017). Insulin and its cardiovascular effects: what is the current evidence? Current diabetes reports, 17(12), 1-8.
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Kjeldsen, T., & Kurtzhals, P. (2021). A Hundred Years of Insulin Innovation: When Science Meets Technology. Diabetes, 70(9), 12.
Mohanty, R. R., & Das, S. (2017). Inhaled insulin-current direction of insulin research. Journal of Clinical and Diagnostic Research, 11(4), 1-2.
Rahman, M. S., Hossain, K. S., Das, S., Kundu, S., Adegoke, E. O., Rahman, M.,… & Pang, M. G. (2021). Role of Insulin in Health and Disease: An Update. International Journal of Molecular Sciences, 22(12), 1-19.
Senior, P., & Hramiak, I. (2019). Fast-acting insulin aspart and the need for new mealtime insulin analogues in adults with type 1 and type 2 diabetes: a Canadian perspective. Canadian journal of diabetes, 43(7), 515-523.
Strachan, M. W., & Frier, B. M. (2013). Insulin therapy. Springer.