Insulin old & new

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2. INTRODUCTION Insulin is a hormone that is importantfor metabolism and utilization of energy from theingested nutrients - especially glucose. Insulin is produced in the islets of Langerhans inthe pancreas. The name insulin comes from theLatin insula for "island" from the cells that producethe hormone in the pancreas. Insulins structure varies slightly between species ofanimal. Both porcine (from pigs) and bovine (fromcows) insulin are similar to human insulin butporcine insulin resembles human insulin moreclosely. 3. Dr. Nicolae Paulescu , Romanian scientist inventedInsulin in 1916. On January 11, 1922 Leonard Thomson a 14 yearold boy who was dyeing of Diabetes , was given thefirst experimental dose of insulin and his life saved. In 1923 , Banting and Macleod were awarded thenoble prize for their work on discovering insulin. 4. WHAT DOES INSULIN DO ? It causes the cells in the liver, muscle, and fat tissue to take upglucose from blood and convert it to glycogen that can bestored in the liver and muscles. Insulin also prevents the utilization of fat as an energy source.In absence of insulin or in conditions where insulin is lowglucose is not taken up by body cells, and the body begins touse fat as an energy source. Insulin also controls other body systems and regulates theamino acid uptake by body cells. It has several other anabolic effects throughout the body aswell. 5. INDICATIONS OF INSULIN THERAPYAt onset :Fasting > 250 mg /dlPost prandial > 300mg/dlHbA1c > 9.0%OHA FailureFasting >150mg/dlRandom or Post prandial > 200mg/dlHbA1c >8.5%Co-morbid conditionsSevere systemic infection or sepsisAcute Myocardial Infarction / Unstable AnginaDiabetic Ketoacidosis/Hyperosmolar stateDiabetic Kidney DiseasePre - gestational / Gestational Diabetes 6. TYPES OF INSULIN Duration of action ( in hours ) of insulin preparationsInsulinOnset Peak DurationRapid- acting(insulin analogues: