Factors That Modify Insulin Levels
Dietary fiber is associated with lower levels of fasting insulin .
Foods with high glycemic index cause a faster and greater insulin spike after their digestion. For instance, fruit juice has a much greater glycemic index than fruits due to the removal of the fiber .
In a study on over 13,000 non-diabetic men and women, high alcohol intake was associated with low fasting insulin levels .
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The Glut4 Vesicle Fusion Machinery
GLUT4 vesicles immobilized at the cell periphery rapidly fuse with the membrane. This is brought about through formation of a SNARE complex between VAMP2 on the vesicles and synatxin4 and SNAP23 on the plasma membrane . The formation of the SNARE complex is regulated by a fine balance of a number of proteins such as Munc18c, Synip, and Doc2b, which receive input emanating from Akt and the phosphatase PTP-1B .
The kinetics, stoichiometry, and upstream regulation of the fusion step still need to be fully investigated. Intriguingly, there are studies of additional participation of Ca2+-regulated proteins such as Doc2b, Tctex1d2, and E-Syt1 , and insulin-dependent Ca2+-spikes have been recorded in muscle cells , suggesting that the ion may impart some fine-tuning to the fidelity and timeliness of GLUT4 vesicle fusion. Lastly, and importantly, the fusion event requires insulin-induced actin polymerization, evincing the contribution of the actin cytoskeleton at different steps in the process of GLUT4 translocation .
The Release Of Insulin In Response To A Meal
The neat and tidy insulin responses described above only occur in laboratory settings. In the real world, the secretion of insulin stimulated by food intake proves far more difficult to predict due to the multitude of variables involved, such as:
- Presence of specific nutrients, including amino acids
- Physical makeup of the foods
- Rate of gastric emptying
- Speed of gastrointestinal motility
Furthermore, neural input as well as other digestive hormones such as incretin affect insulin response.
Specific nutrients produce distinct insulin responses. For instance, non-esterified fatty acids , which may come directly from high-fat foods or from the synthesis of excess carbohydrates, lead to increased output of glucose and reduce insulin sensitivity. There’s some indication, too, that they alter glucose-stimulated insulin secretionin the short-term, elevated levels of NEFA in the blood have been linked to increased glucose-stimulated insulin secretion, but chronically high levels of NEFA result in decreased glucose-stimulated insulin secretion as well as decreased insulin synthesis.
How Do You Choose The Right Syringe For Injecting Insulin
Just as there are different sizes of syringes for administering insulin, there are also varying sizes of insulin needles. Shorter needles usually mean less sting when injecting. The downside is that the shallower the injection is, the longer it takes for the insulin to work. Your doctor will help you find the balance thats best for you.
Insulin Synthesis Processing And Packaging In Pancreatic
Humans have a single insulin gene, INS , located on chromosome 11, the transcription of which is controlled largely by upstream enhancer elements that bind key transcription factors that include IDX1 , MafA, and NeuroD1 along with numerous coregulators . In the insulin-producing pancreatic -cells, these are required for insulin gene expression and contribute to the regulation of INS transcription in response to glucose and autocrine insulin signaling . Given the role of these enhancer elements, transcription factors, and their coregulators in controlling the expression of insulin and many additional components of the -cell secretory pathway, such as glucose transporter 2 and the insulin processing enzyme PC1/3, they are key defining contributors to the establishment and maintenance of -cell identity .
Transit of immature secretory granules through the TGN, and their subsequent budding and maturation, is controlled by a host of regulatory proteins, including newly identified vesicle-sorting by proteins such as SORCS1 and HID-1 . Insulin biosynthesis in this manner is generally rapid and efficient, with only 12% of the protein remaining as proinsulin within mature secretory granules where insulin couples with Zn2+ and exists as a hexameric crystal with the cation. Transport of the insulin hexamer into the secretory granules is thought to be mediated by ZnT8 or related zinc transporters .
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What Happens If I Have Too Little Insulin
People with diabetes have problems either making insulin, how that insulin works or both. The main two types of diabetes are type 1 and type 2 diabetes, although there are other more uncommon types.
People with type 1 diabetes produce very little or no insulin at all. This condition is caused when the beta cells that make insulin have been destroyed by antibodies , hence they are unable to produce insulin. With too little insulin, the body can no longer move glucose from the blood into the cells, causing high blood glucose levels. If the glucose level is high enough, excess glucose spills into the urine. This drags extra water into the urine causing more frequent urination and thirst. This leads to dehydration, which can cause confusion. In addition, with too little insulin, the cells cannot take in glucose for energy and other sources of energy are needed to provide this energy. This makes the body tired and can cause weight loss. If this continues, patients can become very ill. This is because the body attempts to make new energy from fat and causes acids to be produced as waste products. Ultimately, this can lead to coma and death if medical attention is not sought. People with type 1 diabetes will need to inject insulin in order to survive.
What Causes Someone To Be Prescribed Insulin
If your body doesnt make insulin or doesnt make enough, you are eventually diagnosed with type 1 diabetes. It used to be called juvenile diabetes, but new estimates show that as many as half of people with type 1 diabetes are not diagnosed until adulthood. On the other hand, if your body doesnt use insulin properly, you have type 2 diabetes.
While people with type 1 diabetes need to take insulin to survive, many people with type 2 are able to stave off insulin use or even avoid it altogether by exercising, losing weight, adapting healthier eating habits, or using other prescription medications.
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Drugs That Increase Insulin Production
Everyone has a different body that responds differently to lifestyle changes. Many people with diabetes type-1 and type-2 face trouble managing blood glucose levels with diet changes and exercise. Therefore, they should contact their doctor to prescribe medicines that stimulate insulin production in the body. In this way, the pancreas releases more insulin to manage diabetes.
Many diabetes patients do not get much benefit from lifestyle changes and diet control alone. They need medication to stimulate the pancreas to increase the production of insulin. Various classes of medicines are helpful in insulin production in people with diabetes type-2. Some drugs that increase insulin production in your body are:
What Is Insulin Made Of
Insulin is made in different ways. You and your healthcare team will discuss which insulin you can take.
- Human insulin this is synthetic and made in a laboratory to be like insulin made in the body.
- Analogue insulin the insulin molecule is like a string of beads. Scientists have managed to alter the position of some of these beads to create genetically engineered insulin known as analogues.
- Animal insulin This isnt used much anymore, but some people find that insulin from animals works best for them. It is usually from a cow or pig.
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Insulin Function In Human Body
Insulin is a hormonal agent produced by the pancreas that has a number of important functions in the body, particularly in the control of blood sugar levels and avoiding hyperglycemia. It also has a result on several other areas of the body, consisting of the synthesis of lipids and regulation of enzymatic activity.
The Mapk Signaling Pathway
The MAPK pathway is activated when IRS-1 binds to growth factor receptor-bound protein 2 . SOS binds to Grb2 and then to Ras, causing GDPâGTP exchange and the activation of Ras.
Activated Ras recruits c-Raf, which phosphorylates and activates MAPK/Erk kinase . MEK then phosphorylates extracellular signal-regulated kinase . Once activated, Erk is translocated to the nucleus, where its subsequent phosphorylation and transcriptional activation by transcription factors, such as ELK1, ultimately promote cell division, protein synthesis, and cell growth .
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Insulin Sensitivity And Your Dose
You may hear your healthcare professional talk about insulin sensitivity. This is how well your body is using insulin to get your blood sugar levels down. People with high sensitivity need less insulin than those with low sensitivity.
Your healthcare professional can test you for insulin sensitivity, and this will help them decide what dose of insulin you will need, and if insulin of you need it at all.
What Severe Complications Can Occur Because Of Rationing Or Running Out Of Insulin
Diabetic ketoacidosis is an emergency condition that results if you dont have enough insulin to regulate your blood sugar. DKA causes your body to break down fat for energy in the absence of insulin. This leads to a dangerous accumulation of acids known as ketones in your blood that can cause your brain to swell and your body to go into shock.
Signs of diabetic ketoacidosis include:
- Thirst or a very dry mouth
- Frequent urination
- High levels of ketones in your urine
- Nausea, vomiting, or stomach pain
- Difficulty breathing
- A fruity or acetone odor on your breath
- Confusion or acting drunk while sober
DKA is so common and can come on so quickly that it is the first sign of Type 1 diabetes in 20% of cases, and the way many type 1 diabetics are first diagnosed with the condition. If you go into diabetic ketoacidosis, dont try to hide it or make light of it. Treat it as the emergency it is and get to a hospital as soon as possible to recover. Ive had people tell me theyre tired of taking insulin, or that theyre rationing it due to cost. In type 1 diabetes, thats all it takes to end up in a life-threatening situation, says Dr. Zilbermint.
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What Is Insulin Resistance
Insulin resistance, also known as impaired insulin sensitivity, happens when cells in your muscles, fat and liver dont respond as they should to insulin, a hormone your pancreas makes thats essential for life and regulating blood glucose levels. Insulin resistance can be temporary or chronic and is treatable in some cases.
Under normal circumstances, insulin functions in the following steps:
- Your body breaks down the food you eat into glucose , which is your bodys main source of energy.
- Glucose enters your bloodstream, which signals your pancreas to release insulin.
- Insulin helps glucose in your blood enter your muscle, fat and liver cells so they can use it for energy or store it for later use.
- When glucose enters your cells and the levels in your bloodstream decrease, it signals your pancreas to stop producing insulin.
For several reasons, your muscle, fat and liver cells can respond inappropriately to insulin, which means they cant efficiently take up glucose from your blood or store it. This is insulin resistance. As a result, your pancreas makes more insulin to try to overcome your increasing blood glucose levels. This is called hyperinsulinemia.
As long as your pancreas can make enough insulin to overcome your cells weak response to insulin, your blood sugar levels will stay in a healthy range. If your cells become too resistant to insulin, it leads to elevated blood glucose levels , which, over time, leads to prediabetes and Type 2 diabetes.
Focus On What You Are Eating To Stimulate Pancreas
Knowing about foods that are good for a diabetic patient and deliberately making a choice to consume those foods are two different aspects. Thus, it is important to not just be aware of what is good and what is not for you. Diabetic patients must ensure to include the required foods in their diet. Also, certain food categories must be avoided by diabetic patients.
Nutrients are essential for maintaining a healthy level of blood sugar in your body. If your body is insulin resistant, you need to focus on your meals. You need to try to include foods that contain plenty of nutrients for keeping you healthy. Instead of eating only superfoods, you should look at the meals that you are eating. Some foods that improve your insulin sensitivity and prevent the risk of developing diabetes are:
Apart from focussing on what you are eating, you should drink plenty of water. Keeping your body well hydrated helps in removing excess glucose from your blood. Thus, insulin sensitivity gets better. In addition to this, you need to focus on your portion as well. Portion control limits the excessive intake of carbohydrates and calories. Hence, your body can absorb the glucose in your blood at a slow pace and do not cause blood sugar spikes.
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How Common Is Insulin Resistance
Since there arent any common tests to check for insulin resistance and there arent any symptoms until it turns into prediabetes or Type 2 diabetes, the best way to measure the prevalence of insulin resistance is through the number of prediabetes cases. More than 84 million adults in the United States have prediabetes. Thats about 1 out of every 3 adults.
Do You Have Insulin Resistance
How do you find out if youre insulin resistant? No one test will tell you, but if you have high blood sugar levels, high triglycerides , high LDL cholesterol, and low HDL cholesterol, your health care provider may determine you have insulin resistance.
Important note: Type 1 diabetes is different its thought to be caused by an autoimmune reaction . People with type 1 diabetes dont make enough insulin and need to take it to survive.
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What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. Your blood sugar and glycosylated hemoglobin should be checked regularly to determine your response to human insulin. Your doctor will also tell you how to check your response to human insulin by measuring your blood or urine sugar levels at home. Follow these directions carefully.
You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Hemodynamic Insulin Action On Arteries And Arterioles
The peripheral actions of insulin begin inside the vessels of the systemic circulation, where the hormone exerts its hemodynamic effects on endothelial cells to promote blood flow and ensure its delivery to peripheral tissues . Endothelial cells line each blood vessel and constitute a crucial interface between the circulation and the tissue parenchyma. In large blood vessels such as the aorta and large arteries, insulin acts on the IR of endothelial cells, causing phosphorylation of the major endothelial IR substrate, IRS2. This leads to activation of class I phosphatidylinositol 3-kinase , which signals downstream to the serine and threonine kinase Akt/PKB. In turn, Akt activates endothelial NO synthase to catalyze the conversion of l-arginine to NO . NO is a potent vasodilator that rapidly diffuses to the vessels outer layer of smooth muscle cells, where it activates intracellular guanylate cyclase to increase cyclic guanosine monophosphate production . Cyclic guanosine monophosphatedependent reductions in intracellular Ca2+ concentration prevent phosphorylation of myosin light chain required for cytoskeletal cross-bridge formation and contraction , thereby resulting in vessel relaxation .
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Throwing Away Your Needles And Lancets
Sharps bins and needle clippers are the safest way of disposing of your insulin needles and your lancets. A needle clipper removes the needle from your insulin pen, and is useful when youre out and about. How you get rid of your sharps bin depends on where you live. Your healthcare team should have information to help you get rid of your bin.
How To Choose The Right Method For Injecting Insulin
Both syringes and insulin pens use a small needle to inject insulin into your body. There are pros and cons to each, and which one you ultimately end up with will depend on your lifestyle and your doctors advice.
Things to know about insulin syringes:
- They come in a few different sizes.
- Your doctor will tell you how much insulin you need per dose.
- You will usually draw the insulin into the syringe when you need it.
- Theyre not as discreet as an insulin pen.
Things to know about insulin pens:
- Some pens use cartridges that are manually inserted into the pen.
- Other pens are prefilled and thrown away after all the insulin is used.
- Needles in pens are often smaller than those in syringes.
- Not all types of insulin can be used with a pen.
- Pens can be more expensive than syringes and are sometimes not covered by insurance.
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