Control blood sugar with insulin

Diabetes mellitus is a heterogeneous metabolic disorder characterized by hyperglycemia due to defects in insulin secretion, insulin action, or both. Prolonged chronic elevation of glucose will cause disturbances in carbohydrate, lipid, and protide metabolism, causing damage in many different organs, especially in the heart, kidneys, blood vessels, eyes and nerves.
Diabetes includes 2 types:
Type 1 diabetes: also known as insulin dependent diabetes, due to destruction of pancreatic beta cells, leading to absolute insulin deficiency. The disease is common in young people and is a severe form of disease, often with sudden onset and acute course. Type 2 diabetes: is non-insulin dependent diabetes mellitus, due to progressive decrease in pancreatic beta cell function against the background of insulin resistance. Type 2 diabetes is common in the elderly and in obese people. This is a common form of the disease, with up to 90% of people with type 2 diabetes. If diabetes is not controlled and treated, it can cause a number of dangerous complications such as:
Brain complications: causing cerebral vascular occlusion, cerebral emphysema or cerebral hemorrhage. Vascular complications: damage to blood vessels due to hyperlipidemia causes atherosclerosis. Injury to large blood vessels causes myocardial infarction, the rate of myocardial infarction in patients with diabetes is very high, causing constriction and narrowing of the arteries of the extremities, leading to embolism and necrosis. Respiratory complications: susceptible to pneumonia, bronchitis due to bacterial superinfection.

Digestive complications: often have periodontitis, stomach ulcers, diarrhea, liver dysfunction. Renal and urinary complications: causing kidney and bladder dysfunction. Especially acute or chronic pyelonephritis, glomerular failure. Neurological complications: patients feel pain, ants crawling, burning, muscle atrophy,... Eye complications: causing damage to the retinal blood vessels of the eye, eventually impairing vision , even lead to blindness. Skin complications: patients have itchy skin, often boils, palms and feet are yellowish, yellow lumps appear that cause itchy hands, buttocks, pyoderma, slow healing wounds, ...

2.1 Commonly used insulins Insulin is commonly used in the treatment of type 1 diabetes and type 2 diabetes, to replace physiological insulin secretion. Use insulin for the purpose of controlling blood sugar but need to minimize the risk of hypoglycemia. Currently there are many types of insulin used in blood sugar control, some of the main ones are:
Very fast acting insulin analogs: onset of action is usually after 10-20 minutes and persists for 2-5 hour. The brand name of the drug is Apidra, solution for injection 100IU/ml. Rapid-acting insulin: onset of action after 15-30 minutes and duration of 4-8 hours. The brand name is Actrapid HM, solution for injection 100UI/ml. Semi-slow insulin: onset of action after 1-2 hours and maintenance time is 10-16 hours. Brand names are Insulatard FlexPen, Insulatard HM, 100IU/ml injection mixture. Slow-acting insulin analogs: onset of action after 1.5 hours and duration of 22-24 hours. The brand name is Lantus, Lantus SobStar, solution for injection 100IU/ml. Mixture of semi-proliferative insulin and insulin analogues: onset of action is 15 minutes and duration is 12 hours. Brand name is NovoMix 30 Flexpen, suspension for injection 100IU/ml Mixed semi-slow insulin/rapid insulin: onset time is 30 minutes and maintenance time is 12 hours. Brand names are Mixtard 30, Mixtard 30 FlexPen, suspension for injection 100IU/ml.

2.2 Purpose of insulin regimens Insulin regimens in the treatment of diabetes are selected for many different purposes:
Reproduction of insulin to best simulate physiological insulin secretion: When there is no energy to enter the body: basal insulin levels need to be maintained stable. After each meal: insulin levels peak. Minimizing hypoglycemic episodes: When the blood sugar level in the body has reached the normal range, it is necessary to pay attention to using the drug because it can lead to hypoglycemic episodes. The way insulin is used needs to be adjusted properly to avoid hypoglycemia. The insulin regimen needs to be suitable for:
Type of diabetes. Patient's age. Treatment goals. Level of physical activity: Pharmacokinetics of insulin forms 2.3 Indications and contraindications Insulin therapy to control blood glucose is indicated in the following cases:
Type 1 diabetes: Insulin dependent. Diabetes in pregnancy. Type 2 diabetes: not insulin dependent. After the patient has adjusted the diet, lifestyle and used a combination of oral hypoglycemic drugs, there is still no effect. Contraindicated to use insulin in the following cases:
Hypoglycemia. In addition, insulin is a type of diabetes medicine that can be used for pregnant and lactating women with gestational diabetes. During pregnancy, when having diabetes, it is necessary to control blood sugar closely to limit the risk of complications on the fetus.

2.4 Undesirable effects 2.4.1 Hypoglycemia Hypoglycemia is a common undesirable effect when using insulin in the treatment of diabetes. When insulin injections can cause a sudden drop in blood sugar levels in the body, it can even lead to a coma. Patients with hypoglycemia have the following symptoms:
Asthenia . Headache. Hunger feeling. Visual disturbances. Sweating Confusion. In case the patient has low blood sugar, the patient should immediately use fast-dissolving sugar such as jam, candy, sugar tablets, ... to quickly improve symptoms. In more severe cases or coma, a single dose of glucagon may be administered.
In addition, the risk of hypoglycemia may be increased when insulin is used concurrently with the following drugs:
Aspirin and other drugs of the Salicylic class: especially when used in high doses. ACE inhibitors. Ethyl alcohol: due to the high risk of hypoglycemia. Therefore, patients should avoid using alcoholic beverages and alcoholic drugs. Beta-blockers: because these drugs also cause hypoglycemia, especially non-cardioselective drugs such as propranolol. In addition, beta-blockers also blind the autonomic responses during hypoglycemia such as sweating, palpitations, tachycardia. 2.4.2 Allergic reactions Local reactions: patients present symptoms such as edema or itching at the injection site, the appearance of red spots, which may disappear after a few days to a few weeks. This reaction may be related to other factors such as: too shallow injection, irritating antiseptics, allergies to ingredients that are preservatives. Systemic reactions: are rarer and the cause may be insulin or metacresol related. Patients present with wheezing, shortness of breath, hypotension, increased heart rate, or sweating.

2.4.3 Lipodystrophy Insulin administration induces lipodystrophy at the injection site. To limit the complications of lipid dystrophy, muscle atrophy needs to change injection sites frequently.
2.4.4 Weight gain Due to its anabolic effect, insulin can cause weight gain in patients.
2.4.4 Risk of Hyperglycemia If insulin is used with certain drugs that can cause hyperglycemia:
Neuroleptics: There may be a risk of hyperglycemia, due to the use of high doses of sedatives. Danazol: Risk of hyperglycaemia and possible ketoacidosis. Drugs containing excipients such as: Glucocorticoids, lactose, sucrose, high-dose progesterone hormones, thiazide diuretics and loop diuretics, beta-2 stimulants such as salbutamol, terbutaline,... In short, diabetes Sugar is a common chronic disease, caused by metabolic disorders. If diabetes is not treated and controlled, it can lead to dangerous complications. Controlling blood sugar with insulin is one of the treatment regimens for type 1 and type 2 diabetes. People with diabetes need to regularly visit medical facilities for examination and appropriate treatment regimens to prevent complications caused by diabetes.
Currently, Vinmec International General Hospital has been and continues to deploy a screening package for diabetes and dyslipidemia to help early detect pre-diabetes, accurately classify diabetes type, and Time to develop a nutritional regimen, monitor to minimize the risks and complications caused by diabetes.
If you have a need for consultation and examination at Vinmec Hospitals under the nationwide health system, please book an appointment on the website for service.