Insulin and Diabetes

What is it and What is its Role in Diabetes

Treating diabetes in a woman
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What is Insulin?

Insulin is a hormone produced by the beta cells of the pancreas that permits glucose to enter cells and helps the body use glucose for energy. Insulin controls the amount of glucose in the blood.

  • People with Type 1 diabetes must use manufactured insulin, usually in an injectable form (such as an insulin pen or an insulin pump), to replace the natural insulin that is no longer produced by their body.
  • People with Type 2 diabetes sometimes need to use insulin when their cells become too resistant to the insulin that they produce naturally and oral medications are no longer working. This can happen if you've had diabetes for a long time. It doesn't mean you've failed your diabetes, rather that the pancreas (the organ that produces insulin) is tired and needs some help to lower blood sugars.

The Pancreas and Insulin Production:

Your pancreas is a very quiet little organ that sits behind the stomach and produces digestive enzymes and a couple of hormones, such as insulin and glucagon. Most people never think about their pancreas; it just does it's thing, pumping insulin into the blood when glucose is too high and glucagon when the glucose is too low.

What is the Role of Insulin in Digestion:

When you take in food, your body breaks it down into materials that you need for your cells to function.

One of those materials is sugar in the form of glucose (which is broken down from carbohydrates). Your cells use glucose for energy. To get the glucose into your cells, the sugar travels into the bloodstream and triggers your pancreas to produce insulin. Insulin lets the sugar pass from the blood into your cells.

When sugar is converted to energy, it's either used or stored until you need it.

The Rise and Fall of Blood Sugar:

Blood sugar is lower before a meal and then rises once you have eaten. Then, approximately two hours after the meal, it returns to normal. Blood sugar is measured in milliliters per deciliter of blood. Blood sugar targets vary from person to person. Diabetes is diagnosed when blood sugar levels fall out of the normal range because the pancreas either isn't producing any insulin or the insulin it makes is not working effectively.

Insulin and Type 1 Diabetes:

Type 1 diabetes occurs when the pancreas is attacked by the immune system and the insulin producing cells, also known as beta cells, are permanently destroyed. The pancreas no longer produces insulin. The signs and symptoms of type 1 happen swiftly. Typically, insulin production drops off suddenly when the beta cells are destroyed and the person is very quickly in crisis. When there isn't any insulin, the sugar in the blood just keeps circulating and building.

The cells don't get any fuel and the body tries to get rid of the excess sugar. It tries to dilute it by pulling water out of body. This causes excessive thirst and urination.

The body becomes fatigued because the cells aren't getting the glucose they need for energy. The person may suffer a condition called diabetic ketoacidosis where the body starts to break down fats to make energy. This produces ketones which makes the blood increasingly acidic.This can cause a person to go into a diabetic coma and possibly even die. People with Type 1 diabetes must always take insulin for the rest of their lives in order to live with the disease.

Insulin and Type 2 Diabetes:

Type 2 diabetes is different than type 1. The pancreas still makes insulin, but the body develops resistance to insulin, so the cells don't respond to it, and they are unable to take up the sugar that is in the blood. Type 2 used to be almost exclusively an older person's disease, but with the rise in childhood obesity and obesity in general in our country, there are cases of type 2 in children and young adults as well.

Sources:

Insulin Basics, American Diabetes Association, July 16, 2015.

What I need to know about Diabetes Medicines, National Institute of Diabetes and Digestive and Kidney Diseases, December 2013.

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