Insulin: The Life-Saving Hormone in Diabetes Management

Galván Raquel^*
*Correspondence: Galván Raquel, Department of Medicine, Virgen Macarena University Hospital, Andalusia, Spain, Email:

Keywords

Diabetes • Blood sugar levels • Smart insulin pens

Introduction

Insulin is a hormone that plays a crucial role in regulating blood sugar levels in the body. It is primarily known for its role in the management of diabetes, a chronic metabolic disorder characterized by high blood glucose levels. Insulin is essential for the proper utilization of glucose and the maintenance of overall health. In this article, we will delve into the intricacies of insulin, its functions, types, administration methods, and advancements in insulin therapy. We will also explore the future prospects of insulin research and potential alternatives for diabetes management. Insulin is a hormone produced by the beta cells of the pancreas, an organ located behind the stomach. It acts as a key that unlocks cells, allowing glucose to enter and be used as an energy source. When we consume carbohydrates, they are broken down into glucose, which enters the bloodstream. In response, the pancreas releases insulin to facilitate the uptake of glucose into cells, thus lowering blood sugar levels. Insulin also plays a role in the storage of excess glucose in the liver for later use [1].

Diabetes can be broadly categorized into two main types: type 1 diabetes and type 2 diabetes. Type 1 Diabetes also known as insulin-dependent diabetes or juvenile-onset diabetes, type 1 diabetes occurs when the immune system mistakenly attacks and destroys the beta cells in the pancreas. As a result, the production of insulin is severely impaired or completely halted. People with type 1 diabetes require insulin therapy to survive and manage their blood sugar levels effectively. Type 2 diabetes, also referred to as noninsulin- dependent diabetes or adult-onset diabetes, is characterized by insulin resistance or the inability of the body to effectively utilize insulin. Initially, the pancreas compensates by producing more insulin, but over time, it may become unable to keep up with the demand. Lifestyle factors, such as poor diet, sedentary behavior, and obesity, contribute to the development of type 2 diabetes. Initially, type 2 diabetes can often be managed through lifestyle modifications, oral medications, and non-insulin injectables. However, some individuals with type 2 diabetes may eventually require insulin therapy.

Insulin therapy is a cornerstone of diabetes management, especially for individuals with type 1 diabetes and those with type 2 diabetes who have progressed to a stage where oral medications or non-insulin injectables are insufficient to control blood sugar levels effectively. Insulin therapy aims to mimic the natural release of insulin in response to changes in blood glucose levels. It is administered through various methods, including injections, insulin pens, insulin pumps, and inhalation devices. Traditional insulin therapy involves the subcutaneous injection of insulin into the fatty tissue just below the skin. Syringes or insulin pens with disposable needles are commonly used for injections. The injection sites typically include the abdomen, thighs, upper arms, and buttocks. Insulin injections are available in different types, including rapid-acting, short-acting, intermediate-acting, and long-acting insulins. The selection of insulin type and dosage depends on individual needs and blood glucose control targets [2].

Literature Review

Insulin pens are a convenient and user-friendly alternative to traditional syringes. These devices contain a pre-filled cartridge of insulin and a disposable needle. The pen is primed, the dosage is dialed, and the injection is delivered by pressing a button. Insulin pens offer better dose accuracy, discreetness, and ease of use, making them popular among people with diabetes. Insulin pumps are small devices that deliver insulin continuously through a catheter placed under the skin. They mimic the function of the pancreas by providing a basal rate of insulin throughout the day, along with bolus doses at mealtime. Insulin pumps offer greater flexibility in terms of insulin dosing and can help achieve better blood sugar control, especially for those with unpredictable insulin requirements. However, insulin pumps require careful monitoring and frequent adjustments to optimize therapy. Inhalable insulin, also known as inhaled insulin, offers an alternative route of administration. It involves the use of inhalation devices, such as inhalers or nebulizers, to deliver powdered insulin into the lungs. The insulin is absorbed into the bloodstream from the lungs, providing a rapid-acting effect. Inhalable insulin is a relatively new option and is suitable for individuals who prefer to avoid injections [3].

Over the years, insulin therapy has witnessed significant advancements aimed at improving convenience, effectiveness, and safety for individuals with diabetes. Analog insulins are synthetic forms of human insulin that have been modified to optimize their pharmacokinetic properties. Rapid-acting analogs, such as insulin lispro, insulin aspart, and insulin glulisine, have a quicker onset of action and shorter duration, allowing for greater flexibility around mealtimes. Long-acting analogs, such as insulin glargine and insulin detemir, provide a more stable basal insulin level over an extended period, reducing the risk of hypoglycemia. Closed-loop systems, also known as artificial pancreas systems, are a breakthrough in insulin therapy. These systems combine Continuous Glucose Monitoring (CGM) devices with insulin pumps, creating a closed-loop feedback system. The CGM monitors blood glucose levels, and the insulin pump adjusts insulin delivery accordingly. Closed-loop systems offer automated insulin delivery, reducing the burden of constant monitoring and manual adjustments. They have shown promise in improving blood sugar control and reducing the risk of hypoglycemia.

Smart insulin pens are innovative devices that integrate with digital platforms and smartphone applications. They allow users to track insulin doses, analyze blood sugar data, set reminders, and provide personalized recommendations. These pens offer a convenient way to monitor insulin usage, track glucose trends, and enhance overall diabetes management. While insulin therapy has greatly improved the lives of people with diabetes, researchers continue to explore new avenues to enhance its effectiveness and convenience. Some areas of ongoing research and future prospects include: Scientists are developing ultra-rapid-acting insulins that mimic the physiological response of the pancreas to meals even more closely. These insulins have the potential to provide an even faster onset of action and a shorter duration, allowing for precise postprandial glucose control [4].

Discussion

Researchers are working on smart insulin delivery systems that can sense blood glucose levels and release insulin automatically when needed. These systems aim to create a closed-loop system without the need for external devices, such as continuous glucose monitors or insulin pumps. Nanotechnology holds promise in the development of insulin formulations with improved stability, enhanced bioavailability, and targeted delivery. Nanoparticles can be engineered to encapsulate insulin, protecting it from degradation and enabling controlled release at specific sites within the body. Oral insulin is a long-standing goal in diabetes research. Scientists are exploring ways to protect insulin from being broken down by digestive enzymes and finding efficient methods for insulin absorption through the gastrointestinal tract. Successful development of oral insulin would revolutionize insulin therapy by eliminating the need for injections or invasive devices [5].

Pancreas and islet cell transplantation involve replacing the dysfunctional pancreas or its beta cells with a healthy one. These procedures can potentially restore insulin production and eliminate the need for exogenous insulin. However, the availability of donor organs and the need for immunosuppressive medications pose significant challenges. The concept of an artificial pancreas aims to create an automated closed-loop system that mimics the function of a healthy pancreas. It combines continuous glucose monitoring with automated insulin delivery, eliminating the need for constant monitoring and manual insulin adjustments. Artificial pancreas systems are still in development and hold promise for revolutionizing diabetes management in the future. Gene therapy involves introducing specific genes into the body to modify or replace faulty genes associated with diabetes. Researchers are exploring gene therapy approaches to enhance insulin production or improve insulin sensitivity in individuals with diabetes. While gene therapy is still in its early stages of development, it holds potential for personalized and targeted diabetes treatment [6].

Conclusion

Insulin is a life-saving hormone that plays a vital role in regulating blood sugar levels and maintaining overall health. For individuals with diabetes, insulin therapy is an essential component of their treatment regimen. Advances in insulin therapy have made it more convenient and effective, allowing for better blood sugar control and improved quality of life. Ongoing research and development in the field of insulin therapy and alternative approaches to diabetes management offer hope for further advancements in the future. As scientists continue to unravel the complexities of diabetes and insulin, the ultimate goal remains finding a cure and ensuring a better life for those living with diabetes.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Bolhassani, Azam, Behnaz Sadat Jafarzade and Golnaz Mardani. "In vitro and in vivo delivery of therapeutic proteins using cell penetrating peptides."Peptides87 (2017): 50-63.

Google Scholar, Crossref, Indexed at

2. Weill, Claire O., Stéphanie Biri, Abdennaji Adib and Patrick Erbacher. "A practical approach for intracellular protein delivery."Cytotechnology56 (2008): 41-48.

Google Scholar, Crossref, Indexed at

3. Moroz, Elena, Simon Matoori and Jean-Christophe Leroux. "Oral delivery of macromolecular drugs: Where we are after almost 100 years of attempts."Adv Drug Deliv Rev 101 (2016): 108-121.

Google Scholar, Crossref, Indexed at

4. Abu-Awwad, Hosam Al-Deen M., Lalitha Thiagarajan and James E. Dixon. "Controlled release of GAG-binding Enhanced Transduction (GET) peptides for sustained and highly efficient intracellular delivery."Acta Biomater57 (2017): 225-237.

Google Scholar, Crossref, Indexed at

5. Eltaher, Hoda M., Lia A. Blokpoel Ferreras, Aveen R. Jalal and James E. Dixon. "Direct contact-mediated non-viral gene therapy using thermo-sensitive hydrogel-coated dressings."Biomater Advances143 (2022): 213177.

Google Scholar, Crossref, Indexed at

6. Osman, Gizem, Jason Rodriguez, Sze Yan Chan and Jane Chisholm, et al. "PEGylated enhanced cell penetrating peptide nanoparticles for lung gene therapy."J Control Release 285 (2018): 35-45.

Google Scholar, Crossref, Indexed at