Dealing with Diabetes
Basics of insulin

Dr. Ellen Andrews

Insulin is one of those things we just can't live without, like water or oxygen. Without oxygen, we have only minutes to survive. Without water we can make it several days, maybe rarely longer. Without insulin we are in grave danger also.

This is why, when our bodies can no longer manufacture insulin, we must obtain it some other way. Or die. Without insulin, we are unable to extract energy from food. Everything we do in life, thinking, talking, moving about, breathing, having our hearts beat….. all these things require energy. We get that energy from food we eat. Converting the food into energy is a complicated business. That's where insulin comes in. Pills for diabetes help in other ways, but do not replace insulin.

We've all endured power outages which always remind us how much we depend on that constant supply of energy. Why, even the water stops running, because the water pump needs electricity! Without insulin, we face very dire circumstances. Glucose cannot reach the cells, so they have no source of energy. They will not be able to function for long.

The discovery of insulin and the ability to mass-produce it won Nobel prizes for the scientists involved. It was a major breakthrough. Eighty years later we are blessed with ever-more convenient ways of using insulin. We have longacting insulins, taken just once or twice a day, to mimic the body's way of keeping a small supply in our bloodstream all the time. Other insulins we take at meal time, to handle that task of converting food to energy immediately as we eat.

Insulin still requires an injection of some kind, but the technology has helped us enormously. The needles now are tiny, so that one barely feels the injection. Insulin pens look like ball-point pens and can be carried in a purse. You don't need to carry syringes and bottles of insulin around any longer. You may also have heard about insulin pumps. They are about as big as a pager, and dispense insulin at the push of a button through a tube that is taped to the person. The tubing is thinner than the last piece of spaghetti you ate. People with both types of diabetes, Type 1 or Type 2 can use pumps. Pumps look like pagers. They eliminate the need for multiple daily injections of insulin. You can just push a button. There is an inhaled form of insulin available, but it requires a pretty large inhaler, comparable to an aerosol can of whipped cream. It's used for fast-acting insulin only.

Most people with diabetes will eventually need insulin. It's more user-friendly now, so there's less reason to dread it. If the alternative is to be in bad control, with A1C's above 8, don't think twice. If you already take several pills for diabetes, but aren't controlled, it may be time for insulin. Don't settle for poor control of your diabetes and don't be afraid of insulin.

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