How You Take Insulin
You can’t take insulin as a pill because enzymes in your stomach would break it down during digestion. Instead, you inject insulin under your skin through a needle in a syringe, pump, or pen.
There is also a newer inhaled version of insulin. You breathe it in through a device that looks like an asthma inhaler.
People with type 1 diabetes need to take insulin several times a day. Those with type 2 diabetes may only have to take it once a day.
What Are Alternative Medications For People With Diabetes That Arent Insulin
Non-insulin medications that may be prescribed to people with diabetes include:
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Metformin a pill that stops sugar production in the liver
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Glitazones pills that remove sugar from the bloodstream
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Sulfonylureas and glinides pills that increase the release of insulin from your pancreas
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Starch blockers pills that slow starch absorption
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Incretin therapies and amvlin analogs pills and injections that reduce sugar production in the liver and slow food absorption. Types of the former include DPP4 inhibitors and GLP1 analogs .
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SGLT2 inhibitors pills that are taken before meals that prevent the reabsorption of glucose
Regulation And Mechanisms Of Insulin Secretion At The Cellular Level
Synthesis and secretion of insulin is regulated by both nutrient and non-nutrient secretagogues, in the context of environmental stimuli and the interplay of other hormones.8 Nutrient secretagogues such as glucose appear to trigger insulin secretion from the cell by increasing intracellular ATP and closing of K+-ATP channels as outlined above. Generation of cyclic AMP and other cellular energy intermediates is also augmented, further enhancing insulin release. Glucose does not require insulin action to enter the cell .8 Non-nutrient secretagogues may act via neural stimuli such as cholinergic and adrenergic pathways, or through peptide hormones and cationic amino acids.
Neural Stimuli
1. Cholinergic Transmission
It has been well recognised that vagus nerve stimulation results in pancreatic insulin secretion. This is thought to mediate the so-called cephalic phase of insulin secretion, occurring when food is seen, smelled or acutely ingested. Islet cell cholinergic muscarinic receptors activate phospholipase C, with subsequent intracellular events activating protein kinase C, phospholipase A2 and mobilizing intracellular calcium. Insulin secretion by these mechanisms does not occur in the fasting state or if blood glucose levels are low, but may augment the anabolic response to feeding.8
2. Adrenergic Pathway
Peptide Hormones
Amino Acids
Schematic presentation of insulin secretory pathways. Adapted from references: 10& 14.
Footnotes: Figure Abbreviations
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What Severe Complications Can Occur Because Of Rationing Or Running Out Of Insulin
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:
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Thirst or a very dry mouth
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Frequent urination
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High levels of ketones in your urine
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Fatigue
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Nausea, vomiting, or stomach pain
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Difficulty breathing
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A fruity or acetone odor on your breath
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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 people with type 1 diabetes 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.
How Is Insulin Controlled

The main actions that insulin has are to allow glucose to enter cells to be used as energy and to maintain the amount of glucose found in the bloodstream within normal levels. The release of insulin is tightly regulated in healthy people in order to balance food intake and the metabolic needs of the body. This is a complex process and other hormones found in the gut and pancreas also contribute to this blood glucose regulation. When we eat food, glucose is absorbed from our gut into the bloodstream, raising blood glucose levels. This rise in blood glucose causes insulin to be released from the pancreas so glucose can move inside the cells and be used. As glucose moves inside the cells, the amount of glucose in the bloodstream returns to normal and insulin release slows down. Proteins in food and other hormones produced by the gut in response to food also stimulate insulin release. Hormones released in times of acute stress, such as adrenaline, stop the release of insulin, leading to higher blood glucose levels to help cope with the stressful event.
Insulin works in tandem with glucagon, another hormone produced by the pancreas. While insulin’s role is to lower blood sugar levels if needed, glucagon’s role is to raise blood sugar levels if they fall too low. Using this system, the body ensures that the blood glucose levels remain within set limits, which allows the body to function properly.
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Insulin Toxicity Vs Energy Toxicity
Many people lately have been talking a lot about insulin toxicity as if it is what we should fear the most. However, the reality is that high insulin is simply another symptom of being overweight. The root cause of insulin toxicity is energy toxicity. The only way to meaningfully manage it is to lose fat and build more muscle.
So rather than:
eat more carbohydrates -> make more insulin -> get fatter
what appears to be driving obesity is:
low satiety, nutrient-poor foods -> increased cravings and appetite -> increased energy intake -> fat storage -> increased daily insulin
The real solution to managing Type-2 Diabetes, blood sugar, insulin levels and avoiding the myriad complications of metabolic syndrome is:
Consuming high-satiety nutrient-dense foods and meals -> decreased cravings and appetite -> decreased energy intake -> fat loss -> optimised insulin levels
In the final part of this article, Ill share some insights to help you from my research on learning to think like a pancreas and watching Monicas closed-loop pump system.
So What Affects My Blood Sugar Levels
It is important to understand what can make your blood sugar rise or fall, so that you can take steps to stay on target.
Things that can make blood sugar rise include:
- A meal or snack with more food or more carbohydrates than usual
- Inactivity
- Changes in hormone levels, such as during menstrual periods
- Stress
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What Does Insulin Do
Insulin moves glucose from your blood into cells all over your body. Glucose comes from both food and your bodys own natural release of stored glucose. Think of insulin as the key that opens the doors of the cells in your body. Once insulin opens your cell doors, glucose can leave your bloodstream and move into your cells where you use it for energy. Without enough insulin, glucose cant get into your cells and instead builds up in your blood .
Many conditions can affect your bodys ability to produce and release insulin. They include:
- Gestational diabetes, which is diabetes that begins during pregnancy.
- Prediabetes, when your body is resistant to insulin , but blood sugar levels arent high enough for a Type 2 diabetes diagnosis.
- Type 1 diabetes, when your pancreas doesnt make insulin or doesnt make enough to control blood sugar.
- Type 2 diabetes, when your pancreas doesnt produce enough insulin, or your body cant use the insulin as it should.
- Metabolic syndrome , a group of risk factors that increase the risk of diabetes and heart disease. Insulin resistance means that the cells in your body cant use glucose from your blood as energy.
Insulin And Fat Storage
As well as being involved in the regulation of blood glucose, insulin is also involved in how fat is used by the body. When the liver is has taken up its capacity of glycoge, insulin signals fat cells to take up glucose to be stored as triglycerides.
An additional effect of insulin is in inhibiting the breakdown of fats.
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What Is An Insulin Resistance Diet
An insulin resistance diet is often recommended for people who have insulin resistance, a key component of type 2 diabetes. It incorporates foods that will help maintain your bodys balance of insulin and blood sugar. Think nourishing calories from veggies, fruit, lean proteins, and healthy fats.
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The History of a Wonderful Thing We Call Insulin.
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Increasing Insulin Affordability.
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General Overview of Type 1 and Type 2 Diabetes and Resources for Patients/Families: The American Diabetes Association:
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General Overview of Type 1 Diabetes and Resources for Patients/Families: The Juvenile Diabetes Research Foundation :
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Table of Non-insulin Medications:
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American Diabetes Association. Get a Handle on Diabetes Medication
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Joslin Diabetes Center. Managing Diabetes: Insulin A to Z: A Guide on Different Types of Insulin..
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Mayo Clinic. Diabetes treatment: Using insulin to manage blood sugar.
The Insulin Resistance Syndrome
The insulin resistance syndrome describes the cluster of abnormalities which occur more frequently in insulin resistant individuals. These include glucose intolerance, dyslipidaemia, endothelial dysfunction and elevated procoagulant factors, haemodynamic changes, elevated inflammatory markers, abnormal uric acid metabolism, increased ovarian testosterone secretion and sleep-disordered breathing.3 Clinical syndromes associated with insulin resistance include type 2 diabetes, cardiovascular disease, essential hypertension, polycystic ovary syndrome, non-alcoholic fatty liver disease, certain forms of cancer and sleep apnoea.3
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Can I Have A Negative Reaction To Insulin
One complication facing people with diabetes who use insulin is the potential for severe hypoglycemia, also known as insulin shock, which involves using too much insulin and causing your blood sugar to drop extremely low. This can cause coma, seizures, and heart attacks, says Dr. Powers. It requires treatment in a hospital but thankfully is highly treatable once you are there.
Glucose : How Insulin And Glucagon Work

May 24, 2021
If you really want to understand how to manage your blood sugar levels, you should get to know your hormone functions.
âInsulin and glucagon are essential building blocks of human biology. If you’re monitoring your glucose levels for health and optimization reasons, it helps to know the nitty-gritty of the relationship these hormones have.
Our bodies work hard to continually keep our glucose in a tight rangeâonly a few teaspoons are found in the bloodstream at any time. Insulin and Glucagon are the two hormones that work as opposing forces to constantly regulate glucose levels.
When insulin and glucagon are working in perfect harmony, our blood sugar levels will stay nice and balanced. But what happens if they are not in sync? Letâs take a look at how these two hormones keep your blood sugar within healthy limits.
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The Discovery Of Insulin
In 1889 German scientists Minkowski and von Mering noted, from their experimental work with animals, that total pancreatectomy led to the development of severe diabetes.4 They hypothesised that a substance secreted by the pancreas was responsible for metabolic control. Others later refined this hypothesis, noting diabetes to be associated with destruction of the islets of Langerhans. While Minkowski, as well as Zuelzer in Germany and Scott in the USA attempted, with inconsistent results, to isolate and administer the missing pancreatic islet substance, Belgian investigator de Meyer in 1909 proposed the name insuline, as did British researcher Schaefer in 1916.
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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What Does Insulin Do In Your Body
Many people still believe the primary role of insulin is to push energy into fat cells when you eat carbs. This flawed logic goes a bit like this:
eat carbs -> boost insulin > get fat
But the reality is:
- the insulin released after you eat is only a fraction of the insulin produced by your pancreas each day,
- your cells are always using glucose regardless of insulin,
- insulins primary role is to stop your body from disintegrating, and
- the bigger you are, the more insulin your pancreas needs to produce.
The most effective way to reduce your daily insulin requirements is to eat in a way that will increase satiety and will allow you to achieve healthy body fat levels.
To help you move beyond the over-simplified carbohydrate-insulin belief, this article will:
- give you a deeper understanding of how insulin works in your body, and
- show you how to reduce your insulin, blood glucose, and weight to healthy levels through improved food choices and optimised meal timing.
Eager to learn more about the actual role of this critical hormone in your body and how you can manipulate it to your advantage?
Then, lets go!
This is true, but only if he followed you around and jabbed you all day with a needle full of insulin.
But this would be illegal, and anyone who did that would be locked up.
Fortunately, it wouldnt happen for long.
Carbohydrates And Blood Sugar
When people eat a food containing carbohydrates, the digestive system breaks down the digestible ones into sugar, which enters the blood.
- As blood sugar levels rise, the pancreas produces insulin, a hormone that prompts cells to absorb blood sugar for energy or storage.
- As cells absorb blood sugar, levels in the bloodstream begin to fall.
- When this happens, the pancreas start making glucagon, a hormone that signals the liver to start releasing stored sugar.
- This interplay of insulin and glucagon ensure that cells throughout the body, and especially in the brain, have a steady supply of blood sugar.
Carbohydrate metabolism is important in the development of type 2 diabetes, which occurs when the body cant make enough insulin or cant properly use the insulin it makes.
- Type 2 diabetes usually develops gradually over a number of years, beginning when muscle and other cells stop responding to insulin. This condition, known as insulin resistance, causes blood sugar and insulin levels to stay high long after eating. Over time, the heavy demands made on the insulin-making cells wears them out, and insulin production eventually stops.
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How Do You Know If The Insulin In Your Body Isnt Working Properly
People with type 1 diabetes are generally diagnosed when symptoms cause them to seek medical care.
Type 2 diabetes is often diagnosed with a simple blood test during a routine physical exam or annual checkup.
A lab test of your fasting blood sugar levels or an A1C test can indicate if your blood sugar is within a healthy range. This can signal whether the insulin in your body is working correctly.
Insulin And Blood Glucose Levels
Insulin helps control blood glucose levels by signaling the liver and muscle and fat cells to take in glucose from the blood. Insulin therefore helps cells to take in glucose to be used for energy.
If the body has sufficient energy, insulin signals the liver to take up glucose and store it as glycogen.
The liver can store up to around 5% of its mass as glycogen.
Some cells in the body can take glucose from the blood without insulin, but most cells do require insulin to be present.
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The Basics Of High Blood Sugar
Diabetes is a problem with your body that causes blood sugar levels to rise higher than normal. This is also called hyperglycemia.
When you eat, your body breaks food down into sugar and sends it into the blood. Insulin then helps move the sugar from the blood into your cells. When sugar enters your cells, it is either used as fuel for energy right away or stored for later use. In a person with diabetes, there is a problem with insulin. But, not everyone with diabetes has the same problem.
There are different types of diabetestype 1, type 2 and gestational diabetes. If you have diabetestype 1, type 2 or gestationalyour body either doesn’t make enough insulin, can’t use the insulin well, or both.
Learn more about blood sugar Learn more about insulin
What Happens If I Have Too Much Insulin

If a person accidentally injects more insulin than required, e.g. because they expend more energy or eat less food than they anticipated, cells will take in too much glucose from the blood. This leads to abnormally low blood glucose levels . The body reacts to hypoglycaemia by releasing stored glucose from the liver in an attempt to bring the levels back to normal. Low glucose levels in the blood can make a person feel ill.
The body mounts an initial ‘fight back’ response to hypoglycaemia through a specialised set of of nerves called the sympathetic nervous system. This causes palpitations, sweating, hunger, anxiety, tremor and pale complexion that usually warn the person about the low blood glucose level so this can be treated.
However, if the initial blood glucose level is too low or if it is not treated promptly and continues to drop, the brain will be affected too because it depends almost entirely on glucose as a source of energy to function properly. This can cause dizziness, confusion, fits and even coma in severe cases.
Some drugs used for people with type 2 diabetes, including sulphonylureas and meglitinides , can also stimulate insulin production within the body and can also cause hypoglycaemia. The body responds in the same way as if excess insulin has been given by injection.
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