Expert Health Articles

Management of Diabetes

Diabetes is diagnosed when a person’s pancreas is unable to produce insulin properly. Type 1 diabetes is characterized by the destruction of the cells required to make insulin, a hormone that regulates the amount sugar in the blood. Whereas, Type 2 diabetes results from the gradual loss of insulin-producing cells or resistance to insulin throughout the body.

Insulin medication was developed in the 1920s by an orthopedic surgeon from Ontario, Canada. Beginning with pancreas extracts that had shown success in lowering blood sugar, the investigation continued until impurities were removed. Eventually, only a small section of the pancreas was extracted and proved to lower blood sugar in models. As advancements continued, Eli Lilly and Company became interested and acquired the rights to manufacture insulin.

By 1982, Eli Lilly had marketed Humulin which is “human” insulin. Today, there are multiple different insulin products available to treat diabetes. These insulin medications are categorized based on their onset of action and duration of action. The fast-acting insulins begin to work within 5-15 minutes and last for about three hours. Because of the rapid onset, this type of insulin is usually reserved for mealtime coverage. The ultra-long acting insulins can last for more than 24 hours. These long-acting insulins are designed to simulate the amount of insulin that would normally be released from the pancreas throughout the day.

Unlike most medications, insulin is not available in a tablet or capsule. Insulin, in the form of a solution, is administered just under the skin into the subcutaneous fat layer. This is done using an insulin pen with needles, an insulin pump, or syringes with needles. Patients with diabetes are required to test their blood sugar to ensure blood glucose levels do not get too high or too low. Depending on the person, testing can range from once a day to multiple times per day. This can be measured using a glucometer which may require the patient to prick their finger to obtain a sample of blood. With technological advancements, some blood glucose monitors are now attached to the skin, saving patients from pricking their fingers.

Management of diabetes will likely require a team approach with the help of friends, family, nurses, dieticians, physicians and pharmacists. While there is not cure for diabetes, keeping blood glucose levels near normal, taking medication and keeping a healthy diet are key in managing your diabetes and living a healthy life. 

Ross Ellerbrock, Pharm. D.