Normally, insulin is released from the pancreas to help control our blood glucose levels. For diabetic people, this normal bodily function is does not work effectively, so taking insulin several times a day via injections or a pump aims to imitate the normal pattern of insulin production from the pancreas as closely as possible.
What are the different types of insulin?
The insulin used by type 1 diabetics is made in 3 different ways:
- Animal – made from animal sources like pork or beef
- Human – not from humans but made in a lab to match human insulin
- Analogue – made in a lab to have the same effect as insulin, but designed to work at different speeds.
These days it is more common to use human or analogue insulins.
Here young people talk about the types of insulin they have used, the one they are currently using and why some have changed their insulin routine.
Some young people preferred not to change their current insulin routine because they were worried it might mean increasing the number of injections per day. Others described how since changing their routine, they no longer need to eat snacks between meals, meaning that their lives had become much easier.
She does not like the idea of injecting more than two times per day.
Changing your insulin regime
Most of the young people we talked to had changed their insulin routine one or more times since they’d first been diagnosed. Many did so because they’d found it difficult to control their diabetes during their teen years. They described how their control worsened as they reached puberty due to hormonal changes. They experienced more frequent and unexplained hypos (low blood sugar) and/or highs. As teenagers, people wanted to find an insulin routine which allowed them to be more flexible and independent. (See also ‘Hypos’, ‘Highs‘; ‘Diet and diabetes’ and ‘Managing diabetes as a teenager’.)
Recently he changed to another insulin regimen because he started to have problems controlling…
His consultant suggested that he tried another insulin regimen because he was having lots of…
He likes his new insulin regimen but strongly dislikes the disposable pen that he needs to use…
Some young people said that their previous insulin regime had been inflexible and too complicated. Many young people said that they didn’t like regimes where they had to eat snacks between meals whether they felt hungry or not although this regime is unusual now.
She found that as she grew up her insulin regimen was too inflexible and unpractical.
Some young people had experienced problems with some types of insulin routine. One young woman, diagnosed as a child, became irritable and very tired when starting to use a new insulin routine. Doctors kept trying various types of routine until they found one that suited her and her lifestyle. Another young woman who’d been on the same insulin routine for 13 years was advised to change to another type of insulin to allow for a more flexible routine. One week later she became very ill and was admitted into hospital with DKA (diabetic ketoacidosis). She had several episodes of DKA which didn’t stop until after she was put back onto her original type of insulin but with more frequent injections. It’s very important to closely monitor blood glucose levels (doing the ‘finger-pricking’ as instructed by the consultant or nurse) especially when changing insulin regimens.
Her insulin was changed to give her greater flexibility but she reacted badly to the new insulin…
Flexible insulin regimen
Many of the young people we talked to said that basal/bolus regime gave them flexibility, independence and control. They said that they didn’t have to wait before having a meal; they can inject and eat straightaway. However they also said that knowing more about carbohydrate counting helped (see also ‘Diet and diabetes‘). One young man felt a bit upset because he couldn’t see any noticeable improvements at the start of his new regimen. A young woman said that the new-found freedom made her less cautious and she started to eat more chocolate than usual. Young people really appreciated the fact that their new regime meant that they were now able to have ‘a lie-in’ rather than having to wake up early at weekends just to do their insulin injection.
Talks about how she learnt to do carbohydrate counting when started using fast acting insulin.
Says that one of the advantages of her insulin regimen is that she can have a lie in.
Fixed insulin regimen
Some young people found that a fixed routine helps them to manage their diabetes better. One young man recommended doing a set routine when you are first diagnosed because it would be less scary than ‘going it alone’. A young woman who used to have a insulin pump changed back to a fixed insulin routine and doesn’t see the need to change to a 4-injections-a-day regimen.
He found his fixed insulin regimen a pain but prefers it to the flexible one.
It was reassuring to have a fixed regimen when first diagnosed.
Initially she found it difficult to go back to injecting insulin after using a insulin pump. She…
Finding the right insulin routine depends on being aware of what your eating patterns are likely to be and checking the results with daily glucose tests, especially when you unexpectedly eat more or less than usual. (See also ‘Diet and diabetes‘, ‘Doing blood glucose tests’ and ‘Managing diabetes as a teenager‘.)
Kwa kawaida, insulini hutolewa kutoka kwenye kongosho ili kusaidia kudhibiti viwango vyetu vya sukari mdomoni. Kwa watu wenye kisukari, kazi hii ya kawaida ya mwili haifanyi kazi vizuri, kwa hivyo kuchukua insulini mara kadhaa kwa siku kupitia sindano au pampu inakusudia kuiga muundo wa kawaida wa uzalishaji wa insulini kutoka kwa kongosho karibu iwezekanavyo. Kuna aina gani tofauti za insulini? Insulini inayotumiwa na wagonjwa wa kisukari wa aina ya 1 hutengenezwa kwa njia tatu tofauti: - Mnyama - hutengenezwa kutoka kwa vyanzo vya wanyama kama nyama ya nguruwe au ng'ombe - Binadamu - sio kutoka kwa wanadamu lakini hutengenezwa katika maabara ili kufanana na insulini ya binadamu - Analogue - hutengenezwa katika maabara kuwa na athari sawa na insulini, lakini imeundwa kufanya kazi kwa kasi tofauti. Siku hizi ni kawaida zaidi kutumia insulini za kibinadamu au za mfano. Katika makala hii, vijana wanazungumza kuhusu aina za insulini ambazo wametumia, ile wanayotumia sasa na kwa nini baadhi yao wamebadilisha utaratibu wao wa kutumia insulini. Baadhi ya vijana walipendelea kutobadili utaratibu wao wa sasa wa insulini kwa sababu waliogopa kwamba huenda ikamaanisha kuongeza idadi ya sindano kwa siku. Wengine waliripoti kwamba tangu walipoanza kufanya mabadiliko katika maisha yao, hawahitaji tena kula chakula kidogo kati ya chakula cha mchana na jioni, na hivyo maisha yao yamekuwa rahisi zaidi. Yeye hapendi wazo la kutia sindano zaidi ya mara mbili kwa siku. Kubadilisha utaratibu wako wa insulini Wengi wa vijana tuliozungumza nao walikuwa wamebadilisha utaratibu wao wa insulini mara moja au zaidi tangu walipatikana kwa mara ya kwanza. Wengi walifanya hivyo kwa sababu walikuwa wameona ni vigumu kudhibiti ugonjwa wao wa kisukari wakati wa ujana wao. Walieleza jinsi udhibiti wao ulivyozidi kuwa mbaya walipofikia ujana kwa sababu ya mabadiliko ya homoni. Walikuwa na hypos (shukri ya chini ya damu) na/ au highs mara nyingi na bila sababu. Wakiwa matineja, watu walitaka kupata utaratibu wa insulini ambao uliwaruhusu kuwa wenye kubadilika-badilika na wenye kujitegemea zaidi. (Tazama pia ‘Hypos, ‘Highs; ‘Diet and diabetes na ‘Managing diabetes as a teenager.) "Mwanamke huyo alibadilisha dawa yake ya insulini na kuanza kutumia dawa nyingine ya insulini, lakini vijana wengine walisema kwamba dawa yao ya awali ya insulini ilikuwa ""isiyobadilika na ngumu sana.""" Vijana wengi walisema kwamba hawakupenda mifumo ambapo walilazimika kula vitafunio kati ya chakula ikiwa walijisikia njaa au la ingawa mfumo huu ni wa kawaida sasa. Alipokuwa akikua, aligundua kwamba utaratibu wake wa kutumia insulini haukuwa thabiti na haukufaa. Vijana fulani walikuwa wamepata matatizo kwa sababu ya kutumia aina fulani za insulini. Mwanamke mmoja mchanga, aliyegunduliwa akiwa mtoto, alikasirika na kuchoka sana alipoanza kutumia utaratibu mpya wa kutumia insulini. Madaktari waliendelea kujaribu aina mbalimbali za utaratibu hadi walipoupata ule uliomfaa yeye na mtindo wake wa maisha. Mwanamke mwingine ambaye alikuwa amekuwa akitumia insulini kwa miaka 13 alishauriwa kubadilisha aina nyingine ya insulini ili kuwezesha utaratibu wa kubadilika zaidi. Juma moja baadaye akawa mgonjwa sana na alilazwa hospitalini akiwa na DKA (ketoacidosis ya kisukari). Alikuwa na vipindi kadhaa vya DKA ambavyo havikukoma mpaka baada ya kurudishwa kwenye aina yake ya awali ya insulini lakini na sindano za mara kwa mara. Ni muhimu sana kufuatilia kwa karibu viwango vya sukari ya damu (kufanya "kuchoma kidole" kama ilivyoelekezwa na mshauri au muuguzi) haswa wakati wa kubadilisha mifumo ya insulini. Insulini yake ilibadilishwa ili kumpa kubadilika zaidi lakini alijibu vibaya kwa insulini mpya... Mfumo wa insulini ya kubadilika Vijana wengi tuliozungumza nao walisema kwamba mfumo wa basal-bolus uliwapa kubadilika, uhuru na udhibiti. Walisema kwamba hawahitaji kusubiri kabla ya kula; wanaweza kuingiza na kula moja kwa moja. Hata hivyo, pia walisema kwamba kujua zaidi kuhusu kuhesabu wanga kulisaidia (tazama pia "Diet na kisukari"). Mwanamume mmoja mchanga alihisi kuchanganyikiwa kidogo kwa sababu hangeweza kuona maboresho yoyote yanayoonekana mwanzoni mwa utaratibu wake mpya. Mwanamke mmoja alisema kwamba uhuru wake mpya ulimfanya awe asiye mwangalifu sana na akaanza kula chokoleti nyingi kuliko kawaida. Vijana walifurahia sana ukweli kwamba utaratibu wao mpya ulimaanisha kwamba sasa wangeweza "kulala" badala ya kuamka mapema mwishoni mwa juma ili tu kupiga sindano yao ya insulini. Alianza kujifunza kuhesabu wanga kwa kutumia insulini ya haraka. "Mmoja wa faida za matibabu yake ya insulini ni kwamba anaweza ""kuweka""." Mazoea ya kawaida ya kutumia insulini Baadhi ya vijana wamegundua kwamba mazoea ya kawaida huwasaidia kudhibiti ugonjwa wao wa kisukari. Kijana mmoja alipendekeza kufanya utaratibu uliowekwa wakati unapogunduliwa kwa mara ya kwanza kwa sababu ingekuwa yenye kuogopesha kidogo kuliko ‘kufanya peke yako. Mwanamke mchanga ambaye alikuwa na pampu ya insulini alibadilisha kurudi kwenye utaratibu wa insulini wa kudumu na haoni haja ya kubadilisha kwa utaratibu wa sindano 4 kwa siku. Alipata kwamba kutumia insulini kwa njia iliyowekwa imara ni jambo lenye kusumbua lakini alilipendelea kuliko kutumia insulini kwa njia iliyobadilika. Ilikuwa yenye kutuliza kuwa na utaratibu wa kudumu wakati wa utambuzi wa kwanza. Mwanzoni ilimshinda kurudia kutumia sindano ya insulini baada ya kutumia pampu ya insulini. Kupata utaratibu sahihi wa insulini inategemea kuwa na ufahamu wa nini mifumo yako ya kula inaweza kuwa na kuangalia matokeo na vipimo vya sukari vya kila siku, hasa wakati wewe bila kutarajia kula zaidi au chini ya kawaida. (Tazama pia ‘Mlo na kisukari‘, ‘Kufanya vipimo vya sukari ya damu na ‘Kushughulikia kisukari kama kijana‘.)