Insulin Therapy

Abstract

Insulin is a major regulator of overall metabolism, having important effects on fat and protein metabolism in addition to its action on carbohydrates. The increase in insulin secretion which accompanies food ingestion facilitates the storage of all the ingested nutrients, and the fall in insulin level which normally occurs in between meals enhances the mobilization and production of metabolic fuels. In addition insulin is a hormone associated with regulation of the blood glucose concentration. As a major aim of treatment in diabetes is to establish metabolic control, maintaining blood glucose levels within limits and avoiding either hyperglycaemia or hypoglycaemia, it is necessary to supply the correct dose of insulin. While a great many advances have been made since the discovery of insulin at the University of Toronto in 1921, the fact remains that insulin is a polypeptide hormone of complex structure which is destroyed by gastric juices and has, therefore, to be injected rather than ingested orally.