About Insulin

In response to food, the beta cells of the pancreas make insulin and release it into the blood stream. It assures these nutrients get into the cell. Insulin’s primary job is to make sure the cells have enough glucose, and therefore it has a powerful impact on blood sugar levels.

Diabetes occurs when the body does not have the insulin signaling it should. Type 1 diabetes is caused by a lack of insulin, while type 2 diabetes is caused by chronically high levels of blood glucose and insulin. Too much insulin causes insulin resistance. “The underlying cause of insulin resistance appears to be inflammation that can either be increased or decreased by the fatty acid composition of the diet. However, the molecular basis for insulin resistance can be quite different in various organs. This review deals with various types of inflammatory inputs mediated by fatty acids, which affect the extent of insulin resistance in various organs.”1

If you are a type 1 diabetic or type 1.5 (LADA), you will need to take insulin because your pancreas does not make insulin or does not make enough insulin. “We, as diabetics, deserve normal blood glucose levels, the same as non-diabetics…. The primary diabetes management concept Dr. Bernstein recommends in order to achieve normal blood glucose numbers is ‘The Law of Small Numbers’.”2

If you are a type 2 diabetic, typically you are making too much insulin, but your body can’t use the insulin because of your insulin resistance caused by hyperinsulinemia. “Recent studies underscore the need to better understand the mechanisms linking visceral adiposity with liver fat accumulation, the mechanisms by which ectopic fat accumulation cause insulin resistance, and the mechanisms by which the size of adipose tissue depots is determined.”3

After many years of having high blood sugars and insulin resistance, your pancreas may begin to “burn out” and not make enough insulin, so your doctor may give you a prescription for insulin. But frequently doctors prescribe insulin for high blood sugars even if your body makes enough insulin.

Writer Chris Wolf sees it this way: “Because your body doesn’t respond to insulin anymore, we’re gonna shoot you up with more insulin. This is like the American Firefighters Association* (I might have the name wrong) suggesting people with active house fires throw matches at the flames till they’re smothered.”4 (*It’s actually International Association of Fire Fighters and some states have their associations of fire fighters, too.)

Dr. Jason Fung says that “carbohydrates, particularly refined carbohydrates, raise insulin the most. Protein also raises insulin significantly, although blood glucose remains stable. Animal proteins stimulate more insulin release compared to plant proteins. Dietary fat raises neither glucose nor insulin.” Foods that decrease insulin (and thus prevent weight gain) include fermented foods (sauerkraut, kimchee) and vinegar. Dr. Fung further says, “Animal protein causes secretion of incretin hormones that slows absorption of foods thus lowering insulin. Thus meat has both pro- and anti-insulin effects. Fiber also has this same effect of slowing absorption and insulin effect.”5

Insulin is given by injection and comes in different types. The type of insulin you need depends on how severe your insulin depletion is. Options include:

Short-acting insulin

  • Regular insulin (Humulin and Novolin)

Rapid-acting insulins

  • Insulin aspart (NovoLog, FlexPen)
  • Insulin glulisine (Apidra)
  • Insulin lispro (Humalog)

Intermediate-acting insulin

  • Insulin isophane (Humulin N, Novolin N)

Long-acting insulins

  • Insulin degludec (Tresiba)
  • Insulin detemir (Levemir)
  • Insulin glargine (Lantus)
  • Insulin glargine (Toujeo)

Combination insulins

  • NovoLog Mix 70/30 (insulin aspart protamine-insulin aspart)
  • Humalog Mix 75/25 (insulin lispro protamine-insulin lispro)
  • Humalog Mix 50/50 (insulin lispro protamine-insulin lispro)
  • Humulin 70/30 (human insulin NPH-human insulin regular)
  • Novolin 70/30 (human insulin NPH-human insulin regular)
  • Ryzodeg (insulin degludec-insulin aspart)

Injecting Insulin

“Insulin is injected subcutaneously, which means into the fat layer under the skin. In this type of injection, a short needle [6 mm] is used to inject insulin into the fatty layer between the skin and the muscle. The preferred site for insulin injection is your abdomen. Insulin is absorbed more quickly and predictably there, and this part of your body is also easy to reach. Select a site between the bottom of your ribs and your pubic area, steering clear of the 2-inch area surrounding your navel.”6

BD (Becton Dickinson) has a nice 7-minute instructional video, “Injecting insulin with a syringe,” which you may find helpful, whether you are just starting with insulin injections or if you need a refresher. Please see the the URL, https://www.bd.com/en-us/company/video-gallery?video=4475704222001.

Endnotes

1Sears, Barry, and Mary Perry. “The role of fatty acids in insulin resistance,” Lipids Health Dis. 2015; 14: 121. Published online 2015 Sep 29. doi: 10.1186/s12944-015-0123-1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4587882/ (accessed on 7/31/2020).

2“The Law of Small Numbers,” DiaVerge Diabetes (September 19, 2015). https://www.diaverge.com/blog/2015/9/19/the-law-of-small-numbers (accessed on 7/31/2020).

3Hardy, Olga T.; Michael P. Czech; and Silvia Corvera. “What causes the insulin resistance underlying obesity?” Curr Opin Endocrinol Diabetes Obes. May 29, 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038351/ (accessed on 7/31/2020).

4Wolf, Chris. Twitter (August 12, 2018). https://twitter.com/KetoAYF/status/1028684704306941952 (accessed on 7/31/2020).

5Fung, Dr. Jason, MD. “What and when to eat to reduce insulin,” Diet Doctor (May 17, 2018). https://www.dietdoctor.com/what-and-when-to-eat-to-reduce-insulin (accessed on 7/31/2020).

6Morris, Susan York; medically reviewed by Peggy Pletcher, MS, RD, LD, CDE. “Insulin Injection Sites: Where and How to Inject,” Healthline (updated on January 20, 2020). https://www.healthline.com/health/diabetes/insulin-injection (accessed on 10/21/2020).

7BD Video Gallery. “Injecting insulin with a syringe.” https://www.bd.com/en-us/company/video-gallery?video=4475704222001 (accessed on 10/21/2020).

Additional References

Adjusting Insulin Doses
https://www.diabetes.co.uk/insulin/adjusting-insulin-doses.html

Basal Insulin Therapy in Type 2 Diabetes
Source [Not Secure] care-dot-diabetesjournals-dot-org/content/24/4/631

Insulin Injection Sites: Where and How to Inject
https://www.healthline.com/health/diabetes/insulin-injection

Long-Acting Insulin: How It Works
https://www.healthline.com/health/diabetes/long-acting-insulin

Optimizing Nutrition, Managing Insulin
https://optimisingnutrition.wordpress.com/2015/08/17/balancing-diet-and-diabetes-medications/

Prescription Tresiba® is a long-acting insulin used to control high blood sugar in adults with diabetes.
https://www.tresiba.com/

The Keto Wolf‏ @KetoAYF
Follow @KetoAYF
More Replying to @KenDBerryMD @AADEdiabetes and 5 others
Because your body doesn’t respond to insulin anymore, we’re gonna shoot you up with more insulin. This is like the American Firefighters Association (I might have the name wrong) suggesting people with active house fires throw matches at the flames till they’re smothered.
https://twitter.com/KetoAYF/status/1028684704306941952

The Laws of Small Numbers
Source [Not Secure] /www-dot-diabetes-book-dot-com/laws-small-numbers/

Types of Insulin for Diabetes Treatment
https://www.webmd.com/diabetes/diabetes-types-insulin#1

Using Insulin
https://lowcarbrn.wordpress.com/diabetes/using-insulin/

Classes of Medications