Insulin (human)

ATC CodeA10AB01, A10AC01, A10AD01, A10AE01, A10AF01
CAS number11061-68-0
PUB number118984375
Drugbank IDDB00030
Molar mass (g·mol−1)5808
Melting point (°C)81

Basics

Insulin (human) or human insulin is a hormone produced by the pancreas that regulates blood glucose levels in the body. It is a peptide hormone consisting of the two polypeptide chains A and B. Human insulin is used to treat diabetes mellitus, a disease in which the body does not produce enough insulin or cannot properly utilize the insulin it does produce. In the medical context, artificially produced but unmodified inuslin is also referred to as normal insulin.

Use and indications

Insulin human is used for the treatment of type 1 and type 2 diabetes. In type 1 diabetes, it is the drug of first choice. However, modified forms of human insulin with improved properties are now available and are used more frequently. In the treatment of type 2 diabetes, insulin is used only when conventional therapy, as well as lifestyle changes, are not sufficient to reduce blood glucose.

There are basically 2 types of insulin used. Basal insulin is used to regulate blood glucose levels between meals and at night in people with type 1 diabetes and some people with type 2 diabetes. This type of insulin is given once a day, usually at night, and provides about half of a person's daily insulin needs.

Prandial insulin, also known as mealtime or bolus insulin, given before a meal to regulate the rise in blood glucose levels after eating. The dose of this may be static or calculated by the patient based on current blood glucose levels or planned carbohydrate intake, and is usually given along with a rapid-acting insulin or a regular insulin no more than 15-30 minutes before a meal.

Insulin is usually injected subcutaneously. The dosage depends on the meal and the patient. Insulin can also be administered automatically by

History

Insulin was discovered in the early 20th century by Canadian researchers Frederick Banting and Charles Best. They developed a method for extracting insulin from animal pancreases and successfully treated the first human patient with insulin in 1921. For this achievement, the researchers were awarded the Nobel Prize in 1923.

In the 1920s, insulin was first marketed by the Eli Lilly company. In the 1980s, recombinant DNA technology was developed, which enabled the production of human insulin using genetically modified bacteria. This development enabled the production of purer forms of human insulin and reduced the risk of allergic reactions and other side effects. It also made it possible to modify the structure of insulin, resulting in many of the forms used today.

Pharmacology

Pharmacodynamics and mechanism of action

Insulin regulates blood glucose levels by binding to cell insulin receptors and promoting glucose uptake and utilization. This involves translocation of glucose transporter proteins to the cell membrane, allowing glucose to be metabolized by glycolysis for energy or stored as glycogen.

Human insulin also has anabolic effects on adipose tissue and the liver by promoting the uptake of fatty acids and the synthesis of triglycerides and glycogen, respectively. Insulin also plays a role in regulating protein metabolism by promoting amino acid uptake and protein synthesis while inhibiting protein breakdown.

Pharmacokinetics

When injected subcutaneously, the glucose-lowering effect of human insulin begins approximately 30 minutes after administration. The duration of action varies depending on the type of insulin used. Short-acting human insulin usually acts for 4-6 hours, while long-acting human insulin can act for up to 24 hours.

Drug Interactions

Insulin human may interact with other drugs that affect blood glucose levels, such as oral hypoglycemic agents or glucagon-like peptide-1 receptor agonists. This may result in hypoglycemia.

Toxicity

Contraindications

Insulin should not be administered in the presence of hypoglycemia.

Side effects

The following side effects may occur after the use of human insulin:

  • hypoglycemia (low blood sugar)
  • Weight gain
  • reactions at the injection site (redness, pain)
  • Allergic reactions (localized or very rarely generalized as anaphylactic shock)

Pregnancy and lactation

Insulin human is generally considered safe for use during pregnancy, as uncontrolled diabetes can lead to complications for both the mother and the child. However, insulin dosage may need to be adjusted during pregnancy to maintain normal blood glucose levels.

During breastfeeding, the use of insulin is also considered safe.

Sources

  • Quianzon, C. C., & Cheikh, I. (2012). History of insulin. Journal of community hospital internal medicine perspectives, 2(2), 10.3402/jchimp.v2i2.18701. https://doi.org/10.3402/jchimp.v2i2.18701
  • Drugbank.com
  • Drugs.com
  • PubChem.gov
  • Diabinfo.de
Markus Falkenstätter, BSc

Markus Falkenstätter, BSc


Drugs with Insulin (human)

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