The Pros And Cons Of Insulin

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List out various insulin preparation and briefly explain them. Insulin is a polypeptide hormone that consist of two peptide chains connecting by disulphide bonds. It is synthesized as proinsulin (precursor) that undergoes proteolytic cleavage to form insulin and C-peptide. Its secretion is regulated by four factors, which is blood glucose levels, certain amino acids, other hormones, and autonomic mediators. Increasing in blood glucose is the most often factor that trigger insulin secretion. Insulin preparation are classified as:
• Rapid-acting and short-acting
• Intermediate acting
• Long-acting
• Insulin combination A. Rapid-acting and short-acting insulin preparations Regular insulin, insulin lispro, insulin aspart, and insulin glulisine
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For instance, insulin lispro is different to regular insulin in that the reverse positions of lysine and proline at positions 28 and 29 in the B chain. This modification causes more rapid absorption, a quicker onset, and a shorter duration of action due to decreases in hexameric insulin formation after subcutaneous injection. Peak levels of Insulin lispro has peak levels at 30 to 90 minutes. Insulin aspart and insulin glulisine have similar pharmacokinetic and pharmacodynamic properties with insulin lispro. Rapid - or short-acting insulins are provided to mimic the prandial release of insulin during prandial (mealtime) and to control postprandial glucose. They may also be used in cases where swift alteration of elevated glucose to normal is needed. Injection of rapid-acting insulin has been proven to be more effective than regular insulin by which when they are administered pre-meal, having 15-20 minutes onset of action compared to 30 minutes or above respectively. This shorter interval for insulin injection pre-meal is more acceptable for patients and leads to better adherence with prescribed injection timing guidelines. Rapid-acting insulins are commonly used in external insulin pumps and also suitable for IV

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