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Department of Diabetes and Endocrinology

What is Insulin and How Does It Work?

Posted On: Dec 26, 2019

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what is insulin

What is Insulin?

Insulin is a potent hormone released by the pancreas to carry the glucose from the blood to the cells. It keeps the blood sugar levels normal. In type 1 diabetes the levels of the insulin are below the normal value. However, in type 2 diabetes, insulin levels spike to overcome insulin resistance. Diabetes is a major concern in the present population and the management of high sugar levels in blood mainly focuses on increasing the insulin levels either through direct injections or through drugs promoting its secretion. Also, during the conditions such as pregnancy and pancreatic tumours, the levels of insulin are high.

However, long-term use of insulin and its excess production has certain unwanted effects on your system. Take a look at the important adverse effects of hyperinsulinemia and how to manage the condition.

What should be the number in a healthy people?

Insulin is measured in MCU/ml or mIU/ml (microunits per millilitre). The normal levels of insulin in the blood of a healthy person vary with and without food.

  • The fasting value is < 25 mIU/L

  • After 30 minutes of food intake, the value is 30-230 mIU/L

  • After 1 hour of food intake, the value is 18-276 mIU/L

  • After 2 hours of food intake, the value is 16-166 mIU/L

If the levels of insulin are higher than these normal values, then it is considered hyperinsulinemia.

What are the risk factors for elevated insulin?

The following factors can increase your chance of having excess insulin levels in the blood

  • Early puberty – Girls who attain early puberty are found to have elevated insulin levels.

  • Lack of sleep if happens regularly can lead to insulin resistance which over time leads to excess insulin production as a feedback mechanism.

  • The stress hormone ‘Cortisol’ causes insulin resistance as one of the side effects, by blocking the insulin receptor which indirectly leads to excess insulin production.

  • The metabolic syndrome which is a combination of obesity, hypertension, and high blood cholesterol levels can lead to hyperinsulinemia (high levels of insulin in the blood).

Indications that you have hyperinsulinemia

The following symptoms may indicate that you have high insulin levels in your blood:

  • Frequent and intensive hunger

  • Excess cravings for sugar

  • Weight gain, especially around the waist, forming an apple-shape

  • Fatigue

  • Lack of motivation or focus

  • Anxiety and panic

Adverse effects of high insulin levels

Prolonged use of external insulin or its high levels in the blood can have certain side effects on different body parts as discussed below

  • Hypoglycemia (low blood sugar levels) – This is the major side effect of high insulin levels in your blood. It occurs in nearly 16% of type 1 diabetic patients and 10% of type 2 diabetic patients. Severe hypoglycemia can result in sweating, tachycardia, confusion, seizures, coma, and even death in extreme cases. Therefore, regular glucose monitoring is recommended for diabetic patients receiving insulin therapy.

  • Hypersensitivity reactions – It occurs only in 1% of the people taking either biosynthetic human insulin or pork insulin. The reactions include a local erythema (redness), heat, swelling or nodule formation. Desensitization kits are available for patients with a true allergy to insulin.

  • Cardiovascular consequences – Insulin can cause hypertension by stimulating the nervous system to retain sodium. It may also induce an imbalance in the blood fats. Insulin may also increase heart rate if hypoglycemia has not occurred.

  • Weight gain – A sudden restoration of control over the blood glucose levels in diabetic patients treated with insulin causes weight gain. This is due to the increased use of glucose or calories.

  • Metabolic side effects – People treated for diabetic ketoacidosis may have low levels of phosphates, potassium, and magnesium in the blood.

  • Kidney functioning – Hypoglycemia caused by hyperinsulinemia can lead to a decrease in the blood flow to the kidneys thus reducing the filtration rate. It also increases the excretion of urinary albumin (a protein). These changes are reversible if hypoglycemia can be managed.

  • Blood flow – Hyperinsulinemia can decrease blood volume and increase its viscosity. This can predispose the patient to low peripheral perfusion.

  • Gastrointestinal disturbances – Rarely hyperinsulinemia can lead to gastrointestinal distress which can be resolved by lowering the insulin dose.

  • Visual disturbances – A blurred vision can also occur which is self-limited.

  • Lung – Both the lung structure and the function are affected by high levels of insulin. This is of concern, especially in Indians who are found to have the lowest lung function globally.

How to lower high insulin levels in blood?

Lowering the insulin in the blood is similar to lowering the glucose levels.

  • Since hyperinsulinemia is often linked to obesity, weight reduction is the best approach to treat the condition. The key is to reduce the intake of carbohydrates which stimulate insulin production. Avoid sugar-sweetened beverages and refined grains. Instead, go for the foods rich in proteins.

  • Consumption of dairy products is associated with a decreased risk of insulin resistance and thus hyperinsulinemia.

  • Never use insulin inhalation. Instead, go for a healthy diet and exercise to control diabetes. Experts recommend around 30-60 minutes of exercise for most days of the week.

  • Lifestyle changes include limiting alcohol, smoking cessation, and regular exercise.

  • Certain biguanide drugs can also be administered to reduce insulin resistance.

If the above treatments are not effective, bariatric surgery may be required to improve your condition.

You may not experience the symptoms of hyperinsulinemia even if you are on treatment for diabetes. Thus, you may need further evaluation by a doctor who will check for the presence of the condition. Treatment varies with the cause of hyperinsulinemia. So, always take a doctor’s advice.

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