Insulin in diabetes

All people with type 1 diabetes and some with type 2 require treatment with insulin to control blood glucose. There are two basics kinds of insulin used to manage diabetes: long acting and short acting. Short acting (or mealtime) insulin works fast and, as the name suggests, is taken just before or after eating to deal with the subsequent surge in blood glucose as food is digested. Long acting (or background insulin) is usually taken once or twice a day and keeps blood glucose down between meals. While both insulin's are essentially the same protein, almost identical to the version made by the body, the medicines are formulated differently in the lab to speed or slow their absorption, respectively. Oral medications for type 2 diabetes works by either boosting the production of insulin by the beta cells, or making the body less resistant to insulin.

Insulin can't be taken orally because, as a protein, digestive enzymes would destroy it. Instead, it must be put into the body's tissues by syringe, pen, or pump. All of these approaches deliver insulin just under the skin. From there, it diffuses to the bloodstream, where it goes to work.

Researchers are developing better and easier ways to deliver insulin and more closely match the body's need for it. A so-called artificial pancreas (using software to link a continuous glucose monitor and an insulin pump) would automatically dose insulin based on blood glucose measurements. Scientists are developing injected insulin's that work either faster or slower than existing versions to help people with diabetes more precisely control their blood glucose levels. Others are working on an oral form of insulin, the elusive insulin pill, as well as versions of the medication that can be inhaled.

Medical science has come a long way and someday, science may catch up with biology, making insulin and blood glucose levels in people with diabetes as perfect as in those without diabetes.