Initial therapy with insulin is given consideration in patients who are underweight (due to the drastic weight loss), patients with sick hearts, kidneys, and severe pain. Another indication of insulin:
- People with type 1 diabetes
- Diabetes Pregnancy
- Diabetes with ketoacidosis
- In the treatment of hyperglycemia nonketosis hyperosmolar syndrome
- Type 2 diabetes who can not handle blood sugar levels, such as surgery, trauma.
The types of insulin based on the peak effect and duration of works:
- Work quickly (insulin regular): peak 2-4 hours of work, long hours of work 5-8
- Work is (NPH): peak 4-12 hours of work, working long hours 8-24
- Working length (PZI): peak 6-20 hours of work, long hours of work 18-24
- Insulin combination: peak work 2-4 hours, 6-12 hours, and working long hours 8-24
In type 1 diabetes, the pancreas can not produce insulin, so insulin must be given a replacement. Giving insulin can only be done by injection. Insulin is destroyed in the stomach so it can not be taken orally. New forms of insulin (nasal spray) is under study. At this time, this new form of insulin that can not work properly because of different absorption rates cause problems in the determination of the dose. Insulin injected under the skin into the fat layer, usually in the arm, thigh, or abdominal wall. Used needles are very small so as not too painful.