Clinical Nutrition Assignment

Clinical Nutrition Assignment

Clinical Nutrition Assignment

Question:

Insulin associated diseases

In this assignment, you will be asked to investigate one aspect of insulin associated disease in humans and animals.

Topic: In Australia, insulin therapy for T1D (Type 1 Diabetes) involves a number of synthetic insulin analogues, one of them being INSULIN LISPRO. Describe how its (Insulin Lispro) structure differs from natural human insulin and discuss the reasons for, consequences of, that structural change.

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Diagrams can be used.

Drug name: Insulin Lispro

Brand name: Humalog

Manufacturer: Eli Lilly

Sample Draft Solution:

Introduction

Sample Disclaimer

Insulin is the essential hormone of plenty, which is required for being alive and without it severe problems related with metabolism and catabolism, and death result despite sufficient calories consumption. This is a hormone created through the pancreas allows our human body to utilize glucose from carbohydrates present in the nutrition that we eat for liveliness or in storing glucose or sugar for upcoming use (Hunter and Garvey, 1998).

Lack of insulin production is clinically dangerous, as it will diminish insulin act. This primarily causes type-1 diabetes. That occurs when insulin-creating cells are impaired or damaged resulting insulin producing process will be stopped. Insulin deficiency left behind too much sugar into the blood and deficiency of sugar in the cell for energy. Moreover, Insulin Deficiency causes the wide series of epidemic diseases: containing atherosclerosis, ovulatory dysfunction, fatty liver disease, and cancer as well as type-2 diabetes (Medicine Net, 2018).

On the other hand, Hyperinsulinemia is a situation in which there is excess of insulin flowing through the blood comparative to the level of Sugar. Excess insulin in the blood causes cells in our body to engross too much glucose or sugar from our blood. This condition is called hypoglycaemia (Mandal, 2018).

Type-1 Diabetes

There are many diseases associated with abnormal insulin secretion and consumption by the human body (Mandal, 2018). One of them is Type-1 diabetes, which is a subcategory of Diabetes mellitus.

It is also referred as “Insulin dependent diabetes mellitus (IDDM)”. During this disease tolerant having autoimmune destruction process during which the body’s own immune cells fight with the insulin liberating beta cells of pancreas. In the long term, this leads to greater insulin deficiency (Mayo Clinic, 2018). As a remedy of this disease, patients require to be complemented with insulin Lispro injections externally. The exact cause of type 1 diabetes is unknown, thus probable causes include:

  • Genetics
  • Exposure to viruses
  • Exposure to other environmental factors

Insulin therapy for (Type-1 Diabetes)

Type-1 diabetics necessitate insulin therapy to sustain normal glucose level as well as lipid metabolism. To produce suitable insulin for basal bolus action, one of the insulin analogues for the genetic modification of the insulin is rapid and long-acting (basal) insulin (American Diabetes Association, 2018). Rapid-acting insulin analogues (insulin Lispro) are popular for the property of not accumulating when injected hypodermically under the skin tissues (Bhatia and Aggarwal, 2007).

Insulin Lispro

Humalog is the brand name under which Insulin-Lispro injections are manufactured which is a kind of rapid-performing human insulin-analogue for lowering blood sugar. Recombinant DNA technology is being used in a non-pathogenic laboratory for the production of Insulin Lispro (RxList, 2017).

Structure difference between Insulin Lispro and Natural Human Insulin

Insulin Lispro structure differs from natural human insulin inside the amino-acid proline at the lysine in position B29 is replaced by proline (chemically which is Pro (B29)) and the position B28 is replaced by lysine (chemically which is Lys (B28)) (RxList, 2017).

Reasons and Consequences (Clinical Pharmacology)

In spite of some structural difference between synthetic insulin and natural human insulin, on molar basis the Insulin Lispro have equal potential to human insulin. As one-entity of Insulin Lispro has equal glucose-lowering effect as one-entity of natural human insulin (Tritos and Mantzoros, 1998). Studies and research in normal patients of diabetes proved that Humalog is having more quick time of action as well as a lower interval of action than human insulin while given therapeutically (Health24, 2017).

Source: (RxList, 2017)

Further research in patients and healthy volunteers of diabetes revealed that absorption rate of Humalog is quicker than human insulin. When the subjects were given medical doses of the drug ranging in between 0.1 and 0.4unit/kg, then after studies peak levels were perceived 30-90 minutes later. On the other hand, when volunteers were given equal dose of human-insulin, then peak-level insulin attained after around 50-120 minutes after doses were given (RxList, 2017). A result of the study or survey is being shown in below figure:

Source: (RxList, 2017)

Drug interactions of Insulin Lispro

  • Insulin Lispro interacts with antidiabetic agents such as salicylates, sulphonamide antibiotics, fluoxetine, fibrates, pramlintide, disopyramide, and somatostatinanalogs, hence results in increased risk of Hypoglycemia.
  • The glucose decreasing effect of Insulin Lispro may be reduced when it is co-administered with corticosteroids, isoniazid, oral contraceptives, danazol, somatropin, atypicalantipsychotics, protease inhibitors, and thyroid hormones.

Thus, adjustment of dose accordingly and increased regularity of glucose observing is required when Insulin Lispro is co-administered with above mentioned drugs.

Conclusion

This discussion in above paragraphs depicts that appropriate Insulin Level in a human body is very essential part of a healthy life-style. If someone is not having natural proper insulin generation, then immediate treatment should be taken. Treatment or therapy is non-negotiable, as well as there are no easy alternatives for the controlling of this condition, as it can be life threatening. Insulin Lispro injections are the part of insulin treatment for Type-1 Diabetes being one of the synthetic insulin-analogues In Australia.

Online research on Insulin Lispro has concluded following facts about the drug:

  • HUMALOGis synthetic but fast-responding insulin used for controlling high sugar in blood among adults as well as children having diabetes mellitus.
  • It is still a mystery that HUMALOGis harmless and operative in children aged younger than 3 years.
  • Using instructions for this drug: Never share used HumalogKwikPen, cartridges or syringes with others, even if the pointer has been replaced. As the tendency of spreading, a severe infection is being increased. Usage of HUMALOG should be exactly same as suggested by Clinical officer. Prior usage, the specific type, and strength of insulin should be known. Never change the type of insulin prescribed unless the doctor suggested.

As of now, there is no other way to prevent type-1 diabetes; still research is going on for future applications. Gradually, type-1 diabetes obstacles can influence important human body organs, like heart, nerves, blood vessels, and kidneys. Because Glucose is a key supply source of energy for entire, human body that made up with muscles as well as other tissues. In type-1 diabetes, there is high deficiency of human insulin to let sugar through the body cells, which can cause lethal complications. Therefore, maintaining a regular blood glucose level can affectedly decrease other complications.

References

American Diabetes Association (2018) American Diabetes Association, [Online], Available: https://www.diabetes.org/diabetes-basics/type-1/ [25 Aug 2018].

Bhatia, E. and Aggarwal, A. (2007) ‘Insulin therapy for patients with type 1 diabetes’, Journal-Association Of Physicians Of India, vol. 55, no. L, p. 29.

Challis, B.G. and Semple, R.K. (2013) ‘Genetic Disorders of insulin action: Far More than Diabetes’, Current Obesity Reports, vol. 2, no. 4, pp. 293-300.

Health24 (2017) The different types of insulin for type 1 diabetes, 06 Mar, [Online], Available: https://www.health24.com/Medical/Diabetes/Type-1-diabetes/The-different-types-of-insulin-20120721 [25 Aug 2018].

Hunter, S.J. and Garvey, W.T. (1998) ‘Insulin action and insulin resistance: diseases involving defects in insulin receptors, signal transduction, and the glucose transport effector system’, The American Journal of medicine, vol. 105, no. 4, pp. 331-345.

Mandal, A. (2018) Insulin Diseases, [Online], Available: https://www.news-medical.net/health/Insulin-Diseases.aspx [14 Aug 2018].

Mayo Clinic (2018) Type 1 Diabetes, [Online], Available: https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011 [25 Aug 2018].

Medicine Net (2018) Insulin Resistance, [Online], Available: https://www.medicinenet.com/insulin_resistance/article.htm#insulin_resistance_definition_and_facts [14 Aug 2018].

Mlinar, B., Marc, J., Janez, A. and Pfeifer, M. (2007) ‘Molecular mechanisms of insulin resistance and associated diseases’, Clinica chimica acta, vol. 375, no. 1-2, pp. 20-35.

RxList (2017) HUMALOG, 19 Jun, [Online], Available: https://www.rxlist.com/humalog-drug.htm [25 Aug 2018].

Tritos, N.A. and Mantzoros, C.S. (1998) ‘Syndrome of Several Insulin Resistance’, The Journal of Clinical Endocrinology and metabolism, vol. 83, no. 9, Sep, pp. 3025-3030.

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