Sulfonylureas
By Eileen B. Wyner, NP
Bulfinch Medical Group
Sulfonylureas are a class of medications used to lower blood sugar in people with Type 2 Diabetes. These oral agents increase the production of insulin from the beta cells of the pancreas. Sulfonylureas are typically taken once or twice daily before meals and can be used alone or in combination with insulin or other Type 2 Diabetes oral medications. This class of medications may cause severe hypoglycemia if taken incorrectly.
Insulin
By Eileen B. Wyner
Bulfinch Medical Group
Insulin is a hormone produced by the beta cells of the pancreas. Insulin helps glucose move from the bloodstream into the cells of the liver, skeletal muscles, and fat tissue where it is stored for action as an energy source. People with diabetes have sustained a disruption in the workings of the beta cells so they are not producing insulin as well as they used to, meaning their blood sugar values are variable. They may be able to manage this with diet, exercise, or oral medications. There are times when insulin injections will be needed. Insulin cannot be taken as a pill as it would be broken down during digestion just like the protein in food, so it must be injected into the fat under your skin for it to get into your blood system.
Insulin Resistance
By Eileen B. Wyner
Bulfinch Medical Group
Insulin resistance occurs when some of the body’s cells don’t respond efficiently to the insulin it produces. The causes aren’t completely clear but family history, decreased physical activity, and weight gain are clearly factors. Insulin is the key that opens up the cells so glucose can enter and provide the energy they require to stay healthy and do their job. Insulin resistance is a risk factor for heart disease and Type 2 Diabetes.
Beta Cells
Beta cells are the cells in the pancreas that make insulin, a hormone that helps move glucose out of the blood and into cells for energy. Type 1 Diabetes is an autoimmune disease where the body’s immune system attacks and destroys these cells. As a result, a person with Type 1 is no longer able to produce insulin on their own and must supply it through daily insulin injections or an insulin pump.
(Content reviewed by MGH Diabetes Center)
Basal
By Eileen B. Wyner, NP
Bulfinch Medical Group
Basal is a word with many definitions but in the medical world it refers to a minimal level that is necessary for health, such as the minimum insulin dose. People without diabetes are constantly producing insulin to keep the blood sugar level constant. This is called basal insulin. People with diabetes are not producing natural insulin as efficiently, so there are blood sugar fluctuations. Basal insulin therapy is indicated so blood sugar fluctuations can be well controlled. It may be injected once or twice a day and taken in conjunction with other medications to control diabetes.
Bolus
By Eileen B. Wyner, NP
Bulfinch Medical Group
A bolus refers to the administration of a medication, given to raise its concentration in the blood to an effective level. People with diabetes often use a bolus dose of rapid-acting insulin with a meal to keep the after meal time blood sugar well regulated. The key is that rapid acting insulin acts quickly, so it’s important to take this insulin within 15 minutes of the meal in question. There are instances where a bolus of insulin may be used to control high blood sugars in the event of an illness or infection – this would be closely monitored by your health care provider. There are many cases where a combination of basal and bolus insulin are used together for better blood sugar control.
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