b. Type II Diabetes Mellitus (Maturity-Onset Diabetes). Maturity-onset
diabetes mellitus results from an individual's reduced sensitivity to the effects produced
by insulin. Maturity-onset diabetes is characterized by the slow onset of symptoms and
signs associated with diabetes. Maturity-onset diabetes can often be controlled by
requiring the patient to follow a strict diet plan. Oral hypoglycemic agents are also used
in the treatment of this condition.
Section III. TREATMENT OF DIABETES MELLITUS BY INSULIN THERAPY
As previously mentioned (see para 10-8), insulin is essential in the treatment of
juvenile-onset diabetes mellitus. Insulin has been successfully used in the treatment of
juvenile-onset diabetes since 1922. Typically, a person with juvenile-onset diabetes
mellitus must remain on insulin therapy for the remainder of the lifespan. As a person
who works in the pharmacy, you must be familiar with the different types of insulin and
topics of interest associated with insulin therapy.
10-10. SOURCES OF INSULIN
a. Insulin is primarily obtained from the pancreases of slaughtered beef cattle
and pigs. Hence, it is labeled "beef" or "pork" depending on the source of the
pancreases. Insulin you have in the pharmacy consists of either a mixture of pork or
beef insulin or single-source products (i.e., insulin prepared either from beef or pork
pancreases). The information specific to the source of the insulin is contained on the
product label. The mixture products are usually dispensed. However, when a patient
has been taking either pork or beef insulin, the source should not be switched.
b. A new type of insulin, Humulin, has begun being used by some diabetics.
This new product is made by bacteria and by chemical alteration of pork insulin.
Interestingly, this type of insulin is very similar to human insulin.
10-11. MEASUREMENT OF INSULIN
a. You know that many medications have their concentrations expressed in
terms of milligrams per milliliter or milligrams per tablet. Insulin is expressed in terms of
units per milliliter. These units refer to the activity of the insulin.
b. Insulin preparations are most commonly supplied in two concentrations, 40
units per milliliter and 100 units per milliliter.
10-12. USE OF INSULIN PREPARATIONS
Most insulin preparations are suspensions. Therefore, the patient must ensure
that the insulin is thoroughly mixed before the syringe and needle is used to remove it
from the bottle. THE INSULIN BOTTLE MUST NOT BE SHAKEN BEFORE THE DOSE