Insulins
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Insulins
Medicine and surgery
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Insulins
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Insulins
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Insulins
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First Aid
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Aspart insulin
β2 -agonists
insulin and p. 333
C-peptide
insulin and p. 333
in insulinomas p. 359
Detemir insulin
Glargine insulin
Glucagon p. 335
insulin and p. 333, 335
Gluconeogenesis p. 76
in insulin deficiency p. 352
Glucose
insulin and p. 335
Glulisine insulin
Glycogen p. 84
insulin and p. 333
Glycogenolysis
in insulin deficiency p. 352
Insulin p. 335
anabolic effects of p. 333
deficiency in p. 352
diabetic ketoacidosis p. 357
for HHNS p. 357
fructose bisphosphatase-2 and p. 74
GIP effect on p. 380
glucagon and p. 335
glycogen regulation p. 71, 84
hypokalemia from p. 614
in pregnancy p. 333
production of p. 339
secretion of p. 335
signaling pathways for p. 353
somatostatin and p. 380
somatostatinomas and p. 357
Insulinomas
insulin and C-peptide in p. 333
Insulin preparations p. 360
Ketogenesis
insulin deficiency p. 352
Lipolysis
insulin and p. 335
in insulin deficiency p. 352
Lispro insulin
Osmotic diuresis
insulin deficiency/insensitivity p. 352
Plasma osmolality
insulin deficiency/insensitivity p. 352
Pregnancy p. 657
insulin in p. 333
Protein synthesis p. 184, 198
insulin and p. 335
Proteolysis
in insulin deficiency p. 352
Regular insulin
Sulfonylureas p. 361
insulin and p. 333
Triglycerides
insulin and p. 333
Tyrosine kinase
insulin and p. 333
External Links
Transcript
Content Reviewers
Yifan Xiao, MDContributors
Royce Rajan, MD, MBA
Sam Gillespie, BSc
Jake Ryan
Alaina Mueller
Robyn Hughes, MScBMC
Insulin is a type of peptide hormone that reduces the amount of glucose in the blood. It is produced in the pancreas by beta cells. These cells are found within clusters of endocrine cells called the Islets of Langerhans, which are distributed across the pancreas. If the body is unable to produce enough insulin, then insulin therapy is used to keep the blood glucose low.
Insulin’s main function is to facilitate the transport of glucose from the blood into the various insulin-responsive tissues like muscle cells and adipose tissue. This hormone binds to insulin receptors on the surface of the cell membrane. Now, these receptors have two alpha and two beta subunits. Alpha subunits are located outside of the cell and they bind insulin; while two beta subunits are located within the cell and they have tyrosine kinase activity which carries signals into the cell. Once stimulated, insulin receptors cause intracellular storage vesicles, which contain glucose transport proteins called GLUT4, to fuse with the cell membrane. Next, the GLUT4 proteins embed themselves into the membrane and allow glucose to move into the cell.
As a result, insulin promotes glucose uptake and glycogenesis, which is the conversion of glucose to glycogen. Glycogenesis is the process that takes place in the liver and skeletal muscles. When glycogen storage capacity is reached, insulin promotes glycolysis, which is the breakdown of glucose to pyruvate. It also stimulates lipogenesis, the synthesis of fatty acids and triglycerides in the liver and adipose tissue; and amino acid uptake and protein synthesis in skeletal muscles.
Finally, insulin activates Na+/K+- ATPase pumps and shifts potassium into intracellular space, thereby decreasing potassium levels in the blood. On the flip side, insulin inhibits glycogenolysis, which stands for the breakdown of glycogen; and gluconeogenesis, which is glucose production from lactic acids and noncarbohydrate molecules. Finally, insulin inhibits lipolysis, the breakdown of lipids; and proteolysis, the breakdown of proteins.
Sources
- "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
- "Rang and Dale's Pharmacology" Elsevier (2019)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "Insulin lispro: a fast-acting insulin analog" Am Fam Physician (1998)
- "Rapid-Acting and Human Insulins: Hexamer Dissociation Kinetics upon Dilution of the Pharmaceutical Formulation" Pharmaceutical Research (2017)
- "Short-acting insulin analogues versus regular human insulin for adults with type 1 diabetes mellitus" Cochrane Database of Systematic Reviews (2016)
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