From the Guidelines
Low insulin levels are primarily caused by damage to the pancreatic beta cells that produce insulin, which can occur due to various factors including type 1 diabetes, an autoimmune condition, as well as other causes such as pancreatitis, pancreatic cancer, and certain genetic disorders 1. The pathogenesis of low insulin levels can be complex and involves multiple factors, including hyperinsulinaemia due to reduced insulin clearance and hypersecretion of insulin, which is probably driven by a genetic predisposition and lifestyle factors, such as the consumption of a hypercaloric, high-carbohydrate diet 1. Some key points to consider include:
- Type 1 diabetes is characterized by an absolute deficiency of insulin secretion due to destructive lesions of pancreatic beta-cells 1.
- Type 2 diabetes is caused by a combination of decreased insulin secretion and decreased insulin sensitivity, with early stages characterized by insulin resistance causing excessive post-prandial hyperglycaemia 1.
- Other causes of low insulin levels include pancreatitis, pancreatic cancer, certain genetic disorders like maturity-onset diabetes of the young (MODY), cystic fibrosis-related diabetes, and hemochromatosis (iron overload) 1.
- Some medications such as pentamidine, glucocorticoids, and certain antipsychotics can also reduce insulin production, and malnutrition, especially protein deficiency, may impair insulin synthesis 1. The body needs insulin to regulate blood glucose levels by facilitating glucose uptake into cells for energy, and without sufficient insulin, blood sugar rises, causing symptoms like increased thirst, frequent urination, unexplained weight loss, and fatigue 1. Treatment typically involves insulin replacement therapy, with dosing regimens tailored to individual needs based on blood glucose monitoring 1. It is essential to note that the pathophysiology of type 2 diabetes can vary between different populations, and in sub-Saharan Africans, the pathogenesis is characterized by hyperinsulinaemia due to reduced insulin clearance and hypersecretion of insulin, which is probably driven by a genetic predisposition and lifestyle factors 1.
From the Research
Causes of Low Insulin
There are no direct research papers to assist in answering this question, as the provided studies focus on the treatment of type 1 and type 2 diabetes mellitus using insulin glargine, rather than the causes of low insulin.
Related Information on Insulin Glargine
- Insulin glargine is a long-acting insulin analogue that provides a consistent level of plasma insulin over a long duration 2, 3, 4, 5.
- It has a slower onset, a longer duration of action, and no peak in metabolic activity compared to Neutral Protamine Hagedorn (NPH) insulin 4, 5.
- Insulin glargine has been associated with a lower risk of hypoglycemia, particularly at night, and improved treatment satisfaction in several clinical trials 2, 3, 4, 5, 6.
- The use of insulin glargine in type 1 and type 2 diabetes has been extensively reviewed, and it is considered a useful addition to the armamentarium of insulin therapy 2, 3, 4, 5, 6.