Insulin is a hormone. It is made in an organ called the pancreas. The pancreas is a large gland behind the stomach. Within the pancreas are beta cells. These cells make and release insulin. Beta cells help to deliver insulin in the right amount at the right time to keep blood sugar levels normal.

Insulin helps the body use glucose, or sugar, for energy. When you eat, much of your food is broken down into sugar. Sugar is absorbed into the bloodstream from the small intestine. From there it is taken up by the cells of the body with the help of insulin to be used as energy. Without enough insulin, the sugar cannot enter the cells and builds up in the blood. This buildup of sugar is called high blood sugar, or hyperglycemia. High blood sugar is what happens when a person has diabetes.

When the pancreas cannot make enough insulin to control blood sugar, insulin can be given as injections. Because insulin is made from protein, it must be taken by injection and not as a pill. If you took it as a pill, the acid in your stomach would stop it from working.

Recombinant DNA technology is used to make human insulin. The chemical components of human insulin have been slightly changed to make insulin analogs. Rapid acting insulin analogs start to work within minutes, allowing you to take your insulin 15 minutes before a meal. Rapid-acting insulin mimics (copies) the way insulin is released after meals in people who do not have diabetes. Learn more about Novo Nordisk rapid-acting insulin. Long-acting insulin analogs are absorbed slowly and work longer. Learn more about Novo Nordisk long-acting insulin analogs.

Novo Nordisk has been making insulin for more than 80 years. In diabetes care, our firsts include:

• The first hospital dedicated exclusively to diabetes care
• The first long-acting insulin (NPH)
• The first Lente® insulin products
• The first purified insulin
• The first insulin pen delivery system
• The first meglitinide oral antidiabetic agent
• The first insulin pen with a colorful design for children and teenagers
• The first insulin analog approved for pump therapy

Insulin resistance is a condition that is seen in people living with type 2 diabetes. With insulin resistance, the cells and tissues in the body can no longer use insulin properly. This causes sugar to build up in the blood. Insulin resistance gets worse over time. The body starts to need more and more insulin to take the sugar out of the blood. Sometimes a diabetes pill can be taken along with insulin to help the cells and tissues use insulin better. Weight loss can also improve insulin resistance.

Many people with type 2 diabetes gain weight while taking insulin. But careful meal planning and regular physical activity can help prevent weight gain. Work with your diabetes care team to choose an insulin plan that is less likely to result in weight gain. Research shows that some insulin plans can limit the effects of insulin on weight.

By the time many people are diagnosed with type 2 diabetes, their bodies have been working hard to make extra insulin to lower their blood sugar levels. Only about half of the beta cells in the pancreas are left to make insulin. The cells in their bodies have also become insulin resistant and can't make good use of the insulin the pancreas is making. Also, blood sugar levels may have been high for many years. This may have already caused diabetes-related health problems, such as damage to the heart, eyes, and nerves.

As type 2 diabetes progresses, the body's ability to make enough insulin declines. Over time, diabetes pills may not be enough to bring down blood sugar levels. Insulin injections become necessary. This does not mean that you have done anything wrong or have failed to control your diabetes. It just means that your body has changed and needs a different type of treatment.

In type 1 diabetes, the beta cells in the pancreas suddenly stop making insulin. This happens when the body's immune system begins to attack the beta cells. No one knows why the immune system does this. Insulin is always needed to treat type 1 diabetes.

In type 2 diabetes, your body prevents the insulin it does make from working right. Over time, your body makes some insulin, but not enough.

Many people who have type 2 diabetes can take other medicine instead of insulin for a while. But diabetes is a progressive disease. That means that over time the body loses more and more beta cells. At some point, most people with type 2 diabetes will need to take insulin

• Family history of diabetes (parents, brother, or sister)
• High blood pressure (hypertension)
• High cholesterol
• Obesity or overweight
• Diabetes during pregnancy