Dr Jothydev Kesavadev was invited as guest speaker to talk on impact of A1c
lowering on diabetes outcomes. Dr V. Vincent MD, FRCP introduced Jothydev
to the physicians of Nagarcoil. He recalled the great works of late P.
Kesavadev and also appreciated the activities of Diabscreen Kerala ( project
of P. Kesavadev Trust) in its campaign against diabetes and obesity. Senior
physician Dr Raja Paul was also present among the 40 of the other doctors.
Question and Answer
Qn: Ultra lente used to be the long acting insulin very useful in clinical
practice. Isn't for commercial reasons it is widrawn from the market?
Jothydev: I too partly agree with your statement. However, ultra lente
being a long acting insulin is not a basal insulin of right choice;unlike
levemir or Lantus which does not peak. Self monitoring of blood glucose
with a standard glucometer is absolutely mandatory while using ultra lente
so as to prevent life threatening episodes of hypoglycemia expecially during
sleep. In India self monitoring is seldom practiced, except patients
undergoing management at certain specialitycenters. This probably could be
a valid reason while ultra lente bacame unpopular.
Qn:How much insulin is produced from a normal human pancreas everyday?
Jothydev: A normal pancreas secretes into the portal system about 25 unit of
insulin daily, half of which is used by the liver before it reaches the
systemic circulation. Glucose homeostasis is achieved by basal and post
prandial insulin secretion.
The total amount of insulin secreted however depends on blood glucose
values, insulin sensitivity, exercise and dietary intake