How to make a short and long insulin. Cones from insulin
Prolonged insulins are capable of maintaining a normal blood glucose level with any degree of diabetic state throughout the day. At the same time, the decrease in the concentration of sugar in the plasma occurs due to its active absorption of the organism tissues, in particular the liver and muscles. The term "long" insulins makes it clear that the duration of the effect of such injections, compared with other types of sugar preparations, is more durable.
Types of insulin prolonged drugs
Insulin of long-acting is issued as a solution or suspension for intravenous and intramuscular administration. W. healthy man This hormone is continuously produced by the pancreas. The prolonged hormonal composition was developed in order to simulate a similar process in people who are sick. But the injections of the extended type are contraindicated in patients who are in diabetic coma or precompetitive state.
At the moment, the means of a long and ultra-durability are common:
Hormonal substance | Features | Form release |
Humulin NPH | Activated after 60 minutes, the maximum effect is achieved after 2-8 hours. Adjusts the level of glucose in the blood of 18-20 hours. | Extensive type suspension for p / k administration. It is implemented in vials of 4-10 ml or cartridges of 1.5-3.0 ml for syringe-handles. |
PROTAFAN NM | It begins to work for 1-1.5 hours. Maximum efficiency is manifested in 4-12 hours. And no less than a day lasts. | Suspension for the introduction of P / k. Packaged to 3 ml cartridges, in packing 5 pcs. |
Insuman Basal | Activated after 1-1.5 hours. Acts 11-24 hours, the maximum effect occurs in a period of 4-12 hours. | Extended insulin for p / k administration. Available in 3 ml cartridges, in vials of 5 ml and 3 ml cartridges for syringe-handles. |
Sixulin N. | Prolonged insulin is activated for 1.5 hours. Peak activity accounted for the interval between 3-10 hours. The average period of action is a day. | Means P / k use. It is implemented in cartridges for syringe knobs 3 ml, in bottles of 10 ml. |
Begins to act 60 minutes after the injection, regulates the blood sugar concentration of at least a day. | Cartridges are usual and for syringe-handles 3 ml, in 10 ml bottles for n / k application. |
|
Leewemir Flexpen | Peak activity occurs after 3-4 hours. The duration of the effect of the prolonged means is a day. | Extended insulin is implemented in 3 ml syringe knobs. |
The name of the sugar-based substance and how to use the insulin of extended action, can recommend only the attending physician.
In addition, people suffering from diabetes mellitus should not independently replace the prolonged agent on its analogue. The hormonal substance of the extended type must be appointed justified from the medical point of view, and the treatment with its help should be carried out only under the strict control of the doctor.
Features of the use of long insulins
Insulin of extended action, depending on the type of CD, can be combined with a high-speed means, which is done in order to fulfill the basal function to them, or apply as a monopreparation. For example, with the first form of sugar diabetes, the insulin of the prolonged species is customary to combine with a short or ultrashort drug. In the second form of the CD, medication is applied apart. In the list of oral shame composures, with which the hormonal substance is usually combined, are:
- Sulfonylurevine.
- Meglitinides.
- Biguanides.
- Thiazolidindions.
Insulin of extended action can be taken as a monoplant, as with other medicines
As a rule, the sucrospace composition of the prolonged type begin to use in order to replace funds with the average exposure duration. Due to the fact that in order to achieve a basal effect, the average insulin composition is introduced twice a day, and long - once a day, the change of therapy for the first week can provoke the occurrence of morning or night hypoglycemia. You can correct the situation by reducing the amount of extended drug by 30%, which allows partially to compensate for the lack of prolonged hormone, using a short-type insulin during food. After that, the dosage of the extended insulin substance is subject to adjustment.
The basal composition is administered once or twice a day. After entering the body by injection, the hormone begins to show its activity only after a few hours. At the same time, the time frame of the impact of each given in the table of the prolonged sugar-based substance its own. But if the insulin of the extended type is required to introduce in an amount exceeding 0.6 units per 1 kg of human weight, then the indicated dose is separated by 2-3 injections. At the same time, to eliminate the emergence of complications, injections are made in different parts of the body.
Consider how to avoid side Effects Insulin therapy.
Any insulin means, regardless of its exposure, can cause side effects:
- Hypoglycemia - blood glucose levels drops below 3.0 mmol / l.
- General and local allergic reactions - urticaria, itching and seals at the place of injections.
- Violation of fat metabolism - characterized by the accumulation of fat not only under the skin, but also in the blood.
More chances to prevent complications in type 1 and 2 diabetes mellitus gives insulin prolonged action. In addition, long insulin makes the treatment of SD more convenient. To eliminate the manifestation of the specified side effects, diabetics must be taken daily ascribed by the doctor a diet and constantly change the places of injections.
Prolonged means of a new generation
Recently, two new, approved FDAs appeared on the pharmaceutical market, long-term drugs intended for the treatment of adult patients from diabetes:
- Degludek (etc. Tresisiba).
- Ryzodeg Flexstach (Ryzodeg).
Tresisiba is a new drug that FDA approved
Insulin of extended effects of degludek is designed for subcutaneous administration. The duration of controlling the level of glucose in the blood with its help is about 40 hours. Used to treat diabetics with the first and second form of the complexity of the disease. To prove the safety and efficacy of the new product of extended impact, a number of studies were conducted in which more than 2,000 adult patients took part. The degludek was used as an addition to oral treatment.
To date, the use of the drug of the Degleudek is allowed in the territory of the EU countries, Canada and the United States. In the domestic market, the new development appeared under the name Tresiba. The composition in two concentrations is realized: 100 and 200 units / ml, in the form of a syringe knob. Now it is possible to normalize the level of sugar blood sugar using superservation of an extended action by applying an insulin solution only three times a week.
We describe the drug Ryzodeg. The means of extended exposure to Ryzodeg is a combination of hormonal substances, the names of which are well known to diabetics, is the basal insulin of Degludek and high-speed aspart (ratio of 70:30). Two insulin-like substances in a specific way interact with endogenous insulin receptors, due to which its own pharmacological effect is implemented like the effect of human insulin.
The safety and efficacy of the newly developed durable effect was proven by a clinical trial in which 360 adult diabetics took part.
Ryzodeg was taken in conjunction with other sucropping during food intake. As a result, a reduction in blood sugar was reached to the level, which was previously achieved only when using the prolonged exposure insulin preparations.
Hormonal medicines of the extended exposure to Tresiba and Rayjaitg are contraindicated to people with a sharp complication of the SD. In addition, the specified drugs, as the analogues discussed above, should be appointed only by the attending physician, otherwise it is not to avoid side effects in the form of hypoglycemia and all sorts of allergies.
Despite the fact that scientists managed to completely repeat the insulin molecule, which is produced in the human body, the action of the hormone still turned out to be slowed due to the time required for absorption into blood. Insulin Humalog became the first preparation of improved action. It begins to work after 15 minutes after the injection, so sugar from the blood is transferred in a timely manner in tissue, and even short-term hyperglycemia does not occur.
Compared to previously developed human insuls, Humalog shows the best results: Patients with 22% reduced daily sugar fluctuations, glycemia indicators are improved, especially in the afternoon, the likelihood of severe delayed hypoglycemia is reduced. Thanks to the rapid, but stable action, this insulin is increasingly used in diabetes mellitus.
Brief instructions
Instructions for the use of insulin Humalog are quite voluminous, and sections describing side effects and instructions for use occupy not one paragraph. Long descriptions that are accompanied by some drugs are perceived by patients as caution about the danger of their reception. In fact, everything is exactly the opposite: big, detailed instructions – certificate of numerous testswhich successfully endured the drug.
Humalog is approved for applying for more than 20 years ago, you can already say confidently that this insulin is safe with the correct dosage. It is allowed for applying both adults and children, can be used in all cases accompanied by a pronounced shortage of hormone: 1 and 2 type of diabetes, operations on the pancreas.
General About Humalog:
| Description | Transparent solution. Requires special storage conditions, if they are violated, it may lose its properties without changing the appearance, so the drug can only be bought in pharmacies. |
| Operating principle | Provides glucose in tissue, enhances glucose transformation in the liver, prevents fat cleavage. The sugasive effect begins earlier than that of the insulin of a short action, and lasts less. |
| The form | A solution with a concentration of U100, administration - subcutaneous or intravenous. Packed in cartridges or disposable syringe knobs. |
| Manufacturer | The solution produces only Lilly France, France. Packaging is made in France, USA and Russia. |
| Price | In Russia, the cost of packaging containing 5 cartridges in 3 ml each is about 1800 rubles. In Europe, the price for the same volume is approximately the same. In the US, this insulin is more expensive than almost 10 times. |
| Indications |
|
| Contraindications | Individual reaction to insulin Lizpro or auxiliary components. It is more often expressed in allergies at the injection site. With low severity, it takes place a week after the transition to this insulin. Heavy cases are rare, they require the replacement of humulog analogs. |
| Features of the transition to Humalog | During the selection of the dose, more frequent dimensions of glycemia are required, regular medical consultations. As a rule, diabetics need less than 1 hehe units than human. The increased need for hormone is observed during various diseases, nervous overvoltage, active physical activity. |
| Overdose | Dose excess leads to hypoglycemia. To eliminate it, you need a reception. Heavy cases require urgent medical care. |
| Sharing with other medicines | Lower the activity of the humulog can:
Enhance effect:
If these drugs cannot be replaced by others, the dose of humalog must be temporarily adjusted. |
| Storage | In the refrigerator - 3 years, at room temperature - 4 weeks. |
Among the side effects, hypoglycemia and allergic reactions are most often observed (1-10% of diabetics). In less than 1% of patients, lipodystrophy develops in the injection places. The frequency of other unwanted reactions is less than 0.1%.
The most important thing about humulog
At home, the humalog is introduced subcutaneously with the help of a syringe knob or. If you need to eliminate severe hyperglycemia, intravenous administration of the means is possible in medical institutions. In this case, frequent control of sugar is required to avoid overdose.
Insulin Humalog
The active substance of the drug - insulin Lizpro. From human hormone, it is distinguished by the location of amino acids in the molecule. Such a modification does not prevent cell receptors to recognize the hormone, so they easily pass sugar inside. Humalog contains only insulin monomers - single, non-interconnected molecules. Due to this, it is absorbed quickly and evenly, begins work to reduce sugar faster than an unmodified ordinary insulin.
Humalog is a shorter action preparation than, for example, or. According to the classification, it is believed to an analogues of insulin, which has an ultrashort effect. The beginning of his activity is faster, about 15 minutes, so diabetics do not have to wait until the drug will affect, and it is possible to prepare for the reception immediately after injection. Thanks to this short range, the nutrition becomes easier, moreover, the risk is significantly reduced to forget about food after the injection.
For good control of glycemia by means with a rapid action should be combined with mandatory use. The only exception is the use on an ongoing insulin pump.
Selection of dose
The dosage of the humalog depends on many factors and is determined individually for each diabetics. Use standard schemes is not recommended, so they worsen sugar-diabetes compensation. If the patient adheres to a low-carbid diet, the dose of a humulog may be less than standard administration tools can provide. In this case, it is recommended to use a weaker fast insulin.
The hormone of ultrashort action gives the strongest effect. When moving to a humulog, its initial dose is calculated as 40% of the previously used short insulin. According to the results of glycemia, the dosage is adjusted. The average need for a preparation for one grain unit is 1-1.5 units.
Injection scheme
Humalog tickle before each meal, minimum three times a day. In the case of high sugar, adjusting ties between the main injections are allowed. Instructions for use recommends to calculate the required amount of insulin based on carbohydrates planned for the next meal. From the injection to food should pass about 15 minutes.
According to reviews, this time is often less, especially in the afternoon, when insulin resistance is lower. The absorption rate is strictly individual, it is possible to calculate it using repeated blood glucose measurements immediately after injection. If the sacrarizing effect is observed faster than provided by the instruction, the time before meals should be reduced.
Humalog is one of the fastest drugs, so it is convenient to use it as a means of emergency for diabetes, if the patient threatens.
Action time (short or long)
The peak of the work of the ultrashort insulin is observed 60 minutes after its administration. The response time depends on the dose than it is larger, the saha-surging effect is longer, on average - about 4 hours.
Humalog Mix 25 (Humalog Mix 25)
To properly appreciate the action of the humalog, glucose needs to be measured after the expiration of this period, usually do it before the next meal. Early measurements are necessary when suspected hypoglycemia.
The short term of the humulog is not a lack, but the dignity of the drug. Thanks to him, hypoglycemia, especially the night, are less common in patients with diabetes mellitus.
Humalog mix
In addition to Humalog, the pharmaceutical company Lilly France produces a humulog mix. It is a mixture of insulin lezpro and protamine sulfate. Thanks to this combination, the start time of the hormone work remains as fast, and the duration of action increases significantly.
Humalog mix is \u200b\u200bavailable in 2 concentrations:
The only advantage of such drugs is more simple scheme Injection. Compensation of diabetes mellitus when using them worse than with an intensive insulin therapy scheme and the use of a conventional humulog, so for children Humalog Mix is \u200b\u200bnot used.
This insulin is appointed:
- Diabetes, not able to independently calculate the dose or make an injection, for example, due to poor vision, paralysis or tremor.
- Patients with mental illness.
- Elderly patients with numerous complications of diabetes and poor prognosis of treatment, if they do not want to learn.
- Diabetics with 2 types of disease, if its own hormone is still produced.
Treatment of diabetes drug Humalog mixer requires a strict monotonous diet, mandatory snacks between food. For breakfast, it is allowed to eat up to 3 xe, on the second breakfast and lunch - up to 4 hehe, for dinner - about 2 x, before bedtime - 4 xh.
Analogs of Humaloga
Insulin Lizpro as a valid substance is contained only in the original humulog. Close-in-time preparations - (based on aspart) and (blasting). These means are also ultrakotov, so it does not matter which one to choose. All of them are well tolerated and provide a rapid reduction of sugar. As a rule, preference is given to this preparation that can be obtained free of charge in the clinic.
The transition from the humalog on its analogue may be needed in the occurrence of allergic reactions. If diabetics holds a low-carbid diet, or he often occurs hypoglycemia, more rational to use human, and not ultra-screwed insulin.
Insuls in pharmacological science are called special steroid preparations, which allow control of the amount of glucose molecules in the patient's blood. IN modern world In the field of pharmacological production is manufactured a large number of A variety of insulin means. The most common is short and long insulin. The main differences include: species characteristics of raw materials from which it produces this means, methods of production of a substance and duration of action. Today, short insulin is most popular.
The duration of its impact is time to 8 hours. Such a tool has its purpose - quick relief of food intake peaks, as well as the combined therapy of primary diabetes mellitus.
Long insulin is used to simulate the normal production of this hormone by the human body within 24 hours. Depending on the varieties of the drug, it has a period of action from 12 to 30 hours. As varieties of a long hormone, medium duration and long-term drugs are distinguished. Long lowers the level of concentration of glucose molecules contained in the blood improves the ability of muscles and liver to their absorption, accelerates the process of synthesizing protein structures, reduces the time required for the production of sugar molecules with hepatic cells.
People who first encountered primary diabetes mellitus are naturally interested in such questions: how to choose insulin correctly and which insulin is better for administration? These moments are very serious, since the further life and health of the patient depends on the proper selection of the hormone and calculate its dose.
Clinical picture
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Selection of a better insulin preparation
For any insulin-dependent diabetics, the use of a properly selected dose of insulin drug is vital.
It should be noted that it is possible to qualitatively choose the correct dosage of the hormone, suitable for a particular patient, possibly only in hospital conditions.
There are several basic rules used by doctors to select the necessary dosage of the drug.
- It is necessary to check the number of blood sugar molecules several times a day. Normal indicators are considered: on an empty stomach - 5-6 mmol / l and after a pair of hours after eating - 8 mmol / l. The maximum deviation from the last indicator is exceeded by 3 mmol / l.
- Choose this hormone is necessary, taking into account the time of day, the number of consumed carbohydrate compounds, the level of patient's mobility before eating and after it.
- Additionally, attention should be paid to the weight of the patient, the availability of other diseases of acute or chronic flow, time and form of use of other medicines. Especially important data indicators have at the time of appointing a permanent course of prolonged proliferation injuries. The reason for this is the lack of dependence of injections from the time of food intake, since when it is used, it creates a permanent margin of a given hormone in the serum of the patient.
- Highly an important point When selecting good dosage medication is a special diary. In such a diary, indicators of the content of glucose molecules in the composition of the patient's blood, an approximate amount of carbohydrate units consumed during food and a dose of the introduction of a short insulin preparation are made. The analysis is made on an empty stomach. Often the amount of injected means and used carbohydrate units is a proportion of 2 K 1. If the number of glucose molecules in the blood exceeds the permissible one, it is necessary to produce additional introduction of a short preparation.
- The process of selection of an insulin dose from night injections is beginning. With the introduction of a hormone in the amount of 10 units, immediately before the departure to sleep, provided that this dose is suitable, the blood glucose content in morning hours There will be no more than 7 mmol / l. When, after the patient's first dose injection, an excessive sweating is observed, an appetite increases, it is necessary to reduce the night dose for a couple of units. The balance between insulin doses is inserted during the day and at night should be 2: 1.
In the case when the dosage of the drug complies with the needs of the body, the content of glucose molecules in serum should not be changed to a greater or smaller side. The molecular amount of glucose must be unchanged during the day.
What insulin is best used
be careful
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Of the complications, it is most often found: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can lead to the development of cancer tumors. Almost in all cases, diabetics or dies, struggling with painful disease, or turns into a real disabled person.
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To determine the best insulin for one particular patient, it is necessary to choose a basal drug. In order to simulate basal production, often use long insulin preparations. Now the pharmacological industry produces insulins of two types:
- middle durations working until 17 o'clock. These drugs include biosuline, insumanium, general, Protafan, Humulin.
- ultrablin duration, their action is up to 30 hours. This is: Lemmer, Tresis, Lantus.
Insulin means Lantus and Levelmir have cardinal differences from other insulins. Differences are that drugs are completely transparent and characterized by another duration of action on the body of the patient with diabetes. The first type of insulin has a white shade and some turbidity, so before applying the medicine must be shaken.
When using medium duration hormones, peak moments can be observed at their concentration. Second-type drugs do not possess such a feature.
The dosage of a long insulin drug must be selected so that the medicine can hold the glucose concentration in the intervals between the meal within allowable limits.
Long insulin due to the need for slower suction, injected under the skin of the hip or buttocks. Short - in the abdomen area or hands.
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The first injections of long insulin are carried out at night with the surgery of sugar every 3 hours. In the case of a significant change in glucose indicators, the dosage adjustment is made. To identify the cause of the night increasing glucose, it is necessary to study the time interval between 00.00 and 03.00. With lower indicators, the insulin dose at night should be reduced.
It is more accurate to determine the necessary amount of basal insulin possible with the complete absence of glucose and short insulin in the blood. Therefore, when evaluating night insulin, dinner must be abandoned.
To obtain a more informative picture, you should not use short insulin, it is not necessary to eat protein or fatty food
To determine the basal hormone, you need to remove one meal or hungry all day. Measurements are made every hour.
Do not forget that all types of insulins, in addition to Lantus and Levemir, have peak secretion. The peak moment of these medicines occurs after 6-8 hours since the introduction. In this watch, a sugar drop may occur, which is corrected by eating bread units.
Such dosage checks must be made every time they change. To understand how sugar behaves in a dynamics, enough of all three days tests. And only on the results of the results obtained, the doctor is able to prescribe a clear dosage of that or another drug.
In order to estimate the basic hormone in daytime and detecting better preparationIt is necessary to wait from the moment of absorption of the previous meal for five hours. Diabetics applying short insulin are required to withstand the time interval from 6 hours. A group of short insulins is represented by Sansulin, humullin, anktrapism. Ultra-screwed insulin include: Novorahid, Apidra, Humalog. The ultrashort hormone also acts as short as short, but it removed most of the flaws. At the same time, this tool is not able to satisfy the need of the body in insulin.
To give an unequivocal answer to the question of what insulin is the best, it is not possible. But on the recommendation of the doctor, you can choose the correct dosage of the basal agent and short insulins.
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High-quality French drug Insulin Humalog proved its superiority over analogs, which is achieved due to the optimal combination of the main acting and auxiliary substances. The use of this insulin will significantly simplify the fight against hyperglycemia in patients suffering from diabetes.
Description of Insulin Humalog
Short insulin Humalog is produced by the French company LILLY France, and the standard form of its release is a transparent and colorless solution enclosed in a capsule or in the cartridge. The latter can be sold both as part of the already prepared syringe knob quicpen, and separately five ampoules on 3 ml in a blister. Alternatively, a series of drugs of Humalog Mixa produced in the form of a suspension for subcutaneous administration, whereas ordinary humulog can be administered intravenously.
The main active substance of the humulog is insulin Lyspro - a two-phase preparation at a concentration of 100 IU per 1 ml of solution, the action of which is regulated by the following additional components:
- glycerol;
- metacrell;
- zinc oxide;
- sodium hydrophosphate heptahydrate;
- hydrochloric acid solution;
- sodium hydroxide solution.
From the point of view of the clinical and pharmacological group, the humalog refers to the analogues of the human insulin of a short action, but differs from them inverse sequence of a number of amino acids. The main function of the drug is to regulate the absorption of glucose, although it also has both anabolic properties. Pharmacologically, it acts as follows: In the muscular tissue, an increase in the level of glycogen, fatty acids and glycerol is stimulated, and the protein concentration and amino acid consumption of the organism increases. In parallel, such processes such as glycogenolysis, gluconeogenesis, lipolysis, catabolism of proteins and ketogenesis are slowed down.
Studies have shown that in patients with diabetes of both types after eating food, the increased level of sugar is declining noticeably faster if used humalog instead of other soluble insulins.
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It is important to remember that if diabetics at the same time receives a short action insulin and basal insulin, you will need to adjust the dosage and the first, and the second drug to achieve the best result. Despite the fact that the humalog refers to short-acting insuls, the ultimate duration of its action is determined by a number of individuals for each patient factors:
- dosage;
- place of injection;
- body temperature;
- physical activity;
- the quality of blood supply.
Separately, it is worth noting the fact that Insulin Humalog is equally effective both in the case of adult diabetics and in the case of the treatment of children or adolescents. It remains unchanged that the effect of the drug does not depend on the likely presence in patient of renal or hepatic insufficiency, and when combining it with high doses of sulfonylurea, the level of the glycated hemoglobin is noticeably reduced. In general, there is a noticeable reduction in the number of cases of night hypoglycemia, from which diabetics often suffer if they do not take the necessary drugs.
The characteristics of the insulin humulog expressed in numbers look like this: the beginning of the action - 15 minutes after the injection, the time of action is from two to five hours. On the one hand, the period of efficient operation of the drug is lower than that of ordinary analogs, and on the other, it can be used only 15 minutes before meals, and not for 30-35, as in the case of other insulin.
Indications for the use of the drug
Insulin Humalog is designed for all patients suffering from hyperglycemia and incessing insulin therapy. Speech can go both about the diabetes mellitus of the first type, which is an insulin-dependent disease and about a second-type diabete, in which the blood sugar level increases periodically after receiving food containing carbohydrates.
Insulin of short action Humalog will be effective at any stage of the disease, as well as for patients of both sexes and all ages. As an effective therapy, its combination with medium and long-term insuls approved by the attending physician is considered.
Contraindications and side effects
Categorical contraindications to the use of a humulogue are only two: the individual intolerance to this or that component of the medication and chronic hypoglycemia, in which the sugar-based drug will only strengthen the negative processes in the body. Nevertheless, it is necessary to take into account a number of features and guidelines when using this insulin:
- studies have not shown any negative impact of a humulog for pregnancy and the health of the fetus (and a newborn baby);
- insulin-therapy is shown by the pregnant women who suffer from insulin-dependent or gestational diabetes, and in this context, it should be remembered that the need for insulin has a property to decline in the first trimester, and then increase the second and third trimesters. After delivery, this need can dramatically decrease, which must be taken into account;
- when planning pregnancy, a woman with diabetes should consult with the attending physician, and in the future it will take careful control over its condition;
- the need for a humulog dosage correction is likely to correct breastfeedinglike diet correction;
- diabetics with renal or hepatic insufficiency there is a faster suction of a humalog compared to other analogs of insulin;
- any changes in insulin therapy require observation by the doctor: the transition to another type of insulin, changing the trademark of the drug, changing physical activity.
It must be remembered that intensive insulin therapy can over time to lead to non-specific or less pronounced symptoms of the coming hypoglycemia (this also applies to the transition of the patient from an animal insulin to a humulog). It is also important to take into account the fact that both excessive doses of medicine and a sharp cessation of its use can lead to hyperglycemia. The need for diabetics in insulin has a property to increase when infectious diseases or stressing to diabetes.
As for side effects, the active substance of the drug can lead to hypoglycemia, while the combination of other aids in some cases causes:
- local allergic reactions (redness or itching at the injection site);
- system allergic reactions (generalized itching, urticaria, fever, swelling, tachycardia, decrease in blood pressure, increased sweating);
- lipodystrophy in the injection area.
Finally, the overdose of humulog causes severe hypoglycemia with all the ensuing consequences: weakness, increased sweating, violation of heart rhythm, headache and vomiting. It is stopped by hypoglycemic syndrome with standard measures: intake inside glucose or other saham-containing product.
Instructions for use of insulin Humalog
The use of a humulog begins with the calculation of the dose, which individually determines the attending physician, depending on the need for diabetics in insulin. This medicine can be administered both before meals and after it, although the first option is more preferable. Be sure to remember that the solution should not be cold, but comparable with room temperature. Usually, a standard syringe, a syringe knob or an insulin pump, be injected subcutaneously, is used, but intravenous infusion is allowed under certain conditions.
Subcutaneous injections are carried out mainly in the field of hip, shoulder, abdomen or buttocks, alternating the place of the injection so that the same thing is used not more than once a month. It is necessary to carefully monitor not to get into Vienna, as well as strictly it is not recommended to massage the skin in the area of \u200b\u200bthe injection. Humalog gained in the form of a cartridge for a syringe knob is used in the following order:
- you need to wash your hands with warm water and choose a place for injection;
- the skin in the injection area is disinfecting with an antiseptic;
- a protective cap is removed from the needle;
- the skin is fixed manual by pulling or tensioning so that the fold is turned out;
- a needle in the skin is entered, a button on the syringe knob is pressed;
- the needle is extracted, the injection area is neatly pressed for a few seconds (without massaging and rubbing);
- using a protective cap, the needle turns away and eliminates.
All these rules concern and such varieties of the drug as Mix 25 Humalog and Mix 50 Humalog manufactured in the form of a suspension. The difference is the appearance and preparation different types Medicines: The solution should be colorless and transparent, while it is immediately ready for use, while the suspension needs to shake several times so that in the cartridge there is a homogeneous turbid liquid similar to milk.
Intravenous injection of humalog is carried out in clinical conditions using a standard infusion system, where the solution is mixed with a 0.9% sodium chloride solution or a 5% dextrose solution. The use of insulin pumps for the introduction of a humulog is organized according to the instructions attached to the device. When conducting injections of any type, you need to remember how much sugar reduces 1 insulin unit to correctly assess the dose and the body's reaction. On average, this indicator is 2.0 mmol / l for most insulin preparations, which is valid for the humalog.
Interaction with other drugs
The drug interaction of the humalog with other drugs in general corresponds to its counterparts. Thus, the hypoglycemic effect of the solution will be reduced during its combination with oral contraceptives, glucocorticosteroids, hormonal preparations for the thyroid gland, a number of diuretics and antidepressants, as well as nicotine acid.
At the same time, the hypoglycemic effect of this insulin will increase when a combination of therapy using:
- beta adrenoblockers;
- ethanol and drug-based drugs;
- anabolic steroids;
- oral hypoglycemic agents;
- sulfanimamides.
Terms and Storage Terms
Humalog should be stored in an unavailable place for children inside the ordinary refrigerator, at a temperature of +2 to +8 degrees Celsius. The standard shelf life is two years. If the package has already been opened, this insulin must be kept at room temperature from +15 to +25 degrees Celsius.
It should be carefully ensured that the drug does not heat up and was not under the right sunlight. In the case of the start of use, the shelf life is reduced to 28 days.
Analogs
The direct analogues of the humulog should be considered all insulin preparations acting on the organism of diabetics in a similar way. Among the most famous trademarks, you can allocate an actrapide, efaline, generaluline, insulant, insulter, chumodar, Isophane, Protafan and Homolong.
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For a person with an absolute deficit of the insulin hormone, the aim of treatment is the most close repetition of natural secretion as the main and stimulated. This article will tell about the correct selection of the insulin dose of basal.
Among the diabetics are popular expression "to keep a flat background", for this you need an adequate dose of insulin of prolonged action.
Prolonged Insulin
To be able to imitate basal secretion use insulin of extended action. In the diabetic slang diabetics there are phrases:
- "Long insulin",
- "Basic Insulin",
- "Basal",
- "Extended Insulin",
- "Long insulin".
All these terms indicate - insulin of prolonged exposure. Today, two types of insulins of long-term exposure are used.
Insulin of medium duration - its action lasts until 16 hours:
- Bosululin N.
- Insun Basal.
- PROTAFAN NM.
- Humulin NPH.
Insulin of ultrand action - works more than 16 hours:
- Leewemir.
- Lantus.
Levemir and Lantus differ from other insulins not only to different duration of action, but also by their external absolute transparency, while the preparations of the first group have a white turbid color, and before administration they need to ride in the palms, then the solution becomes uniformly turbid.
Such a difference is due different ways Production of insulin preparations, but this is later. The drugs of the average duration of action are considered peak, that is, in the mechanism of their actions, a not too pronounced path is viewed, like the insulins of short, but still there is peak.
Insulines of ultrastine action are considered unmanned. When selecting a dose of basal drug, this feature must be taken into account. Nevertheless, the rules of the general plan for all insulins remain the same.
Important! A long action insulin dose should be selected in such a way as to keep blood glucose concentration between food intakes. Small oscillations are allowed in the range of 1-1.5 mmol / l.
In other words, with the correct dosage of glucose in the bloodstream should not decline or, on the contrary, to increase. The indicator must be stable during the day.
It is necessary to clarify that the injection of a long action insulin is made in the thigh or buttock, but not in the stomach and not in hand. Only so you can provide smooth suction. Insulin of short action is introduced into hand or area of \u200b\u200bthe abdomen to achieve the maximum peak, which must match the suction period.
Insulin Long - dose overnight
Choosing a dose of long insulin is recommended to start with a dose of night. Sick diabetes must trace the blood glucose behavior at night. To do this, every 3 hours it is necessary to measure the level of sugar, starting from the 21st hour and ending the 6th hours of the next day.
If significant fluctuations in the concentration of glucose are observed in one of the gaps in the direction of increasing or, on the contrary, towards the decline, this indicates that the dose of the drug is chosen incorrectly.
In such a situation, this area of \u200b\u200btime needs to be viewed. For example, the patient goes to rest with glucose 6 mmol / l. At 24:00, the indicator rises to 6.5 mmol / l, and at 03:00 unexpectedly rises to 8.5 mmol / l. The morning a person meets with a high sugar concentration.
The situation indicates that the nightly amount of insulin was not enough and the dose gradually needs to be increased. But there is one "but"!
With the existence of such an increase (and higher) at night, it may not always be possible to mean insulin shortage. Sometimes under these manifestations is hidden hypoglycemia, which makes a kind of "rollback", manifested by increasing the level of glucose in the bloodstream.
- To understand the mechanism of improving sugar at night, the gap between level measurements must be reduced to 1 hour, that is, to measure each hour between 24:00 and 03:00 CC.
- If in this place there is a decrease in glucose concentration, it is possible that it was disguised "progressing" with a rollback. In this case, the dose of basic insulin should not be increased, but to reduce.
- In addition, the effectiveness of basic insulin affects the food eaten.
- Therefore, in order to correctly assess the action of basal insulin, there should be no glucose and insulin of a short action received with food in the blood.
- For this dinner preceding the assessment, you should skip or transfer it to an earlier time.
Only then meals and the short insulin introduced at the same time will not affect the clarity of the picture. For the same reason, only carbohydrate products are recommended for dinner, but exclude fats and proteins.
These elements are absorbed far slower and subsequently can increase the level of sugar, which is extremely undesirable to correctly assess the action of basal night insulin.
Insulin Long - dose on day
It is also quite simple to check the basal insulin in the afternoon, it is also quite simple, for this just have to spill a little, but to do the sugar measurements every hour. This method will help determine what period there is an increase, and in what is the decline.
If this is not possible (for example, young children), the basic insulin work must be viewed by periods. For example, you must first skip breakfast and measure every hour from the moment of awakening or from the moment the basic daily insulin is introduced (if appointed) and before lunch. A few days later the scheme is repeated with lunch, and even later - with dinner.
Most prolonged action insulins have to be administered 2 times a day (the exception is Lantus, it is cololled only once).
Note! All the above-listed insulin preparations, in addition to Leveliers and Lantus, have a secretion peak, which, as a rule, occurs 6-8 hours after injection.
Therefore, during this period there may be a decrease in glucose levels, to maintain which a small dose of "bread unit" is necessary.
When changing the dose of basal insulin, all these actions are recommended to repeat several times. Most likely, 3 days will be quite enough to make sure the dynamics in one direction or another. In accordance with the result, further steps are being taken.
When evaluating the basic daily insulin between meals, no less than 4 hours should pass, ideally 5. For those who use short insulins, and not ultrashort, this gap should be much longer (6-8 hours). This is due to the specific effect of these insulins.
If a long insulin is selected correctly, you can start the selection of short insulin.