home Thyroid Short-acting insulin for diabetics. Long-acting insulins: names, prices, analogues of drugs

Short-acting insulin for diabetics. Long-acting insulins: names, prices, analogues of drugs

Insulins in pharmacology are special hormonal agents, which help regulate blood glucose levels. The modern pharmacological industry produces these drugs in a huge variety. They differ in the type of raw materials, methods of production and duration of action. Insulin is especially popular today short acting. This drug, first of all, is intended for quick relief of food peaks, but can also be used in combination treatment diabetes mellitus

Short-acting insulin drugs

Short-acting insulins are soluble and can quickly normalize metabolic processes in the human body associated with the absorption of glucose. Unlike insulins long acting, the composition of short-acting hormonal preparations includes an exclusively pure hormonal solution that does not contain any additives. Distinctive feature of such means is that they begin to work very quickly and in a short time able to lower blood sugar levels to normal. The peak activity of the drug is observed approximately two hours after its administration, and then there is a rapid decline in its effect. After six hours, slight traces of the administered hormonal agent remain in the blood. These drugs are classified into the following groups according to the time of their activity:

Short-acting insulins that begin to work 30 minutes after administration. They are recommended to be taken no later than half an hour before meals.
Ultra-short insulins that start working in a quarter of an hour. It is recommended to take these medications approximately 5 to 10 minutes before meals or immediately after meals.

The table below shows the speed and duration of action of various types of hormonal agents for comparison. The names of the drugs are given selectively, as there are a huge variety of them.

Features of short and ultra-short insulins

Short-acting insulin is a pure hormonal drug that is produced in two ways:

based on animal insulin (pork);
using biosynthesis using genetic engineering technologies.

Both remedies fully correspond to the natural human hormone, and therefore have a good sugar-lowering effect. Unlike similar drugs long-acting, they do not contain any additives, so they almost never cause allergic reactions. For supporting normal level blood sugar in patients suffering from diabetes mellitus, short-acting insulins are often used, which are administered approximately half an hour before meals. It is important to understand that each patient has his own physiological characteristics, therefore, the calculation of the required volume of the drug is always carried out by the doctor individually. In addition, it is very important that the amount of food consumed corresponds to the administered dose of insulin. Basic rules of introduction hormonal drug before eating are as follows:

For injection, you need to use only a special insulin syringe, which allows you to administer the exact dose prescribed by the doctor.
The administration time should be constant and the injection site should be changed.
The place where the injection was given cannot be massaged, since the natural absorption of the drug into the blood should be smooth.

Ultra-short insulin is a modified analogue of human insulin, which explains the high speed of its action. This drug was developed for the purpose of emergency assistance to a person who had a jump in blood sugar at the most various reasons. That is why it is rarely used in the complex treatment of diabetes mellitus. An injection of ultra-short insulin is also recommended when a person does not have the opportunity to wait a certain time before eating. But on condition proper nutrition this remedy It is not recommended to take it, due to the fact that its effect decreases from the peak value very sharply, so it is very difficult to calculate the correct dose.

Insulin for bodybuilding

Short and ultra-short insulins are very widely used in bodybuilding today. The drugs are considered very effective anabolic agents. The essence of their use in bodybuilding is that insulin is a transport hormone that can capture glucose and deliver it to muscles, which respond to this with rapid growth. It is very important that athletes begin to use the hormonal drug gradually, thereby accustoming the body to the hormone. Since insulin preparations are very strong hormonal agents, young beginner athletes are prohibited from taking them.

The main property of insulin is the transport of nutrients. But at the same time, the hormone performs this function in different directions, namely:

V muscle tissue,
into fat deposits.

In this regard, if you take a hormonal drug incorrectly, you may not build beautiful muscles, but gain ugly weight. It should be remembered that when taking the drug, training must be effective. Only in this case will the transport hormone deliver glucose to the developed muscle tissue. For each athlete who engages in bodybuilding, the dose is prescribed at individually. It is established after measuring the amount of glucose in the blood and urine.

In order not to knock down the natural hormonal background body and do not reduce the production of insulin by the pancreas, you should definitely take breaks from taking medications. It is optimal to alternate a two-month period of taking the drug with a four-month rest from it.

Rules for taking medications and overdose

Since short-acting and ultra-short-acting insulins are high-quality drugs close to human insulin, they rarely cause allergies. But sometimes it looks like this unpleasant effect such as itching and irritation at the injection site.

It is recommended to inject a hormonal agent into the area abdominal cavity subcutaneously immediately after strength training. You need to start with small doses and be sure to monitor the body’s reaction. Approximately a quarter of an hour after the injection, you should eat something sweet. The ratio of carbohydrates consumed per unit of administered drug should be 10:1. After this, after an hour you need to eat thoroughly, and the diet should contain food rich in protein.

An overdose of a hormonal drug or its improper use can cause hypoglycemic syndrome, which is associated with a sharp decrease in blood sugar levels. Almost every time after taking ultra-rapid and short-acting insulin, it causes mild or average degree hypoglycemia. It manifests itself with the following symptoms:

dizziness and darkening of the eyes with a sudden change in body position,
acute feeling of hunger,
headache,
increased heart rate,
increased sweating,
condition internal anxiety and irritability.

If at least one of the listed symptoms appears, you should immediately drink a large number of sweet drink, and after a quarter of an hour eat a portion of protein-carbohydrate food. Also side symptom hypoglycemia is the emergence of a desire to sleep. This is strictly forbidden, as it can worsen the condition. It should be remembered that in case of an overdose of short-acting and ultra-short-acting insulin coma can come very quickly. If an athlete loses consciousness, it is imperative to seek medical help.

The main advantage insulin drugs when used in bodybuilding, it is believed that they cannot be traced to a doping test. Short and ultra-short insulin are safe means that do not adversely affect the work internal organs. It is also important that the drugs can be purchased without prescriptions and their cost, in comparison with other anabolic steroids, is quite affordable. The most important disadvantage of insulin drugs, but at the same time a very significant one, is the need to take them in strict accordance with the schedule established by the doctor.

For a person with an absolute deficiency of the hormone insulin, the goal of treatment is to reproduce as closely as possible natural secretion, both basal and stimulated. This article will tell you about correct selection basal insulin doses.

Among diabetics, the expression “keep an even background” is popular; this requires an adequate dose of long-acting insulin.

Long-acting insulin

To be able to simulate basal secretion, long-acting insulin is used. Diabetic slang for diabetics includes the following phrases:

"long insulin"
"basic insulin"
"basal"
"extended insulin"
"long insulin".

All these terms mean long-acting insulin. Today, two types of long-acting insulins are used.

Intermediate-acting insulin – its effect lasts up to 16 hours:

Biosulin N.
Insuman Bazal.
Protafan NM.
Humulin NPH.

Ultra-long-acting insulin - lasts more than 16 hours:

Levemir.
Lantus.

Levemir and Lantus differ from other insulins not only of different durations action, but also by its external absolute transparency, while the drugs of the first group have a white cloudy color, and before administration they need to be rolled in the palms, then the solution becomes uniformly cloudy.

This difference is due to different methods of producing insulin preparations, but more on that later. Medium-acting drugs are considered peak, that is, their mechanism of action does not have a very pronounced pathway, like short-acting insulins, but there is still a peak.

Ultra-long-acting insulins are considered peak-free. When selecting the dose of the basal drug, this feature must be taken into account. However, the general plan rules for all insulins remain the same.

Important! The dose of long-acting insulin should be adjusted to maintain normal blood glucose concentrations between meals. Small fluctuations within 1-1.5 mmol/l are allowed.

In other words, when correct dosage Glucose in the bloodstream should not decrease or, conversely, increase. The indicator should be stable throughout the day.

It should be clarified that long-acting insulin injections are given in the thigh or buttock, but not in the stomach or arm. This is the only way to ensure smooth suction. Short-acting insulin is injected into the arm or abdominal area to achieve a maximum peak, which should coincide with the period of absorption of food.

Long insulin - dose at night

It is recommended to start choosing a dose of long-acting insulin with a night dose. A patient with diabetes mellitus should monitor the behavior of glucose in the blood at night. To do this, you need to measure your sugar level every 3 hours, starting at 21 o'clock and ending at 6 o'clock in the morning the next day.

If during one of the intervals there are significant fluctuations in glucose concentration towards an increase or, conversely, towards a decrease, this indicates that the dose of the drug was chosen incorrectly.

In such a situation, this period of time needs to be viewed in more detail. For example, a patient goes on vacation with a glucose level of 6 mmol/l. At 24:00 the reading rises to 6.5 mmol/l, and at 03:00 it suddenly rises to 8.5 mmol/l. A person greets the morning with high concentration Sahara.

The situation indicates that the nightly amount of insulin was not enough and the dose needs to be gradually increased. But there is one “but”!

If there is a similar increase (and higher) at night, it may not always mean a lack of insulin. Sometimes these manifestations hide hypoglycemia, which makes a kind of “rollback”, manifested by an increase in glucose levels in the bloodstream.

To understand the mechanism of the increase in sugar at night, the interval between level measurements should be reduced to 1 hour, that is, measured every hour between 24:00 and 03:00 h.
If a decrease in glucose concentration is observed in this place, it is quite possible that this was a disguised “buckling” with a rollback. In this case, the dose of basal insulin should not be increased, but decreased.
In addition, the effectiveness of basal insulin is also affected by the food eaten during the day.
Therefore, in order to correctly assess the effect of basal insulin, there should be no glucose and short-acting insulin in the blood from food.
To do this, the dinner preceding the assessment should be skipped or moved to an earlier time.

Only then will food intake and short-term insulin administered at the same time not affect the clarity of the picture. For the same reason, it is recommended to eat only carbohydrate foods for dinner, but exclude fats and proteins.

These elements are absorbed much more slowly and can subsequently increase sugar levels, which is extremely undesirable for correctly assessing the effect of basal night insulin.

Long insulin - dose per day

Checking your basal insulin during the day is also quite simple; all you have to do is fast for a while and measure your sugar every hour. This method will help determine in which period there is an increase and in which period there is a decrease.

If this is not possible (for example, in small children), the performance of basal insulin should be monitored periodically. For example, you should first skip breakfast and measure every hour from the moment you wake up or from the moment you administer your basal daily insulin (if prescribed) until lunch. A few days later the pattern is repeated with lunch, and even later with dinner.

Most long-acting insulins must be administered 2 times a day (the exception is Lantus, which is injected only once).

Note! All of the insulin preparations listed above, except Levemir and Lantus, have a secretion peak, which usually occurs 6-8 hours after injection.

Therefore, during this period, a decrease in glucose levels may be observed, to maintain which a small dose of “bread unit” is required.

When changing the dose of basal insulin, it is recommended to repeat all these steps several times. Most likely, 3 days will be enough to verify the dynamics in one direction or another. Based on the result, further steps are taken.

When assessing basal daily insulin, at least 4 hours should pass between meals, ideally 5. For those using rapid insulin rather than ultra-fast insulin, this interval should be much longer (6-8 hours). This is due specific action these insulins.

If long insulin is chosen correctly, you can start choosing short insulin.

The fundamental source of energy for humans is carbohydrates, which are involved in most metabolic processes of the body's cells. Despite all the benefits, its excess is fraught with metabolic disorders of various types.

The consequence of this is irreversible changes in internal organs and the functions they perform. The quality of life deteriorates significantly, and performing daily activities becomes an impossible task. Similar problems arise as a result malfunction pancreas, with difficult cases its complete dysfunction.

The beta cells of the organ are unable to produce the necessary hormone in a concentration sufficient to maintain glucose levels, taking into account generally accepted standards acceptable for the body. Experts call this process insulin therapy.

For therapy for insulin-dependent diabetes, the attending physician can prescribe long-acting insulin and short-acting insulin, the names and manufacturers of which will be presented in the article.

It is no secret to many that in diabetes there is a lack of the hormone produced naturally replaced with analogues. Physiologically, the body, responding to an increase in sugar levels, for example, after a meal, gives a signal to the pancreas to reduce it by releasing a hormone.

At the same time, the rest of the time (outside of meals), the organ independently maintains the necessary concentration. In diabetes, a person himself is forced to maintain this balance through the use of pharmaceuticals.

Important. The correct dose of various types of insulin is selected on the recommendation of a doctor based on the patient’s individual parameters, medical history, laboratory tests, and lifestyle.

Full functioning of the pancreas in a healthy person allows the body to regulate carbohydrate metabolism in calm state within a day. And also cope with the load of carbohydrates when eating or infectious and inflammatory processes in diseases.

Therefore, to maintain blood glucose artificially, a hormone with similar properties but different rates of action is required. Unfortunately, on this moment science has not found a solution to this problem, but it has become a salvation for diabetics complex treatment two types of drugs such as long and short insulin.

Table No. 1. Table of differences between types of insulin:

In addition to the above, there are combination insulin products, that is, suspensions that simultaneously contain both hormones. On the one hand, this significantly reduces the number of injections required for a diabetic, which is a big plus. However, in this case it is difficult to maintain the balance of carbohydrate metabolism.

When using such medications, it is necessary to strictly regulate the amount of carbohydrates consumed, physical activity, in general. This occurs due to the impossibility of selecting the exact dosage of the currently required type of insulin separately.

Long acting hormone

Quite often, the long-acting hormone is also called background. Taking it provides the body with insulin for a long time.

Absorbed from subcutaneous adipose tissue gradually, the active substance allows you to maintain within normal limits throughout the day. As a rule, no more than three injections per day are sufficient for this.

According to the duration of action, they are divided into three types:

Medium duration. The hormone begins to act 1.5 to 2 hours after the administration of the medicine, which is why it is injected in advance. In this case, the maximum effect of the substance occurs no later than 3-12 hours. The total action time of a medium-acting product is from 8 to 12 hours, therefore, a diabetic will have to use it 3 times for 24 hours.
Long-term exposure. The use of this type of prolonged hormonal solution can provide a background concentration of the hormone sufficient to retain glucose throughout the day. The duration of its action (16-18 hours) is sufficient when the medication is administered in the morning on an empty stomach and in the evening before bedtime. The maximum effect of the drug is from 16 to 20 hours from the moment it enters the body.
Extra long-lasting. Particularly suitable for the elderly and people with disabilities disabilities taking into account the duration of action of the substance (24-36 hours) and, consequently, reducing the frequency of its administration (1 time per 24 hours). The action begins after 6-8 hours, with a peak effect in the period of 16-20 hours after entering the adipose tissue.

Involves simulating natural hormone secretion by applying medicines. Unfortunately, it is impossible to achieve effective results using only one type of hormone-containing product. That is why short-acting insulins are no less important.

Short acting hormone

The name of this type of hormone speaks for itself.

Opposite to long-acting drugs, short-acting ones are designed to pay off sharp jumps glucose in the body caused by factors such as:

eating;
excessive physical activity;
the presence of infectious and inflammatory processes;
severe stress and so on.

Eating carbohydrates increases their concentration in the blood, even while taking basal insulin.

Based on the duration of exposure, fast-acting hormones are divided into two types:

Short. Short-acting insulin preparations begin to act within 30-60 minutes after administration. Possessing a high absorption rate, the peak of maximum effectiveness is achieved 2-4 hours after entering the body. According to average estimates, the effect of such a medicine lasts no more than 6 hours.
Ultra-short insulin. This modified analogue human hormone is unique in that it is able to act faster than naturally produced insulin. Already 10-15 minutes after the injection, the active substance begins its effect on the body with a peak occurring 1-3 hours after the injection. The effect lasts for 3-5 hours. The speed with which the ultra-short solution is absorbed into the body allows it to be taken before meals or immediately after.

Important. The onset of action of the antidiabetic drug should coincide with the time of digestion of food and absorption of carbohydrates from it. The time of administration of the drug, taking into account the selected type of insulin and the body’s carbohydrate load, should be agreed upon.

The selection of a hormone suitable for use is strictly individual, as it is based on laboratory research, the degree of illness of a person with diabetes, a complete medical history, and lifestyle. An important factor is the price of the drug, given the frequency of its use. As a rule, it increases proportionally in direct proportion to the complexity of the production of the drug, the country of manufacture, and packaging.

Features of choosing short-acting insulin. Most popular drugs

From the material in the previous section of the article, it becomes clear what short-acting insulin is, but not only the time and speed of action are important. All medicines have their own characteristics, and the analogue of the human pancreatic hormone is no exception.

List of features of the drug that you need to pay attention to:

source of receipt;
degree of purification;
concentration;
pH of the drug;
manufacturer and mixing properties.

For example, an analogue of animal origin is produced by processing the pancreas of a pig and its subsequent purification. For semi-synthetic medicines, the same animal material is taken as a basis and, using the method of enzymatic transformation, insulin is obtained that is close to natural. These technologies are usually used for short-term hormone production.

The development of genetic engineering has made it possible to recreate real human insulin cells, produced from E. coli with genetically modified changes. Ultrashort hormones are usually called human hormones.

Solutions are considered the most difficult to produce. highest degree cleaning (mono-component). The fewer impurities, the higher the efficiency and fewer contraindications to its use. Reduces the risk of occurrence allergic manifestations using a hormone analogue.

Drugs different ways production, speed of exposure, companies, brands, can be represented by different concentrations. Therefore, the same dose of insulin units can occupy different volumes in the syringe.

It is preferable to use medications with neutral acidity, this allows you to avoid discomfort at the injection site. However, the price of such products is an order of magnitude higher than sour ones.

Since science abroad is significantly ahead of domestic science, it is generally accepted that medicines produced in developed countries are of higher quality and more effective. Imported goods from well-known manufacturers are correspondingly more expensive.

Important. Greater value in insulin therapy, it is not the country of origin, the properties of the drug and their possible compatibility when using both long and short hormones simultaneously.

Top five most popular short-acting insulin preparations

Considering that each body is individual and susceptibility to medications of a particular brand may differ. Using an insulin therapy regimen, in which the drug is administered three times a day before meals, diabetics most often use short insulins, the names of which are presented in the table.

Table No. 2. List of antidiabetic drugs most often prescribed by specialists.

Name	Description
	Biosynthetic human insulin obtained by genetic engineering. Active ingredient: neutral mono-component hormone solution similar to human. Used for type 1 diabetes, as well as resistance to tablet drugs for type 2 diabetes.
	Human recombinant semisynthetic insulin has a neutral acidity level. Country of origin: Ukraine.
	Genetically engineered biosynthetic antidiabetic drug for regulating glucose metabolism. Human (DNA – recombinant). Country of origin: France.
	Porcine mono-component drug when used, which can be mixed with long-term drugs containing protamine sulfate as a depot-forming substance. Made in Ukraine.
	Soluble human hormone genetically engineered using DNA recombinant technology. Made in Russia.

Most often, analogues of human insulin are produced in a concentration of 40/100 IU, in vials or cartridges intended for use in syringe pens.

Almost all of modern means insulin group have much fewer contraindications than their predecessors. Most of them are allowed to be used during pregnancy and breastfeeding.

Important. You should use short-acting insulin and tablets, injections, and other medications with caution. Some of them may reduce or, on the contrary, enhance the effect of antidiabetic drugs. It is mandatory to consult a specialist and carefully study the section of the instructions on interactions with other medications.

Ultra-short preparations

Despite the fact that ultra-short-acting insulin was developed as emergency help when there are sharp jumps in glucose, bringing a person out of a hyperglycemic coma, it is now used in insulin therapy. Currently, three hormone preparations with similar effects have undergone clinical trials.

Table No. 3. List of ultra-short-acting antidiabetic agents.

Name	Description
	Recombinant insulin (lispro) has high speed absorption, as a result of which it acts faster than the hormone produced naturally. Manufacturer France.
	Biotechnically created recombinant analogue of human insulin (aspart). Increases intracellular glucose transport. Made in Denmark.
	Insulin luisine is recombinant human insulin, the potency of which is equal to that of the naturally produced hormone. Made in France.

Before injecting a short-acting hormone, a person has to calculate and control in advance the amount of carbohydrates taken with food. This is due to the fact that the calculated dose of the solution is administered 30-40 minutes before meals.

Often, diabetics who have a flexible work schedule in which it is difficult to predict meal times in advance experience difficulties in controlling carbohydrate metabolism. It’s not easy for parents of children with diabetes either. If the portion is not eaten or the child refuses to eat at all, the pre-administered dose of insulin will be too high, which can lead to severe hypoglycemia.

Ultra-short-acting fast-acting medications are good because they can be taken almost simultaneously with or after meals. This makes it possible to more accurately select the dose needed at the moment.

Important. Hypoglycemia is no less dangerous than sudden rises in blood sugar. Lack of glucose leads to the breakdown of fat cells for energy, which leads to poisoning due to the accumulation of ketone bodies.

It should be noted that science and Genetic Engineering don't stand still. Scientists are constantly refining and modifying existing drugs, creating new and improved versions based on them.

Insulin pumps of various models are becoming increasingly popular, allowing active image life experiencing minimal discomfort from injections. Thanks to this, the quality of life of insulin-dependent people has become much higher.

Video materials will allow you to clearly see the technique of administering such drugs.

This page describes different types insulin and the differences between them. Read what medium-, long-, short- and ultra-short-acting drugs are. Convenient tables list their brands, international titles and additional information.

Read the answers to the questions:

The types of intermediate and long-acting insulin are compared with each other - Protafan, Levemir, Lantus, Toujeo, as well as new drug Tresiba. It tells how to combine them with injections fast acting before meals - short-term insulin or one of the ultra-short versions of Humalog, NovoRapid, Apidra.

Types of insulin and their action: detailed article

You'll get best result from injections if you use them together with other recommendations. Read more or. Hold glucose level 3.9-5.5 mmol/l stable 24 hours a day, like healthy people - this is real. All information on this site is free.

Is it possible to do without insulin injections for diabetes?

Diabetics, who have relatively mild disorders of glucose metabolism, manage to maintain normal sugar levels without the use of insulin. However, they should master insulin therapy, because in any case they will have to give injections during colds and other infectious diseases. During periods of increased stress, it is necessary to support the pancreas by administering insulin. Otherwise, after suffering a short illness, the course of diabetes may worsen for the rest of your life.

Theory: the necessary minimum

As you know, insulin is a hormone produced by beta cells of the pancreas. It lowers sugar by forcing tissues to absorb glucose, which causes its concentration in the blood to decrease. You also need to know that this hormone stimulates fat deposition and blocks the breakdown of adipose tissue. In other words, high insulin levels make losing weight impossible.

How does insulin work in the body?

When a person begins to eat, the pancreas secretes large doses this hormone. They help quickly normalize blood sugar after eating, so that it does not remain elevated for long and complications of diabetes do not have time to develop.

Important! All insulin preparations are very fragile and easily spoil. Study them and follow them diligently.

There is also some insulin circulating in the body at any time during a fasting state and even when a person has been fasting for many days in a row. This level of the hormone in the blood is called background. If it were zero, the conversion of muscles and internal organs into glucose would begin. Before the invention of insulin injections, people with type 1 diabetes died from it. The ancient doctors described the course and finale of their illness as “the patient melted into sugar and water.” Now this does not happen with diabetics. The main threat was chronic complications.

Many diabetics who are treated with insulin believe that low sugar in the blood and its terrible symptoms cannot be avoided. In fact, You can keep your blood sugar at a stable level even with severe autoimmune disease. And even more so with relatively mild type 2 diabetes. There is no need to artificially increase your blood glucose levels to protect yourself from dangerous hypoglycemia.

Watch a video discussing this issue with the father of a child with type 1 diabetes. Learn how to balance your diet and insulin doses.

To quickly provide a large dose of insulin for the absorption of food, beta cells produce and store this hormone in the intervals between meals. Unfortunately, with any diabetes this process is violated first. Diabetics have little or no insulin reserves in their pancreas. As a result, blood sugar remains elevated for many hours after eating. This gradually causes complications to develop.

The background level of insulin in a fasting state is called the baseline. To keep it fit, long-acting injections are given at night and/or in the morning. These are products called Lantus, Toujeo, Levemir, Tresiba and.

Tresiba is such an outstanding drug that the site administration has prepared a video about it.

A large dose of the hormone that must be quickly provided for food absorption is called a bolus. To give it to the body, injections of short or ultra-short insulin are given before meals. The simultaneous use of long-acting and rapid insulin is called a basal-bolus insulin regimen. It is considered troublesome but gives the best results.

Read about short-acting and ultra-short-acting insulin preparations:

Simplified regimens do not provide good diabetes control. That’s why the website doesn’t recommend them either.

How to choose the appropriate, best insulin?

Treating diabetes with insulin cannot be done in a hurry. You need to spend a few days to thoroughly understand everything, and then start giving injections. The main tasks you will have to solve:

Explore or.
Go to . Diabetics who have excess weight, you also need to take pills according to the scheme with gradual increase dosage.
Monitor the dynamics of your sugar for 3-7 days, measuring it with a glucometer at least 4 times a day - in the morning on an empty stomach before breakfast, before lunch, before dinner and again at night before bed.
During this time, learn and study the rules for storing insulin.
Parents of children with type 1 diabetes need to read how to dilute insulin. Many adult diabetics may need this too.
Figure it out as well.
Study the article “”, stock up on glucose tablets at the pharmacy and keep them on hand.
Provide yourself with 1-3 types of insulin, syringes or a pen, an accurate imported glucometer and test strips for it.
Based on the accumulated data, select an insulin therapy regimen - determine which injections of which drugs you need, at what hours and in what doses.
Keep a self-monitoring diary. Over time, as information accumulates, fill out the table below. Recalculate your odds periodically.

Read about factors affecting the body's sensitivity to insulin.

Is it possible to manage the administration of long-acting insulin without the use of short and ultra-short preparations?

You should not inject large doses of extended-release insulin, hoping to avoid an increase in sugar after meals. Moreover, these drugs do not help when you need to quickly bring down increased level glucose. On the other hand, short- and ultra-short-acting drugs that inject before meals cannot provide a stable background level for regulating metabolism on an empty stomach, especially at night. You can get by with just one drug only in the mildest cases of diabetes.

Which insulin injections are given once a day?

Long-acting drugs Lantus, Levemir and Tresiba are officially allowed to be administered once a day. However, Lantus and Levemir are strongly recommended to be injected twice a day. Diabetics who try to manage with one shot of these types of insulin usually have poor glucose control.

Tresiba is the newest extended-release insulin, each injection of which lasts up to 42 hours. It can be injected once a day, and this often gives good results. Dr. Bernstein switched to this drug from insulin Levemir, which he had previously used for many years. However, he injects himself with Tresiba insulin twice a day, just as he used to inject Levemir. And he advises all other diabetics to do the same.

Read about long-acting insulin preparations:

Some diabetics try to replace the administration of rapid insulin before meals several times a day with one daily injection of a large dose of a long-acting drug. This inevitably leads to disastrous results. Don't go this route.

This is a big problem. The only way to avoid it is to switch to, due to which the required insulin dosages are reduced by 2-8 times. And the lower the dose, the smaller the spread of its effect. It is not advisable to inject more than 8 units at a time. If you require more high dose, divide it into 2-3 approximately equal injections. Do them one by one in different places, away from each other, with the same syringe.

How is insulin produced on an industrial scale?

Scientists have learned to force the genetically modified Escherichia coli to produce insulin suitable for humans. The hormone that lowers blood sugar has been produced this way since the 1970s. Before we mastered the technology with coli, diabetics injected themselves with insulin from pigs and large cattle. However, it was slightly different from human and also had undesirable impurities, due to which frequent and severe allergic reactions. The hormone obtained from animals is no longer used in the West, Russia and the CIS countries. All modern insulin is a GMO product.

What is the best insulin?

There is no universal answer to this question for all diabetics. It depends on the individual characteristics of your disease. Moreover, after switching to insulin, insulin needs change significantly. Dosages will probably decrease and you may need to switch from one drug to another. It is not recommended to use it, even if it is given free of charge, but other extended-release drugs are not. The reasons are explained below. There is also a table of recommended types of long-term insulin.

For patients on a low-carbohydrate diet, short-acting drugs () are better suited for bolus insulin before meals than ultra-short-acting ones. Low-carbohydrate foods are absorbed slowly, while ultra-short-acting drugs act quickly. This is called an action profile mismatch. It is not advisable to inject Humalog before meals, because it acts less predictably and more often causes sugar spikes. On the other hand, Humalog is the best at helping to bring down high sugar, because it begins to act faster than other types of ultra-short and, especially, short-acting insulin.

To maintain the recommended 4-5 hours between injections, you should try to have breakfast early. To wake up with normal sugar in the morning on an empty stomach, you should have dinner no later than 19:00. If you follow the recommendation for an early dinner, you will have a great appetite in the morning.

Diabetics who follow a low-carbohydrate diet require very low doses of rapid insulin compared to patients treated with standard schemes. And the lower the doses of insulin, the more stable they act and less problems call.

Humalog and Apidra - what is the action of insulin?

Humalog and Apidra, as well as NovoRapid, are types of ultra-short-acting insulin. They start to work faster and are stronger than short-acting drugs, with Humalog being faster and stronger than the others. Short drugs are real human insulin, and ultra-short ones are slightly modified analogues. But you don't need to pay attention to this. All short and ultra-short drugs have an equally low risk of allergy, especially if you take them and inject them in low doses.

Which insulin is better: Humalog or NovoRapid?

It is officially believed that the ultra-short drugs Humalog and NovoRapid, as well as Apidra, act with the same strength and speed. However, he says that Humalog is stronger than the other two and also starts working a little faster.

All of these remedies are not very suitable for injections before meals for diabetics who follow. Because low-carbohydrate foods are absorbed slowly, and ultra-short medications quickly begin to lower blood sugar. Their action profiles do not match enough. Therefore, to assimilate eaten proteins and carbohydrates, it is better to use short-acting insulin - Actrapid NM, Humulin Regular, Insuman Rapid GT, Biosulin R or another.

On the other hand, Humalog and other ultra-short medications bring elevated sugar levels back to normal faster than short ones. Sick severe diabetes Type 1 may need to use 3 types of insulin at the same time:

Extended
Short on food
Ultra short for emergency cases, quickly knocking down high sugar.

Perhaps a good compromise would be to use the drug NovoRapid or Apidra as universal remedy instead of Humalog and short-acting insulin.

Insulin is a hormone produced by endocrine cells of the pancreas. Its main task is to maintain carbohydrate balance.

Insulin drugs are prescribed for diabetes mellitus. This condition is characterized by insufficient secretion of the hormone or disruption of its action in peripheral tissues. Medicines differ in their chemical structure and duration of effect. Short forms are used to reduce sugar that enters the body with food.

Indications for use

Insulin is prescribed to normalize blood glucose levels when various types diabetes mellitus Indications for the use of the hormone are the following forms of the disease:

Type 1 diabetes, associated with autoimmune damage to endocrine cells and the development of absolute hormone deficiency;
type 2, which is characterized by a relative lack of insulin due to a defect in its synthesis or a decrease in the sensitivity of peripheral tissues to its action;
gestational diabetes, which occurs in pregnant women;
pancreatic form of the disease, which is a consequence of acute or chronic pancreatitis;
non-immune types of pathology - Wolfram syndrome, Rogers syndrome, MODY 5, neonatal diabetes and others.

In addition to the hypoglycemic effect, insulin preparations have anabolic effect- promote growth muscle mass and updating bone tissue. This property is often used in bodybuilding. However, in official instructions this indication is not registered for use, and the administration of the hormone healthy person threatens sharp drop blood glucose - hypoglycemia. Similar condition may be accompanied by loss of consciousness up to the development of coma and death.

Types of insulin preparations

Depending on the production method, genetically engineered drugs are distinguished and human counterparts. pharmachologic effect the latter are more physiological, because chemical structure of these substances is identical to human insulin. All medications differ in their duration of action.

During the day, the hormone enters the bloodstream from at different speeds. Its basal secretion allows you to maintain a stable sugar concentration regardless of food intake. Stimulated insulin release occurs during meals. In this case, the level of glucose that enters the body with foods containing carbohydrates decreases. In diabetes mellitus, these mechanisms are disrupted, which leads to negative consequences. Therefore, one of the principles of treating the disease is to restore the correct rhythm of hormone release into the blood.

Physiological secretion of insulin

Short-acting insulins are used to mimic the stimulated hormone secretion associated with food intake. The background level is maintained by long-acting medications.

Unlike fast-acting remedies, extended-release forms are used regardless of food.

The classification of insulins is presented in the table:

Characteristics of prandial forms

Prandial insulins are prescribed to correct glucose after meals. They come in short and ultra-short and are used 3 times a day before main meals. They are also used to reduce high level sugar and maintaining background hormone secretion using insulin pumps.

Medicines differ in the time of onset of action and duration of effect.

The characteristics of short and ultra-short preparations are presented in the table:

Directions for use and dose calculation

Insulin is dispensed from pharmacies only with a doctor's prescription. Before using the drug, you must familiarize yourself with the method of its use described in the instructions.

Medicines are produced in the form of solutions that are injected into subcutaneous tissue. Before injecting prandial insulin, glucose concentration is measured using a glucometer. If the sugar level is close to the norm established for the patient, then short forms are used 20–30 minutes before meals, and ultra-short forms are used immediately before meals. If the indicator exceeds the permissible values, the time between injection and food is increased.

Insulin solution in cartridges

The dose of drugs is measured in units (U). It is not fixed and is calculated separately before breakfast, lunch and dinner. When determining the dosage of the medication, the sugar level before meals and the amount of carbohydrates that the patient plans to consume are taken into account.

For convenience, we use such a concept as grain unit(HE). 1 XE contains 12–15 grams of carbohydrates. The characteristics of most products are presented in special tables.

It is believed that 1 unit of insulin reduces sugar levels by 2.2 mmol/l. There is also an approximate need for the drug for 1 XE during the day. Taking this data into account, it is easy to calculate the dose of medication for each meal.

Estimated insulin requirement for 1 XE:

Let's assume that a person with diabetes has a morning fasting blood glucose of 8.8 mmol/L (with an individual goal of 6.5 mmol/L) and plans to eat 4 XE for breakfast. The difference between the optimal indicator and the real one is 2.3 mmol/l (8.8 - 6.5). To reduce sugar to normal without taking into account food, 1 unit of insulin is required, and when using 4 XE, another 6 units of the drug are required (1.5 units * 4 XE). This means that before eating, the patient needs to administer 7 units of a prandial agent (1 unit + 6 units).

A low-carbohydrate diet is not required for patients receiving insulin. The exception is those who are overweight or obese. They are recommended to eat 11–17 XE per day. For intense physical activity the amount of carbohydrates can increase to 20–25 XE.

Injection technique

Fast-acting drugs are produced in vials, cartridges and ready-made syringe pens. The solution is administered using insulin syringes, syringe pens and special pumps.

Medicine that is not in use should be kept in the refrigerator. The product for daily use is stored at room temperature for 1 month. Before administering insulin, check its name, the patency of the needle, evaluate the transparency of the solution and expiration date.

Prandial forms prick into the subcutaneous tissue of the abdomen. In this zone, the solution is actively absorbed and begins to act quickly. The injection site within this area is changed every day.

This technique allows you to avoid lipodystrophy, a complication that occurs when the technique of performing the procedure is violated.

When using a syringe, it is necessary to check the concentration of the drug indicated on it and the bottle. As a rule, it is 100 units/ml. During administration of the drug, it forms skin fold, the injection is made at an angle of 45 degrees.

NovoRapid FlexPen pen for single use

There are several types of syringe pens:

Pre-filled (ready-to-use) - Apidra SoloStar, Humalog QuickPen, Novorapid FlexPen. After finishing the solution, the pen must be disposed of.
Reusable, with a replaceable insulin cartridge - OptiPen Pro, OptiClick, HumaPen Ergo 2, HumaPen Luxura, Biomatic Pen.

Reusable pen for introducing an ultra-short analogue of Humalog - HumaPen Luxura

Before using them, a test is performed to evaluate the patency of the needle. To do this, take 3 units of the drug and press the trigger piston. If a drop of solution appears at its tip, you can inject insulin. At negative result The manipulation is repeated 2 more times, and then the needle is replaced with a new one. With a fairly developed subcutaneous fat layer, the product is administered at a right angle.

Insulin pump

Insulin pumps are devices that allow you to maintain both basal and stimulated levels of hormone secretion. They install cartridges with ultra-short analogues. Periodic injection of small concentrations of solution into the subcutaneous tissue simulates normal hormonal levels during the day and night, and additional introduction the prandial component reduces sugar from food.

Some devices are equipped with a system that measures blood glucose levels. All patients with insulin pumps receive training on how to set them up and operate them.