For nearly a century, the production of hormonal drugs for diabetics has been an important branch of the pharmaceutical industry. A quarter of a century there are more than fifty different types of hypoglycemic agents. Why is the diabetic forced to inject insulin of ultrashort action several times a day? How do drugs differ from each other and how to calculate the required dosage?
Insulins and their Duration
Today, a number of insulins are known. For diabetics, the important parameters of the synthesized drug are its type, category, packaging method, manufactured by the company.
The time interval of the impact of hypoglycemic agents on the body appears according to several criteria:
- when insulin begins to unfold after the injection has been performed;
- its maximum peak;
- total expiration date from start to finish.
Ultrashort insulin is one of the categories of the drug, except for the intermediate, mixed, long. If we look at the graph of the ultrafast hormone action curve, then it has a sharp rise and is highly compressed along the time axis.
Graphic lines of secretion intermediate, and even more prolonged, means smoother and stretched over a time interval
In practice, the duration of insulin of any category, except for the injection site, depends on many factors:
- zones of entry of hypoglycemic agents (under the skin, into the blood capillary, muscle);
- body temperature and the environment (reduced slows down processes, increased accelerated);
- massage the skin at the injection site (stroking, tingling increase the rate of absorption);
- localization, it is possible to store drugs in the subcutaneous tissues;
- individual response to the drug.
Having calculated the exact dose necessary to compensate for the carbohydrates eaten, the patient may not take into account the warm shower or sun exposure and feel signs of a drop in blood sugar. Hypoglycemia is manifested by dizziness, confused consciousness, a feeling of severe weakness in the whole body.
The supply of subcutaneous insulin is manifested a few days after the injection. To prevent an attack of unexpected hypoglycemia, which can lead to a comatose state, a diabetic should constantly have on hand products with fast carbohydrates, sugar, sweet bakery products made from high-grade flour.
The effect of an injection of pancreatic hormone depends on the place of its implementation. From the abdomen up to 90% is absorbed. For comparison, with arms or legs - less than 20%.
From the dose injected into the abdomen, the medicine will begin to unfold its action faster than from the one performed in the shoulder or thigh.
Time indicators of ultrashort insulin, depending on the dose
Insulins have the same spectrum of action, but different firms can be interchanged. Novorapid is produced by the joint Danish-Indian firm Novo Nordiks. Producers Humalog - USA and India. Both are human insulin species. The latter has two packaging options: in a bottle and in a foam case. Hormone Apidra German production company Sanofi-Aventis packed in a syringe-pens.
Devices in the form of special designs that look like an ink fountain pen have indisputable advantages over the traditional bottles and syringes:
- they are necessary for people with impaired vision, as the doses are set by well audible clicks;
- with their help, medication can be administered in any public place, through clothing;
- needle thinner than insulin.
Imported drugs entering the Russian Federation are marked in Russian. Dates of manufacture and shelf life (normal - up to 2 years) are stamped on the packaging and vial (glass sleeve). On the temporal characteristics indicate prospectuses from manufacturers. The instructions are enclosed in packages, they contain theoretical figures that a diabetic should be guided by.
The duration of the peak lasts a couple of hours. It occurs at the time of intensive digestion of food in the stomach, the breakdown of complex carbohydrates, and the entry of glucose into the blood. The rise in blood glucose level is fully compensated by the insulin given at the correct dose.
The regularity is determined, which consists in the fact that an increase in the dose also affects the period of action of the hypoglycemic drug, within the interval specified in the instructions. In reality, fast hormones work up to 4 hours at a dosage of less than 12 units.
A large dose increases the duration for another couple of hours. It is not recommended to inject more than 20 units of ultrashort insulin at one time. There is a significant risk of hypoglycemia. Excess insulin is not absorbed by the body, they will be useless and dangerous.
"Long" and "intermediate" drugs look unclear because of the prolongator added to them. The type of ultrashort insulin is different. It is clean and transparent, with no clouding, blotches and stains. This external feature separates ultrashort insulins from prolonged insulins.
Another significant difference between different types of insulin is that “short” is performed subcutaneously, intravenously and intramuscularly, and “long” is only subcutaneously.
In addition, the diabetic should know that you can not do the following:
- use a strongly expired drug (more than 2-3 months);
- purchase it at unverified sales locations;
It is required to be careful with the new, unknown manufacturing company. Store the drug is recommended in the refrigerator at a positive temperature of 2-8 degrees. Insulin for current use should not be kept in a cold place; room temperature is suitable for its preservation.
Special uses of ultrashort hormone
In the dawn period, some people produce a large amount of hormones with a kind of daily rhythm. Their names are adrenaline, glucagon, cortisol. They are antagonists of a substance whose name is insulin. Hormonal secretion means that the body is preparing to actively enter its daily phase of life activity. At the same time, there is too high a sugar level in the absence of nighttime hypoglycemia, gross violations of the diet.
Due to the individual characteristics, hormonal secretion can flow rapidly and rapidly. In a diabetic, morning hyperglycemia is established. There is a similar syndrome often, and in patients with 1 and 2 types. To eliminate it is almost impossible. The only way out is the injection of up to 6 units of ultrashort insulin, made in the early morning.
The use of ultrashort drugs does not exclude the obligatory observance of low-carb diet therapy items.
Ultrafast preparations are most often made for food. Because of their lightning efficiency, you can perform an injection during the meal, and immediately after it. The short duration of the insulin action forces the patient to make multiple injections during the day, imitating the natural secretion of the pancreas to the intake of carbohydrate products in the body. Up to 5-6 times, according to the number of meals.
To quickly eliminate serious metabolic disturbances in the pre-comatose or comatose states, with injuries, infections in the body, ultrashort drugs are used without combinations with prolonged. Using a glucometer (a device for measuring blood sugar), blood glucose is monitored and diabetes decompensation is restored.
How is the dose of ultrafast insulin calculated?
The dosage depends on the ability of the pancreas to produce its own insulin. Check its capabilities is easy. It is believed that a healthy endocrine organ produces so much hormone per day that there are 0.5 units per 1 kg of weight. If a diabetic weighs, for example, 70 kg and to compensate he needs 35 U or more, this indicates a complete cessation of the functioning of the pancreatic cells.
In this case, ultrashort insulin is required, in combination with prolonged, in different ratios: 50 to 50 or 40 to 60. The best option is set by the endocrinologist. And with a partially lost ability of the pancreas to cope with its function, correct calculation is necessary.
During the day, the need for "super-fast" is also changing. In the morning it is necessary for breakfast 2 times more than the eaten bread units (HE), in the afternoon - 1.5, in the evening - the same. It is necessary to consider the performed physical work, sports activities. With small loads, the dose of insulin usually does not change. When bodybuilding, for example, it is recommended against the background of normal glycemia (6-8 mmol / l) to eat in addition to 4 XE.
Insulin edema, in contrast, is a rare complication of endocrine disease. In order not to forget where the injection was performed, the scheme will help. On her abdomen (legs, hands) is divided into sectors by days of the week. After a few days, the skin in the obkolotom place is safely restored.