Principles of use of short-acting insulin and long-acting insulin. Short-acting insulins: the names of the best drugs Humalog short-acting or long-acting insulin

Insulin therapy is the use of insulin preparations for medicinal purposes. This method is widely used not only in the treatment of diabetes mellitus, but also in psychiatric practice, with liver pathology, malnutrition, furunculosis and thyroid diseases. There are a huge number of synthetic drugs that are divided into groups depending on the time of onset of the effect and its duration.

Short-acting insulin is one of the "participants" of the treatment regimen. It is quite popular in use, because it allows you to quickly reduce blood glucose levels. Modern drugs have the maximum therapeutic effect with minimal side effects. The following is considered what is the best short insulin and its features.

Drug differences

According to the onset of action, the speed of the onset of the "peak" and the duration of the effect, the following types of medicines are distinguished:

• Short acting insulin Also called food. It is able to stop the peaks and have an effect from 10 to half an hour after the injection. This group includes medicines of ultrashort and short action.
• Long-acting insulins- the second name is "basal". This includes medium-term and long-acting drugs. The purpose of their administration is based on maintaining a normal amount of insulin in the blood throughout the day. Their effect can develop from 1 to 4 hours.

Meals and the introduction of short-acting insulin are interrelated elements of the treatment of diabetes mellitus

In addition to the reaction rate, there are other differences between groups of drugs. For example, short insulin is injected into the region of the anterior abdominal wall so that absorption processes occur faster. Long-acting insulins are best injected into the thigh.

Means of ultra-short and short action are constantly tied to the time of food intake into the body. They are administered before meals to lower glucose levels immediately after eating foods that have carbohydrates in their composition. Long-acting drugs are used strictly according to the schedule in the morning and evening. They have nothing to do with meals.

Important! It is impossible to violate the above rules, as this can lead to an acute complication of the disease. The scheme of insulin therapy is selected individually by the attending specialist.

Short insulins

Each drug has certain features of the composition and action on the human body, which should be considered in more detail.

Instructions for use of the drug says that this remedy is an analogue of human insulin. Its structure has a reverse sequence of residues of some amino acids in the molecule. Of all short-acting insulins, this one has the fastest onset and end of effect. The decrease in blood glucose levels occurs within 15 minutes after injection and lasts up to 3 hours.

Indications for the appointment of Humalog:

• insulin-dependent type of diabetes;
• individual intolerance to other drugs based on the hormone;
• hyperglycemia that occurs after eating, which is not corrected by other means;
• insulin-independent type with resistance to tableted hypoglycemic drugs;
• non-insulin-dependent form of diabetes in combination with surgery or concomitant diseases that increase the manifestations of the "sweet disease".

The dose of short insulin is selected individually. Humalog in vials can be administered not only subcutaneously, but also into the muscle, into the vein. In cartridges - exclusively subcutaneously. The drug is administered before food enters the body (up to 6 times a day), combined with long-acting insulins.

Humalog is a "short" drug available in cartridges and vials

Side effects of the application can be a mild decrease in blood sugar, in the form of precoma, coma, visual pathologies, allergic reactions, lipodystrophy (decrease in the subcutaneous fat layer at the site of frequent injection).

Important! Humalog is stored in the refrigerator, but do not allow freezing, because in this case the agent loses its effectiveness.

The name of the drug (NM) indicates that its active substance is biosynthetic human insulin. Actrapid NM reduces glucose levels after half an hour, the duration is up to 8 hours. The drug is prescribed for the insulin-dependent type of "sweet disease", as well as for type 2 disease in combination with the following conditions:

• loss of sensitivity to hypoglycemic tablets;
• the presence of intercurrent diseases (those that worsen the course of the underlying disease);
• surgical interventions;
• childbearing period.

Actrapid NM is indicated for hyperglycemic conditions (ketoacidosis, hyperosmolar coma), hypersensitivity to drugs of animal origin, against the background of cell transplantation of the islets of Langerhans-Sobolev.

The introduction of short insulin is possible from 3 to 6 times a day. If the patient is transferred to this agent from another human insulin, the dosage is not changed. In case of transfer from drugs of animal origin, the dose should be reduced by 10%.

Actrapid NM is a remedy that has a quick action, but keeps it for a long time

Important! Actrapid NM is not prescribed for low blood glucose levels and in the presence of a hormone-secreting pancreatic tumor (insulinoma).

Insuman Rapid

The composition includes a hormone that is close in molecular structure to human insulin. A strain of Escherichia coli is involved in its synthesis. The effect of short-acting insulin occurs within half an hour and lasts up to 7 hours. Insuman Rapid is available in vials and cartridges for syringe pens.

Indications for prescribing the drug are similar to Actrapid NM. It is administered subcutaneously 20 minutes before food enters the body, each time changing the injection site. Insuman Rapid can be combined with long-acting insulins containing protamines as a depot-forming substance.

Homorap 40

Another representative of short insulin, the effect of which is manifested within half an hour and can reach 8 hours. The duration of the action depends on the following factors:

• dose of the drug;
• method of administration;
• injection site;
• individual characteristics of the patient's body.

The remedy well stops the manifestations of emergency conditions (diabetic coma, precoma), is prescribed during the period of surgical interventions. Homorap 40 is indicated for patients in childhood and adolescence, during the period of childbearing.

Injections of the drug are made up to 3 times a day, individually selecting the dosage. Can be administered with insulin pumps or in the same syringe with a range of long-acting insulins.

Important! With "combined" injections, first a short-acting insulin is drawn into the syringe, and then a long-acting agent.

In the case of the use of glucocorticosteroids, beta-blockers, antidepressants and combined oral contraceptives, a dose adjustment of the hormonal drug is required.

Based on recombinant human insulin. Available in cartridges and vials. Subcutaneous (shoulder, thigh, anterior abdominal wall), intramuscular and intravenous administration is provided. The injection site should be constantly changed so that the same area does not repeat more than once in 30 days.

Humulin Regular is one of the drugs that can be prescribed from birth

Adverse reactions:

• decrease in blood sugar;
• local allergic manifestations (redness, swelling and itching at the injection site);
• systemic allergy;
• lipodystrophy.

Humulin Regular can be taken from birth. In this case, the dosage of the drug is calculated based on the patient's body weight.

Berlinsulin HU-40

Available in several forms. The table of insulins and their features are discussed below.

Names of insulin	Compound	Number of phases in the preparation	The amount of active substance in 1 ml	Duration
H normal U-40	Insulin	One	40 units	Up to 8 hours (starts in 15 minutes)
H basal U-40	insulin and protamine	One	40 units	Up to 20 hours (starts in 40 minutes)
H 10/90 U-40	insulin and protamine	Two	4 units	Until 18:00 (starts in 45 minutes)
H 20/80 U-40	insulin and protamine	Two	8 units	Until 16:00 (starts in 40 minutes)
H 30/70 U-40	insulin and protamine	Two	12 units	Up to 15 hours (starts in 40 minutes)
H 40/60 U-40	insulin and protamine	Two	16 units	D 15 hours (starts in 45 minutes)

Correction of the dosage of insulin therapy with the described drugs is necessary for diseases of infectious genesis, surgical interventions, during the period of bearing a child, with thyroid pathology, renal and adrenal insufficiency, "sweet disease" in the elderly.

Important! Any of the forms of Berlinsulin should not be mixed with other insulin-based products. These forms can only be mixed with each other.

The following groups of drugs can enhance the hypoglycemic effect of drugs, which should be considered when choosing a treatment regimen:

• antidepressants;
• beta-blockers;
• sulfonamides;
• combined oral contraceptives;
• medicines based on testosterone;
• antibiotics (group of tetracyclines);
• products based on ethyl alcohol;
• heparin;
• diuretic drugs;
• lithium preparations;
• medicines based on thyroid hormones.

Short acting drugs in bodybuilding

In the modern world, the use of short insulins is widely used in the field of bodybuilding, since the effect of drugs is similar to the action of anabolics. The bottom line is that the hormone transfers glucose into muscle tissue, resulting in its increase in volume.

Building muscle mass with short insulins is a method that should only occur after a full examination and consultation with a doctor

It has been proven that such use should be done “wisely”, since the function of insulin is the transfer of monosaccharides not only to muscles, but also to adipose tissue. Ineffective workouts can lead not to muscle building, but to banal obesity. Therefore, the dosage of drugs for athletes, as well as for sick people, is selected individually. It is advisable to take a break of 4 months after 2 months of injections.

Attention should be paid to the rules for storing insulin and its analogues. For all types they are the same:

• Vials and cartridges should be stored in the refrigerator (not in the freezer!). It is advisable to put them on the door.
• Preparations should be kept exclusively in closed form.
• After the drug is opened, it can be used within 30 days.
• The product must be transported so that there is no direct contact with the sun's rays. This destroys the molecules of the hormone and reduces its effectiveness.

Before using the medicine, be sure to check the absence of turbidity, sediment or flakes in the solution, expiration date, storage conditions.

Compliance with the advice of specialists is the key to a high quality of life for patients and the ability to prevent the development of complications of the underlying disease.

Last update: April 18, 2018

In the treatment of diabetes, several types of insulin are used, one of them is long-acting or extended-acting insulin. The drug must be able to dose and control.

Insulin is a drug to be taken against a diabetic condition, injections of which lower the concentration of glucose in the blood, increasing its absorption by tissues (liver and muscles). Long-acting insulin is so named because its duration of action is longer than that of other versions of the drug, and this requires a lower frequency of administration.

Action of long insulin

Examples of drug names:

• Lantus;
• Insulin Ultralente;
• Insulin Ultralong;
• Insulin Ultratard;
• Levemir;
• Levulin;
• Humulin.

Available in the form of suspensions or solutions for injection.

Long-acting insulin reduces the concentration of glucose in the blood, enhances its absorption by muscles and the liver, accelerates the synthesis of protein products, and reduces the rate of glucose production by hepatocytes (liver cells).

If you correctly calculate the amount of prolonged-acting insulin, then its activation begins 4 hours after the injection. The peak of effectiveness should be expected after 8-20 hours (depending on the individual characteristics of the person and the amount of insulin injected). The activity of insulin in the body is reduced to zero 28 hours after administration. Deviations from these time frames reflect the external and internal pathologies of the human body.

Subcutaneous administration allows insulin to remain for some time in adipose tissue, which contributes to slow and gradual absorption into the blood.

Indications for the use of long-acting insulin

1. Presence of type 1 diabetes.
2. Presence of type 2 diabetes.
3. Immunity to oral drugs to reduce the amount of glucose in the blood plasma.
4. Use as a complex therapy.
5. Operations.
6. Gestational diabetes in pregnancy.

Mode of application

The amount of hormone administered is determined by the attending physician individually for each patient. You can calculate the dose yourself only after consulting a specialist and conducting laboratory tests.

Shaking insulin is prohibited. It is only necessary to scroll in the palms before injection. This contributes to the formation of a homogeneous composition and the simultaneous uniform heating of the medicine from the heat of the hands.

After the injection, do not immediately remove the needle. It needs to be left under the skin for a few seconds to fully administer the dose.

Correction is subject to the transition from insulin of animal origin to human. The dose is selected again. Also, the transition from one type of insulin to another should be accompanied by medical supervision and more frequent checks of blood sugar levels. If the transition has resulted in an administered dose exceeding 100 units, the patient should be sent to the hospital.

All insulin preparations are administered subcutaneously, and each subsequent injection must be made in a different place. Insulin preparations cannot be mixed and diluted.

Calculate extended insulin

In order for the level of glucose in the blood to remain in a normal amount throughout the day, it is necessary to administer a background dose of insulin, or a basis dose. Basis is a long-acting or intermediate-acting insulin that is designed to maintain blood sugar without food intake or on an empty stomach, as in a healthy person basal secretion.

With the normal functioning of the cells of the pancreas, a person produces 24-26 IU of insulin per day. This is about 1 unit per hour. This means that the final amount of insulin is the level of baseline or extended insulin that needs to be delivered.

If an operation, hunger, emotional and physical stress are planned, then the level of required prolonged insulin should be doubled.

Basis insulin test

You can understand whether the basis level is chosen correctly. This is the responsibility of every diabetic, since even the dosage of insulin prescribed by a doctor may be incorrect in relation to your particular case. Therefore, as they say, trust, but verify, especially if it directly concerns your health and well-being.

To check, you must select a specific day, it is better that it be a day off, since careful monitoring of glucose will be needed. So, how can you check if your extended insulin dose is correct?

1. You can not eat for 5 hours.
2. Every hour you need to measure sugar with a glucometer.
3. During all this time, there should be no hypoglycemia or a jump in glucose by 1.5 mmol / l.
4. A decrease in sugar or an increase indicates the need to adjust the basis insulin.

Such a test must be carried out repeatedly. For example, you checked your basal insulin levels in the morning, but the situation with glucose changes in the afternoon or in the evening. Therefore, choose another day to check the evening and even night insulin.

You just need to remember: so that the short insulin administered in the evening does not have an effect on blood sugar levels, the test should be carried out 6 hours after its administration (even if it is late at night).

Checkpoints

Control points also exist for various long-acting or intermediate-acting insulin preparations. If it turns out that when checking sugar at these “points”, it will be increased or decreased, then the basal test described above should be performed.

In Lantus, at any time of the day, glucose should not exceed 6.5 mmol / l on an empty stomach.

Protafan NM, Humalin NPH, Insumal Bazal, Levemir. For these drugs, the control point should be before dinner if the dose is given in the morning. In the event that the dose is administered in the evening, then it should be controlled in the morning on an empty stomach. In both the first and second cases, the value of glucose on an empty stomach should not exceed 6.5 mmol / l.

If you notice that there is a decrease or increase in sugar on an empty stomach, then you should not adjust the dose of insulin yourself! A baseline test should be done. And only then change the dosage or consult a doctor for this. Such surges can occur as a result of dawn syndrome or the wrong dosage of evening insulin.

Overdose

Even a small increase in insulin concentration that does not meet the needs of the body can lead to hypoglycemia, which, if the necessary medical intervention is not taken, can lead to death of the patient or serious complications.

With hypoglycemia, the patient needs to take fast carbohydrates, which in a short time will increase the amount of glucose in the blood.

It can lead to convulsions, nervous disorders and even coma. In the future, a doctor's control and correction of nutrition and administered doses of long-term insulin are necessary.

lantus

Lantus is an analogue of human insulin. It is obtained in the laboratory from the genetic apparatus of the bacterium, Escherichia coli. It differs from the human only in the presence of two molecules of arginine and the presence of asparagine instead of glycine.

Lantus, like any other insulin, must not be mixed with other types of insulin and, moreover, with hypoglycemic drugs. Mixing will lead to improper and untimely absorption of insulin by the body. The most dangerous side effect of mixing will be precipitation.

Since insulin Lantus has human antibodies, its absorption and susceptibility by the body is much better than that of analogues. However, in the first week it is worth paying more attention to the body's reaction to this type of insulin, especially after switching from another type.

Lantus is used by subcutaneous injection. Intravenous administration is unacceptable, as there is a risk of acute hypoglycemia.

Since insulin has some contraindications for use (childhood, renal insufficiency), the exact side effects with these restrictions could not be identified, since studies have not been conducted.

For pregnant and breastfeeding women, the use of long insulin is possible, but under the supervision of a specialist and with the use of auxiliary agents: hypoglycemic tablets, diet.

Contraindications

1. Hypoglycemia.
2. Sensitivity to the components of the drug.
3. Children under 6 years old.
4. Pregnancy.

After consulting a specialist, these contraindications may not be decisive, since the positive effect is much higher than the risks of possible complications. It is only necessary to correctly calculate the dose of insulin administered.

Side effect

1. Hypoglycemia.
2. Coma and precoma.
3. Redness and itching at the injection site.
4. Allergy.
5. Destruction of body lipids.

Special instructions and precautions

Long-acting insulin is not intended for the treatment of ketoacidosis. Ketone bodies are excreted from the body only with intravenous administration of short-acting insulin.

For type 1 diabetes, both long-acting and short-acting insulin is used. Prolonged acts as a base, that is, it maintains the amount of insulin in the blood that the pancreas should produce in a normal state.

Different injection sites do not have differences in the final result, that is, the concentration of the drug in the blood will be the same in any case. It is only necessary to change places for each subsequent injection.

When switching from medium to long insulin, you should be under the supervision of a doctor and a glucometer, as the dose of insulin administered will be adjusted and additional measures to reduce blood sugar (pills, short insulin) will be required.

To prevent hypoglycemia at night and after waking up, it is advised to reduce the concentration of long insulin and increase short insulin during meals. Only the doctor himself should calculate the dose.

The dose of long-acting insulin is adjusted when:

• change in nutrition;
• with increased physical activity;
• diseases of an infectious nature;
• operations;
• bearing a child;
• diseases of the endocrine system;
• kidney disease (especially insufficiency);
• diabetes mellitus in the elderly (65 or more);
• with pronounced weight loss or weight gain;
• alcohol consumption;
• other reasons that affect the concentration of glucose in the blood.

It is also worth being careful for those who have glycosylated hemoglobin below normal. Such people may have hypoglycemia both during the day and at night for no apparent reason.

How to store

It is necessary to find a place where the average temperature is from + 2°C to + 8°C. Usually these are the side shelves of the refrigerator. It is important not to freeze insulin, which means that both the injections themselves and the container cannot be stored in the freezer.

Keep out of reach of children.

Once opened and started to use, the storage temperature should not exceed +25 degrees. Please note that the shelf life of insulin after opening is 4 weeks.

At the expiration date, the use of the drug is prohibited.

You can buy extended insulin only at a pharmacy and only with a doctor's prescription.

Insulin is a hormone produced by cells in the pancreas. Its main task is the regulation of carbohydrate metabolism and the "curbing" of growing glucose.

The mechanism of work is as follows: a person begins to eat, after about 5 minutes insulin is produced, it balances the sugar increased after eating.

If the pancreas does not work correctly and the hormone does not secrete enough, diabetes develops.

Mild forms of impaired glucose tolerance do not require treatment, in other cases it is indispensable. Some drugs are injected once a day, while others - every time before eating.

Short-acting insulin begins to act 30-40 minutes after entering the body. After this time, the patient must eat. Skipping meals is not allowed.

The duration of the therapeutic effect is up to 5 hours, about the time it takes for the body to digest food. The action of the hormone significantly exceeds the time for the increase in sugar after meals. To balance the amount of insulin and glucose, after 2.5 hours, a light snack is recommended for a diabetic.

Fast insulin is usually prescribed for patients who have a sharp increase in glucose levels after eating. When using it, it is necessary to take into account some subtleties:

• serving size should always be about the same;
• the dose of the drug is calculated taking into account the amount of food eaten so as to make up for the lack of a hormone in the patient's body;
• if the amount of the drug was not administered enough, hyperglycemia occurs;
• too high a dose will provoke hypoglycemia.

Both hypo- and hyperglycemia are extremely dangerous for a diabetic patient, as they can provoke serious complications.

The action of ultrashort insulin occurs instantly. This is its main difference: the patient does not have to wait for the allotted time so that the medicine has time to act. It is prescribed for patients who are not helped by fast insulin.

The ultra-fast-acting hormone was synthesized to enable diabetics to indulge in fast carbohydrates, in particular sweets, from time to time. However, in reality it is not so.

Any easily digestible carbohydrates will increase sugar sooner than the fastest insulin will work.

This is why a low-carbohydrate diet is the cornerstone of diabetes management. By adhering to the prescribed diet, the patient can significantly reduce the likelihood of severe complications.

Ultrafast insulin is a human hormone with an improved structure. It can be used for type 1 and type 2 diabetes, as well as for pregnant women.

Like any drug, short insulin has its strengths and weaknesses.

Advantages:

• this type of insulin lowers the blood to a normal state without provoking hypoglycemia;
• stable effect on sugar;
• it is enough to simply calculate the size and composition of the portion that can be eaten after the prescribed time after the injection;
• the use of this type of hormone contributes to better absorption of food, with the proviso that the patient follows the prescribed diet.

Disadvantages:

• The need to wait 30 to 40 minutes before eating. In some situations, this is extremely difficult. For example, on the road, at a celebration.
• The therapeutic effect does not occur immediately, which means that such a drug is not suitable for instant relief of hyperglycemia.
• Since such insulin has a more prolonged action, an additional light snack is needed 2.5-3 hours after the injection to stabilize the sugar level.

In medical practice, there are diabetics diagnosed with slow gastric emptying.

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Such patients should be given an injection of rapid insulin 1.5 hours before meals. In many cases, this is extremely inconvenient. In this case, the only way out is the use of an ultra-rapid hormone.

In any case, only a doctor can prescribe this or that drug. Switching from one drug to another should also be under medical supervision.

Currently, the choice of rapid insulin preparations is quite wide. Most often, the price depends on the manufacturer.

Table: "Fast-acting insulins"

Name of the drug	Release form	Country of origin
"Biosulin R"		India
"Apidra"	Glass cartridge 3 ml	Germany
"Gensulin R"	10 ml glass ampoule or 3 ml cartridge	Poland
"Novorapid Penfill"	Glass cartridge 3 ml	Denmark
"Rosinsulin R"	Bottle 5 ml	Russia
"Humalog"	Glass cartridge 3 ml	France

Humalog is an analogue of human insulin. Colorless liquid, produced in glass cartridges of 3 milliliters. The acceptable route of administration is subcutaneous and intravenous. Duration of action - up to 5 hours. It depends on the selected dosage and the susceptibility of the body, the patient's body temperature, as well as the injection site.

If the introduction was under the skin, then the maximum concentration of the hormone in the blood will be in half an hour - an hour.

"Humalog" can be administered before meals, as well as immediately after it. Subcutaneous administration is carried out in the shoulder, abdomen, buttock or thigh.

The active ingredient in Novorapid Penfill is insulin aspart. It is an analogue of the human hormone. It is a liquid without color, without sediment. Such a drug is allowed to be used by children over two years old. Typically, the daily requirement for insulin ranges from 0.5 to 1 unit, depending on the body weight of the diabetic.

Apidra is a German drug whose active ingredient is insulin glulisine. This is another analogue of the human hormone. Since studies of the effect of this drug have not been conducted on pregnant women, its use for such a group of patients is undesirable. The same goes for breastfeeding women.

"Rosinsulin R" is a Russian-made drug. The active ingredient is genetically engineered human insulin. The manufacturer recommends administration shortly before a meal or 1.5-2 hours after it. Before use, it is necessary to carefully examine the liquid for the presence of turbidity, sediment. In this case, the hormone can not be used.

The main side effect of rapid insulin preparations is hypoglycemia. Its mild form does not require dose adjustment of the drug and medical care. If the low sugar level has passed into an average or critical degree, then urgent medical attention is needed. In addition to hypoglycemia, patients may experience lipodystrophy, pruritus, and urticaria.

Nicotine, COCs, thyroid hormones, antidepressants, and some other drugs weaken the effect of insulin on sugar. In this case, you will need to adjust the dose of the hormone. If any drugs are taken by the patient every day, he must notify the attending physician about this.

Like every medicine, fast insulin preparations have their own contraindications for use. These include:

• some heart diseases, in particular a defect;
• acute nephritis;
• diseases of the gastrointestinal tract;
• hepatitis.

In the presence of such diseases, the treatment regimen is selected individually.

Rapid insulin preparations are prescribed for diabetics as a therapy. To achieve the maximum effect of treatment, strict adherence to dosing and dietary regimen is necessary. It is possible to change the amount of the administered hormone, to replace one with another, only in agreement with the doctor.

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The pharmaceutical industry produces a wide variety of hormonal drugs for regulating blood sugar. One of them is short-acting insulin. It is able to normalize blood glucose levels in diabetic patients in a short time, which makes it an indispensable tool.

The concept of short-acting insulins

As soon as such insulin is introduced, it dissolves and quickly normalizes the metabolic processes that are associated with the absorption of glucose.

Unlike long-acting drugs, they consist only of a pure hormonal solution without any additives. From the name it is obvious that after the introduction they begin to work as quickly as possible, that is, in a relatively short time they lower the level of sugar in the blood. But at the same time, they stop their action faster than drugs with an average duration of action, as can be seen in the example of the following scheme:

When is this type of insulin prescribed?

Short-acting insulins are used alone or in combination with long-acting hormones. It is allowed to enter up to 6 times a day. Most often, they are prescribed in such cases as:

• resuscitation therapy;
• unstable need of the body for insulin;
• surgical interventions;
• fractures;
• complications of diabetes - ketoacidosis.

How long does short insulin last and when does it peak?

With subcutaneous administration, the longest effect of the drug is observed, which occurs after 30-40 minutes, just when the food eaten is digested.

After taking the drug, the peak action of insulin is reached after 2-3 hours. The duration depends on the administered dose:

• if 4 UNITS–6 UNITS, the duration of the normalization of the state is approximately 5 hours;
• if 16 units or more, it can reach 6-8 hours.

After the expiration of the time of action, the drug is excreted from the body by contrainsular hormones.

Types of short-acting insulin preparations

There are many short-acting insulin preparations, among which the preparations from the table are very popular:

The listed insulins are considered human genetically engineered, except for Monodar, which is classified as a pig. Produced in the form of a soluble solution in vials. All of them are intended for the treatment of type 1 and type 2 diabetes. Often prescribed before long-acting drugs.

The drugs are not contraindicated in pregnant and lactating women, since this type of insulin does not cross the placenta and into breast milk.

Ultrashort-acting insulin

This is the latest invention in pharmacology. It differs from other species in its almost instant action, normalizing blood sugar. The most prescribed drugs are:

These drugs are analogues of the human hormone. They are convenient in cases where you need to take food, but its quantity is not known, when it is difficult to calculate the dose of insulin for digestion. You can first eat, then calculate the dose and inject the patient. Since the action of insulin is fast, the food will not have time to digest.

This ultra-short insulin is designed for use in cases where diabetics break the diet and eat more sweets than recommended. Usually in such cases there is a sharp increase in sugar, which can lead to health complications. That's when these drugs can help. Sometimes, when the patient cannot wait for about 40 minutes, but breaks into a meal much earlier, this type of insulin can be pricked again.

Such insulin is not prescribed to patients who follow all the rules in nutrition. Most often, only as an ambulance with a sharp jump in sugar.

It is not contraindicated in pregnant women diagnosed with diabetes. It is allowed to apply, even if there is toxicosis of pregnancy.

The benefits of ultrashort insulin are that it can:

• reduce the frequency of high blood sugar at night, especially at the beginning of pregnancy;
• help to quickly normalize sugar in a future mother during a cesarean section;
• reduce the risk of complications after eating.

These drugs are so effective that they can normalize sugar in a short time, while the dose is administered much less, which helps to prevent various complications.

How to calculate short insulin - formulas for diabetics

There are various methods for calculating a single dose of short-acting insulin, which can be found below:

Based on the level of glycemia

Calculation of the dose based on the food consumed

Not only the level of glucose in the blood, but also the food consumed depends on a single dose of short-acting insulin. So, for the calculation it is worth considering the following facts:

• The unit of measure for carbohydrates is bread units (XE). So, 1 XE \u003d 10 g of glucose;
• For each XE, you need to inject 1 unit of insulin. For a more accurate calculation, this definition is used - 1 unit of insulin reduces the hormone by 2.0 mmol / l, and 1 XU of carbohydrate food raises it to 2.0 mmol / l, therefore, for every 0.28 mmol / l that exceed 8, 25 mmol / l, 1 unit of the drug is injected;
• If the food does not contain carbohydrates, then the level of the hormone in the blood practically does not increase.

Calculation example: If before a meal the glucose level is 8 mmol / l, and it is planned to eat 20 g of carbohydrate food or 2 XE (+ 4.4 mmol / l), then after eating the sugar level will rise to 12.4, while the norm is 6. Therefore, it is necessary to enter 3 IU of the drug so that the sugar index drops to 6.4.

The maximum dose for a single injection

Any dose of insulin is adjusted by the attending physician, but it should not exceed 1.0 U, which is calculated per 1 kg of its weight. This is the maximum dose.

An overdose can lead to complications.

Usually the doctor adheres to the following rules:

• If type 1 diabetes has only recently been diagnosed, a dose of no more than 0.5 U / kg is prescribed.
• With good compensation during the year, the dose is 0.6 U / kg.
• If instability is observed in type 1 diabetes, sugar is constantly changing, then 0.7 U / kg is taken.
• With the diagnosis of decompensated diabetes, the dose is 0.8 U / kg.
• With ketacidosis, 0.9 U / kg is taken.
• If pregnancy is in the last trimester - 1.0 U / kg.

How to inject short insulin? (video)

All types of insulin are basically administered in approximately the same way and before meals. It is recommended to choose those areas on the human body where large blood vessels do not pass, there are deposits of subcutaneous fat.

With venous administration, the action of insulin will be instantaneous, which is unacceptable in daily therapy. Therefore, subcutaneous administration of the drug is recommended, which contributes to uniform absorption of insulin into the blood.

You can choose the abdomen, but do not inject within a radius of 6 cm from the navel. Before the injection, you need to wash this area and hands with soap and dry. Prepare everything you need for the procedure: a disposable syringe, a vial of the drug and a cotton pad. Be sure to check the expiration date of the drug!

1. Remove the cap from the syringe, leaving the rubber cap.
2. Treat the needle with alcohol and insert carefully into the drug vial.
3. Get the right amount of insulin.
4. Remove the needle and release air by pushing the plunger of the syringe until a drop of insulin drips.
5. Use your thumb and forefinger to make a small fold of leather. If the subcutaneous fat layer is thick, then the needle is inserted at an angle of 90 degrees, with a thin one, the needle must be slightly tilted at an angle of 45 degrees. Otherwise, the injection will not be subcutaneous, but intramuscular. If the patient is not overweight, it is better to use a thin and small needle.
6. Slowly and smoothly inject insulin. The speed should be uniform during the introduction.
7. When the syringe is empty, quickly remove the needle from under the skin, and release the fold.
8. Put a protective cap on the syringe needle and discard it.

You can not constantly prick in the same place, and the distance from one injection to another should be about 2 cm. Alternate injections: first in one thigh, then in the other, then in the buttock. Otherwise, thickening of the fat tissue may occur.

The rate of absorption of the hormone even depends on the choice of place. Insulin is absorbed most rapidly from the anterior wall of the abdomen, then the shoulders and buttocks go, and later from the anterior surface of the thighs.

It is best to inject into the abdomen so that the action occurs faster immediately after eating.

You can learn more about the technique of administering insulin in this article or the following video:

In conclusion, it is worth noting that you cannot independently choose a short-acting drug, change its dosage without a doctor's prescription. It is necessary to develop, together with the endocrinologist, a scheme for its administration according to the regimen and amount of food taken. It is advisable to constantly change the injection site, store the drug correctly, and monitor the expiration dates. And at the slightest change and complications, consult a doctor.

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

The consequence of this are irreversible changes in the internal organs and their functions. The quality of life deteriorates significantly, and the performance of daily activities becomes an impossible task. Similar problems appear as a result of improper functioning of the pancreas, in complex cases of 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 norms acceptable for the body. This process is called insulin therapy.

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

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

At the same time, the rest of the time (outside meals), the body 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 insulin of various types is selected on the recommendation of a doctor based on the patient's individual indicators, the characteristics of the medical history, laboratory tests, and lifestyle.

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

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

Table number 1. Table of differences between types of insulin:

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

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

long acting hormone

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

Being absorbed from the 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 enough for this.

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

1. medium duration. The hormone begins to act in 1.5 maximum 2 hours after the administration of the medicine, and therefore it is pricked in advance. In this case, the maximum effect of the substance occurs no later than 3-12 hours later. The time of general action from a medium-acting agent is from 8 to 12 hours, therefore, a diabetic will have to use it 3 times in 24 hours.
2. Prolonged 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 enough when the drug is administered in the morning on an empty stomach and in the evening before bedtime. The highest value of the action of the drug is from 16 to 20 hours from the moment it enters the body.
3. Extra long acting. Particularly convenient for the elderly and people with disabilities, given the duration of the action of the substance (24-36 hours) and, consequently, the reduction in 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.

It implies the imitation of the natural secretion of the hormone through the use of drugs. Unfortunately, it is impossible to achieve effective indicators using only one type of hormone-containing agent. That is why short-acting insulins are equally important.

short acting hormone

The name of this type of hormone speaks for itself.

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

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

Eating carbohydrates in food increases their concentration in the blood even while taking basic insulin.

According to the duration of exposure, fast-acting hormones are divided into two types:

1. Short. Short-acting insulin preparations after administration begin to act within 30-60 minutes. Possessing a high resorption rate, the peak of maximum efficiency is reached 2-4 hours after ingestion. According to average estimates, the effect of such a medicine lasts no more than 6 hours.
2. Ultrashort insulin. This modified human hormone analogue is unique in that it can 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 ultrashort agent solution is absorbed into the body allows it to be taken before meals or immediately after.

Important. The onset of action of the antidiabetic agent should coincide with the time of digestion of food and the absorption of carbohydrates from it. The time of administration of the drug, taking into account the selected type of insulin and the load of the body with carbohydrates, should be coordinated with each other.

The selection of a hormone suitable for use is strictly individual, as it is based on laboratory tests, the degree of disease of a person with diabetes, a complete medical history, and lifestyle. Not unimportant factor is the price of the drug, given the frequency of its use. As a rule, it proportionally increases in direct proportion to the complexity of the production of the drug, the country of the manufacturer, and the packaging.

Features of the choice of short-term insulin. The most popular drugs

From the material of the previous section of the article, it becomes clear what short insulin is, but not only the time and speed of exposure is important. All drugs have their own characteristics, the analog of the human pancreatic hormone is no exception.

The list of features of the drug, which you need to pay attention to:

• source of receipt;
• degree of purification;
• concentration;
• drug pH;
• 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 drugs, 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 hormone.

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.

Solutions of the highest degree of purification (monocomponent) are considered the most difficult to manufacture. The less impurities, the higher the efficiency and fewer contraindications to its use. The risk of allergic manifestations is reduced with the use of a hormone analogue.

Preparations of different production methods, exposure rates, firms, brands, can be represented by different concentrations. Therefore, the same dose of units of insulin can occupy a different volume in the syringe.

It is preferable to use medicines with neutral acidity, this avoids discomfort at the injection site. However, the price of such funds is an order of magnitude higher than acidic ones.

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

Important. Of greater importance in insulin therapy is not the country of origin, the properties of the drug and their possible compatibility when using both long and short hormones at the same time.

Top five most popular short-acting insulin preparations

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

Table No. 2. List of antidiabetic agents most commonly prescribed by specialists.

Name	Description
	Biosynthetic human insulin obtained by genetic engineering. Active ingredient: neutral mono-component solution of the hormone, similar to the human one. It is used for type 1 diabetes, as well as resistance to tablet preparations for type 2 diabetes.
	Human recombinant semi-synthetic insulin, has a neutral level of acidity. Country of manufacture Ukraine.
	Genetically engineered biosynthetic antidiabetic drug for regulation of glucose metabolism. Human (DNA - recombinant). Country of origin France.
	Pork mono-component preparation, when used, which can be mixed with long-term preparations containing protamine sulfate as a depot forming substance. Production Ukraine.
	The soluble human hormone is genetically engineered thanks to DNA recombinant technology. Production Russia.

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

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

Important. It is necessary to use short insulin and tablets, injections, and other medicines with caution. Some of them can reduce or vice versa enhance the effect of antidiabetic agents. It is mandatory to consult a specialist and carefully study the section of the instructions on interaction with other drugs.

Ultrashort preparations

Despite the fact that ultrashort-acting insulin was developed as an emergency aid in case of sharp jumps in glucose, removing a person from a hyperglycemic coma, it is now used in insulin therapy. At the moment, clinical trials have been completed with three preparations of a hormone of similar action.

Table No. 3. List of antidiabetic agents of ultrashort exposure.

Name	Description
	Recombinant insulin (lispro) has a high rate of absorption, and therefore acts faster than the hormone produced naturally. Manufacturer France.
	Biotechnically created recombinant analogue of human insulin (aspart). Increases intracellular transport of glucose. Made in Denmark.
	Insulin gluisin is a recombinant human insulin that is as potent as a naturally produced hormone. Made in France.

A person, before injecting a short-acting hormone, has to calculate and control the amount of carbohydrates taken with food in advance. 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 floating work schedule in which it is difficult to predict meal times in advance experience difficulties in controlling carbohydrate metabolism. It is not easy for parents of children with diabetes. In the event of undereating a portion or even refusing to eat a child, the dose of insulin administered in advance will be too high, which can lead to severe hypoglycemia.

Fast-acting medicines of the ultrashort group are good because they can be taken almost simultaneously with or after meals. This makes it possible to more accurately select the dose required 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 do not stand still. Scientists are constantly improving and modifying existing drugs, creating new and improved versions on their basis.

Insulin pumps of various models are gaining popularity more and more, allowing you to lead an active lifestyle with 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 visually see the technique of administering such drugs.