Extended-release insulins name list. Is it possible to do with the introduction of long insulin without the use of short and ultrashort preparations? The main differences between "short" and "long" insulins

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 insulin is so named because its duration of action is longer than that of other variants 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 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 one of the important hormones in the human body. Insulin is produced in the pancreas and has a multifaceted effect on metabolic processes in body tissues. The main task of this bioactive compound is to reduce the concentration of sugars in the body.

When insulin production is impaired, a person develops a disease called diabetes mellitus. As a result of the development of this disease, there is a violation of the processes of carbohydrate metabolism.

People with diabetes are faced with the fact that the level of insulin in the body should be maintained artificially. The amount of insulin injected into the body depends on the size of the difference between the insulin produced by the body and the amount of insulin that the body needs for normal functioning. Existing insulin preparations are divided into several varieties, depending on the speed of achieving the effect and the duration of the drug's action in the body. One type is long-acting insulin.

Extended insulin has a prolonged action due to this property, this type of preparation is called prolonged insulin. This type of artificial hormone acts as the main basic hormone that creates the required insulin background in the patient's body.

Preparations of this type are able to accumulate insulin in the body throughout the day. During the day, it is enough to carry out 1-2 injections to normalize the content of the hormone in the blood. Gradually, from the use of long-acting insulin, the hormonal background in the body normalizes. The effect is achieved on the second or third day, it should be noted that the maximum effect is achieved after 2-3 days, and the drug begins to act after a few hours.

The most common long-acting insulin preparations are as follows:

• Insulin Monodar Long;
• Insulin Ultralong;
• Insulin Lantus.

Among long-acting drugs, the so-called faceless insulin preparations stand apart. This type of insulin, when administered to the body, does not have a pronounced peak of action. The effect of these drugs on the body is smooth and softer. The most famous drugs in this group are Levemir and Lantus.

All types of insulin are given subcutaneously and the injection site should be changed each time. Insulin preparations must not be mixed and diluted.

Choice of long-acting insulin

Before choosing long-acting insulins, you should study information about what this type of insulin is. Additionally, you should study the information specified in the instructions for use and consult with an endocrinologist.

To date, two types of extended-acting insulins are used to treat the disease:

• Insulins with a duration of action up to 16 hours;
• Insulins that have an ultra-long action that lasts more than 16 hours.

The group of first insulins includes:

1. Gensulin N.
2. Biosulin N.
3. Isuman NM.
4. Insuman Bazal.
5. Protafan NM.
6. Humulin NPH.

The group of ultra-long-acting insulins includes:

• Tresiba NEW.
• Levemir.
• Lantus.

Ultralong insulins are peakless. When calculating the dose for an injection with an ultra-long-acting drug, this feature must be taken into account. The remaining selection rules are common to all types of insulin.

When calculating the dose of a single dose in the body, the indicator should be such that the concentration of glucose throughout the entire time between injections remains at the same level within the normal range. Permissible fluctuations should not exceed 1-1.5 mmol / l during this time.

With the correct choice of the dose of insulin, the concentration of glucose in the blood is stable.

It is forbidden to use medicines containing insulin, the shelf life of which is overdue. In the process of storing drugs, it is required to comply with the storage conditions and the shelf life of medical devices. The use of expired insulin in the treatment can provoke increased sweating, weakness, tremors, convulsions, and in some cases even a coma in the patient's body.

Modern long-acting insulin preparations can be taken not only by injection, but also by oral administration of the drug in the process of eating.

Oral administration of the drug is a promising development, which is designed to make life easier for a person with diabetes mellitus.

The action of insulin, indications for use and method of administration

Sugar level

Subcutaneous administration of the drug allows the hormone to be in fatty tissue for some time, which makes it possible to slow down its absorption into the bloodstream.

Indications for the use of long-acting insulin are:

1. The patient has type 1 diabetes.
2. The patient has type 2 diabetes.
3. The presence of the patient's immunity to oral drugs intended to reduce the content of sugars in the blood plasma.
4. Use as a component of complex therapy.
5. Carrying out surgical interventions.
6. Presence of gestational diabetes in pregnancy.

The volume of the hormone used is determined by the endocrinologist on an individual basis and taking into account all the individual characteristics of the patient's body. The endocrinologist will be able to calculate the dose only after receiving the results of a comprehensive examination of the patient and obtaining laboratory tests.

Do not shake the vial of insulin before injecting. Before administering the drug, you only need to scroll the vial of insulin in the palm of your hand, this will allow a homogeneous composition to form and at the same time allow you to warm up the medication before the injection.

When a patient switches from animal insulin to human insulin, the dose should be recalculated.

In the case of a transfer of a patient from one type of drug to another, it is also necessary to adjust the dose of insulin received.

Characteristics of the most common types of extended-acting insulin

One of the common insulin preparations with a prolonged action is Digludec. This drug has a super long-term effect. It is an analogue of human insulin. The manufacturer of this drug is the Danish company Novo Nordisk.

The action of this drug is based on enhancing the utilization of glucose from blood plasma by fat cells and muscle tissue cells.

This process is activated by attaching the hormone to cell receptors. The second effect of the drug is to block the production of glucose by liver cells, which reduces the amount of glucose in the patient's body.

The duration of action of this drug is more than 42 hours. The maximum concentration of insulin in the body is reached 24-36 hours after the administration of the drug.

Insulin glargine is produced by the French company Sanori-Aventis. The composition of the drug includes insulin-glargine, m-cresol, zinc chloride, glycerol, sodium hydroxide, water for injection are used as auxiliary compounds in the composition of the drug.

This form of the drug is an analogue of human insulin.

With the introduction of the drug once a day, a stable concentration of the compound in the patient's body is observed for 2 to 4 days after the administration procedure.

Having a long duration of action of the drug, it allows you to use it during the day only once. After the injection, the effect of the drug begins one hour after the injection.

The drug is allowed to be used only by subcutaneous injection. The drug is injected into the subcutaneous fatty tissue in the abdomen, shoulder or thigh.

Side effects of the use of this remedy are the development of lipodystrophy and a delay in the absorption of insulin.

Contraindication to use is the presence of hypersensitivity to insulin glargine or any of the components of the medication. Additionally, this drug should not be used in children under 6 years of age.

The drug Humulin L is a medical device produced by the American company Eli-Lilli. The tool is a sterile suspension of crystalline human insulin. The drug has a long-term effect.

In the video in this article, the doctor will continue to cover the topic of extended insulin.

Sugar level

Recent discussions.

Just a hundred years ago, diabetes was considered a fatal disease. Doctors knew how the disease manifests itself, and called indirect causes - for example, or. And only in the second decade of the last century, scientists discovered and calculated its role in. It was a real salvation for diabetics.

Groups of insulin preparations

The main principle of therapy for type I diabetes is the introduction of certain doses of synthesized insulin into the patient's blood. According to individual indications, this hormone is also used in type II diabetes.

The main role of insulin in the body is to participate in the metabolic processes of carbohydrates and to establish an optimal level of sugar in the blood.

Modern pharmacology divides insulin preparations into categories, taking into account the speed of onset of the hypoglycemic (lowering blood sugar) effect:

Long-term effect: pros and cons

Until recently, long-acting insulin preparations were divided into two subgroups: medium-acting and long-acting. In recent years, the development of ultra-long-acting insulin has become known.

The key difference between the drugs of all three subgroups is the duration of the hypoglycemic effect:

• action of average duration - 8-12, in some patients - up to 20 hours;
• long-term action - 20-30 (in some cases 36) hours;
• ultra-long action - more than 42 hours.

Long-acting insulins are usually produced in the form of suspensions and are intended for subcutaneous or intramuscular administration.

Normally, a person who does not have diabetes mellitus produces insulin constantly. Long-acting insulin preparations have been developed to mimic a similar process in diabetic patients. Their long-term work in the body is very important in maintenance therapy. Reducing the number of injections is another significant plus of such drugs.

But there is a limitation: long-acting insulins cannot be used in diabetic coma or in a pre-coma state of the patient.

What are long acting insulin preparations?

Consider the drugs that are the most famous in their subgroup.

Insulin Isophane

This active ingredient is used in preparations middle term actions. The representative can be considered the French Insuman Bazal GT. It is available in the form of suspensions containing 40 or 100 units of insulin. The volume of one bottle is 10 or 5 ml, respectively.

The peculiarity of the drug is its good tolerance by patients who have been noted intolerance to other insulins. In addition, the drug can be used in expectant and nursing mothers (medical supervision is required). Insulin isophane is administered once every day.

The estimated cost of a package of five bottles of 5 ml is from 1300 rubles.

insulin glargine

This drug long-acting is unique in its own way. The fact is that most insulins have a so-called peak. This is the moment when the concentration of the hormone in the blood reaches a maximum. The use of insulin glargine excludes such a peak moment: the drug acts evenly and constantly. The drug is intended for a single daily administration.

One of the commercial names is "Lantus". Produced in France as a suspension for subcutaneous injection. The cost of the medicine is approximately 3500 rubles for 5 syringes of 3 ml each.

Insulin degludec

This is the international name of the drug extra long acting. According to expert estimates, now it has no complete analogues in the whole world. Trade name - "TRESIBA Penfill", country of origin - Denmark. Release form - cartridges with a capacity of 3 ml (100 units of insulin / ml), in a box - 5 cartridges. The estimated price of the drug is about 7500 rubles.

The drug is administered once every 24 hours at any convenient time (then it must be followed). Insulin degludec is indicated for the treatment of diabetes in adult patients, including those over 65 years of age. Now it is not used for the treatment of diabetes in lactating, pregnant women, as well as in children and adolescents.

Long-acting insulins are able to maintain a normal level of glucose in the blood throughout the day with any degree of diabetic condition. At the same time, a decrease in the concentration of sugar in plasma occurs due to its active absorption by body tissues, in particular the liver and muscles. The term "long" insulins makes it clear that the duration of the effect of such injections, compared with other types of hypoglycemic drugs, is longer.

Types of insulin long-acting drugs

Long-acting insulin is produced as a solution or suspension for intravenous and intramuscular administration. In a healthy person, this hormone is continuously produced by the pancreas. Prolonged hormonal composition was developed to mimic a similar process in people with diabetes. But extended-type injections are contraindicated in patients who are in a diabetic coma or pre-coma.

At the moment, long-term and ultra-long-term means are common:

The name of the hypoglycemic agent and how to use long-acting insulin can only be recommended by the attending physician.

In addition, people suffering from diabetes mellitus should not independently replace the prolonged remedy with its analogue. An extended-type hormonal substance should be prescribed medically justified, and treatment with it should be carried out only under the strict supervision of a physician.

Features of the use of long insulins

Long-acting insulin, depending on the type of diabetes, can be combined with a fast-acting agent, which is done in order to perform its basal function, or it can be used as a single drug. For example, in the first form of diabetes mellitus, it is customary to combine insulin of a prolonged type with a short or ultrashort preparation. In the second form of diabetes, drugs are used separately. The list of oral hypoglycemic formulations with which a hormonal substance is usually combined includes:

1. Sulfonylurea.
2. Meglitinides.
3. Biguanides.
4. Thiazolidinediones.

Extended-release insulin can be taken as a monotherapy, as with other medicines.

As a rule, a hypoglycemic composition of a prolonged type is being used to replace agents with an average duration of exposure. Due to the fact that to achieve a basal effect, the average insulin composition is administered twice a day, and the long one once a day, a change in therapy for the first week can provoke the occurrence of morning or night hypoglycemia. The situation can be corrected by reducing the amount of prolonged drug by 30%, which allows you to partially compensate for the lack of prolonged hormone, using short-type insulin with meals. After that, the dosage of the extended insulin substance is adjusted.

The basal composition is administered once or twice a day. After entering the body by injection, the hormone begins to show its activity only after a few hours. At the same time, the time frame for the impact of each of the prolonged hypoglycemic substances listed in the table has its own. But if prolonged-type insulin is required to be administered in an amount exceeding 0.6 units per 1 kg of human weight, then the indicated dose is divided into 2-3 injections. At the same time, in order to exclude the occurrence of complications, injections are made in different parts of the body.

Consider how to avoid the side effects of insulin therapy.

Any insulin agent, regardless of the duration of its exposure, can cause side effects:

• Hypoglycemia - the level of glucose in the blood falls below 3.0 mmol / l.
• General and local allergic reactions - urticaria, itching and induration at the injection site.
• Violation of fat metabolism - characterized by the accumulation of fat not only under the skin, but also in the blood.

Long-acting insulin is more likely to prevent complications in type 1 and type 2 diabetes. In addition, long insulin makes the treatment of diabetes more convenient. To exclude the manifestation of these side effects, a diabetic must follow the diet prescribed by the doctor every day and constantly change injection sites.

Prolonged means of a new generation

Recently, two new, FDA-approved, long-acting drugs have appeared on the pharmaceutical market for the treatment of adult patients with diabetes mellitus:

• Degludek (so-called Tresiba).
• Ryzodeg FlexTach (Ryzodeg).

Tresiba is a new FDA-approved drug

Long-acting insulin Degludec is intended for subcutaneous administration. The duration of regulation of blood glucose levels with its help is about 40 hours. It is used to treat diabetics with the first and second forms of the complexity of the disease. To prove the safety and efficacy of the new extended-release drug, a number of studies were conducted in which more than 2000 adult patients took part. Degludec has been used as an adjunct to oral treatment.

To date, the use of the drug Degludec is allowed in the EU, Canada and the United States. In the domestic market, a new development appeared under the name Tresiba. The composition is implemented in two concentrations: 100 and 200 U / ml, in the form of a syringe pen. Now you can normalize blood sugar levels with the help of a long-acting super remedy by using an insulin solution only three times a week.

Let us describe the drug Ryzodeg. Ryzodeg, a long-acting agent, is a combination of hormonal substances whose names are well known to diabetics - this is Degludec basal insulin and fast-acting Aspart (70:30 ratio). Two insulin-like substances specifically interact with endogenous insulin receptors, due to which they realize their own pharmacological effect, similar to the effect of human insulin.

The safety and efficacy of the newly developed long-acting drug was proven in a clinical trial involving 360 adult diabetics.

Ryzodeg was taken in combination with another hypoglycemic drug at mealtimes. As a result, a reduction in blood sugar was achieved to a level that had previously been achieved only with the use of established long-acting insulin preparations.

The long-acting hormonal drugs Tresiba and Rayzodeg are contraindicated in people with an acute complication of diabetes. In addition, these drugs, as the analogues discussed above, should be prescribed only by the attending physician, otherwise side effects in the form of hypoglycemia and various kinds of allergies cannot be avoided.

Insulins in pharmacological science are called special steroid drugs that make it possible to regulate the number of glucose molecules in the patient's blood. In the modern world, a large number of various insulin preparations are manufactured in the field of pharmacological production. The most common are short and long insulin. Their main differences include: the specific characteristics of the raw materials from which this agent is produced, the methods of production of the substance and the duration of action. Short insulin is the most popular today.

The duration of its effect is up to 8 hours. Such a tool has its purpose - the rapid relief of peaks in food intake, as well as the combined therapy of primary diabetes mellitus.

Long insulin is used to mimic the normal production of this hormone by the human body over a 24 hour period. Depending on the varieties of the drug, it has a period of action from 12 to 30 hours. As varieties of a long hormone, drugs of medium duration and long-term are isolated. Long lowers the concentration of glucose molecules in the blood, improves the ability of the muscles and liver to absorb them, accelerates the process of synthesizing protein structures, and reduces the time required for the production of sugar molecules by liver cells.

People who first encountered primary diabetes mellitus are naturally interested in such questions: how to choose the right insulin and which insulin is better for administration? These moments are very serious, since the further life and health of the patient depends on the correct selection of the hormone and the calculation of its dose.

Clinical picture

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Choosing the best insulin preparation

For any insulin-dependent diabetic, it is vital to use the right dose of insulin preparation.

It should be noted that it is possible to qualitatively choose the correct dosage of the hormone, suitable for a particular patient, only in a hospital setting.

There are several basic rules used by physicians to select the required dosage of the drug.

• It is necessary to check the number of sugar molecules in the blood several times a day. Indicators are considered normal: on an empty stomach - 5-6 mmol / l and after a couple of hours after eating - 8 mmol / l. The maximum deviation from the last indicator is an excess of 3 mmol / l.
• It is necessary to select this hormone taking into account the time of day, the amount of carbohydrate compounds consumed, the patient's level of mobility before and after eating.
• Additionally, attention should be paid to the weight of the patient, the presence of other diseases of an acute or chronic course, the time and form of using other medicines. These indicators are of particular importance at the time of prescribing a permanent course of long-acting insulin injections. The reason for this is the lack of dependence of injections on the time of food intake, since when it is used, a constant supply of this hormone is created in the patient's blood serum.
• A very important point in choosing a good dosage of medicine is to keep a special diary. In such a diary, indicators of the content of glucose molecules in the patient's blood, the approximate number of units of carbohydrates consumed during meals and the dose of a short insulin preparation are entered. The analysis is usually done on an empty stomach. Often, the amount of the injected agent and the consumed units of carbohydrates is 2 to 1. If the number of glucose molecules in the blood exceeds the allowable limit, an additional administration of a short preparation should be made.
• Begin the process of selecting an insulin dose with nightly injections. With the introduction of the hormone in the amount of 10 units, immediately before going to bed, provided that this dose is suitable, the blood glucose in the morning will not exceed 7 mmol / l. When, after the injection of the first dose, the patient has excessive sweating, increased appetite, it is necessary to reduce the nightly dose by a couple of units. The balance between doses of insulin administered during the day and at night should be 2:1.

In the case when the dosage of the drug meets the needs of the body, the content of glucose molecules in the blood serum should not change up or down. The molecular amount of glucose should be unchanged throughout the day.

What is the best insulin to use?

be careful

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The most common complications are: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can also lead to the development of cancerous tumors. In almost all cases, a diabetic either dies while struggling with a painful disease, or turns into a real invalid.

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To determine the best insulin for a particular patient, it is necessary to choose a basal preparation. In order to model basal production, long insulin preparations are often used. Now the pharmacological industry produces two types of insulin:

• medium duration, working up to 17 hours. These drugs include Biosulin, Insuman, Gensulin, Protafan, Humulin.
• ultra-long duration, their action is up to 30 hours. These are: Levemir, Tresiba, Lantus.

Insulin drugs Lantus and Levemir have fundamental differences from other insulins. The differences are that the drugs are completely transparent and are characterized by a different duration of action on the body of a diabetic patient. The first type of insulin has a white tint and some turbidity, so the medicine must be shaken before use.

When using hormones of medium duration, peak moments in their concentration can be observed. Medicines of the second type do not have this feature.

The dosage of the long-acting insulin preparation should be chosen so that the drug can keep the glucose concentration in the intervals between meals within acceptable limits.

Due to the need for slower absorption, long insulin is injected under the skin of the thigh or buttocks. Short - in the abdomen or arm.

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Everything changed when my daughter gave me one article to read on the Internet. You have no idea how grateful I am to her. This article helped me completely get rid of diabetes, a supposedly incurable disease. For the last 2 years, I started to move more, in spring and summer I go to the country every day, my husband and I lead an active lifestyle, we travel a lot. Everyone is surprised how I manage to do everything, where so much strength and energy come from, everyone will not believe that I am 66 years old.

Who wants to live a long, energetic life and forget about this terrible disease forever, take 5 minutes and read this article.

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The first injections of long insulin are carried out at night with sugar measurements every 3 hours. In the case of a significant change in glucose levels, the dosage is adjusted. To identify the cause of the nighttime increase in glucose, it is necessary to study the time interval between 00.00 and 03.00. With a decrease in performance, the dose of insulin at night must be reduced.

The most accurate way to determine the required amount of basal insulin is possible in the complete absence of glucose and short insulin in the blood. Therefore, when evaluating nightly insulin, it is necessary to refuse dinner.

To get a more informative picture, you should not use short insulin, you should not eat protein or fatty foods at the same time.

To determine the basal hormone during the day, you need to remove one meal or starve all day. Measurements are taken every hour.

Do not forget that all types of insulin, in addition to Lantus and Levemir, have peak secretion. The peak moment of these medicines occurs after 6-8 hours from the time of administration. During these hours, a decrease in sugar may occur, which is corrected by eating bread units.

Such dosage checks must be made every time they are changed. To understand how sugar behaves in dynamics, just a three-day test is enough. And only on the basis of the results obtained, the doctor is able to prescribe a clear dosage of a particular drug.

In order to evaluate the base hormone in the daytime and identify the best preparation, it is necessary to wait five hours from the moment of ingestion of the previous meal. Diabetics using short insulin are required to withstand a period of time from 6 hours. The group of short insulins is represented by Gensulin, Humulin, Actrapid. Ultrashort insulins include: Novorapid, Apidra, Humalog. The ultrashort hormone acts in the same way as the short one, but most of the shortcomings have been removed. At the same time, this remedy is not able to satisfy the body's need for insulin.

It is not possible to give an unambiguous answer to the question of which insulin is the best. But on the recommendation of a doctor, you can choose the right dosage of basal agent and short insulins.

Drawing conclusions

If you are reading these lines, we can conclude that you or your loved ones have diabetes.

We conducted an investigation, studied a bunch of materials and, most importantly, tested most of the methods and drugs for diabetes. The verdict is:

All drugs, if they gave, then only a temporary result, as soon as the reception was stopped, the disease increased sharply.

The only drug that has given a significant result is Difort.

At the moment, this is the only drug that can completely cure diabetes. Difort showed a particularly strong effect in the early stages of the development of diabetes.

We made a request to the Ministry of Health:

And for readers of our site now there is an opportunity
receive DEFORTH. IS FREE!

Attention! Cases of the sale of counterfeit Difort have become more frequent.
By placing an order using the links above, you are guaranteed to receive a quality product from the official manufacturer. In addition, ordering official website, you get a money back guarantee (including shipping costs) if the drug does not have a therapeutic effect.