In the article we will compare ultrashort insulins.
For almost a century, the production of hormonal drugs for patients with diabetes has been the most important industry in the pharmaceutical industry. A quarter of a century there are more than fifty numerous types of hypoglycemic drugs. Why does a diabetic need to inject ultrashort insulin into the body several times a day? How do drugs differ from each other, how is the required dose calculated?
Insulins and their period of action
A whole list of insulins is currently known. Important indicators of the synthesized drug for diabetics are its category, type, manufacturing company and packaging method.
The time of action of ultrashort insulin on the human body is determined by several parameters: when insulin begins to deploy after the injection; maximumits concentration; the total duration of the funds from start to finish.
What does it all mean? Let's figure it out.
Ultra-short insulin is one of the categories of the remedy in addition to long-term, mixed and intermediate. If you study the curve of the effect of the ultra-fast hormone on the graph, you can see that it rises sharply and contracts strongly along the time axis.
In practice, the duration of action of short and ultrashort insulin depends on various factors, not only on the site of injection:
- areas of penetration of a hypoglycemic drug (into a blood capillary, under the skin, into a muscle);
- Massage the skin in the injection area (pinching and stroking increase the rate of absorption);
- ambient and body temperature (reduced makes processes slower, and increased, on the contrary, speeds up);
- localization, there may be a point supply of the drug in the tissues under the skin;
- individual body reaction to the remedy.
Determining the exact dose needed to compensate for the carbohydrates taken in food, the patient may not take into account sun exposure or warm showers, feel symptoms of a drop in sugar concentration. Hypoglycemia has symptoms such as confusion, dizziness, and a feeling of extreme weakness throughout the body.
A few days after the injection of ultrashort insulin, its supply under the skin appears. In order to avoid an attack of sudden hypoglycemia that can cause a coma, a diabetic should always have foods with fast carbohydrates that contain sugar, bakery sweets “at hand”.products based on the highest grade of flour.
The effectiveness of an injection with pancreatic hormone is determined by the place of its execution. Up to 90% is absorbed from the abdomen. So, for example, from a leg or arm - 20% less.
The most popular names of ultra-short acting insulin will be listed below.
Dosage and timing
General spectrum insulins from different companies can be interchanged. Humalog ultrashort insulin is produced in India and the USA. Novorapid is produced by the joint Danish-Indian company Novo Nordix. Both drugs are human types of insulin. The first one has two packaging options: in a penfil case and in a vial. The Apidra hormone is produced in Germany by Sanofi-Aventis and is available in syringe pens. All devices in the form of special designs that look like an ink fountain pen have undeniable advantages over traditional syringes and vials:
- they are needed for people with low vision, since the dosage is determined by audible clicks;
- through them the drug can be administered through clothes, in any public place;
- needle is thinner compared to insulin.
Imported medicines entering Russia are labeled in Russian. Expiration dates (up to two years - normal) and production dates are marked on the bottle and packaging. Prospects from manufacturing companies speak of temporary properties. Instructions are in the packagestheoretical values are indicated, and it is on them that a diabetic should be guided.
When does it start?
Ultra-short insulins begin to act instantly, within minutes of being injected under the skin. The “short” ones start from 15 to 30 minutes. The duration of action is slightly increased. The patient will feel the maximum effect of the introduction of "superfast" drugs in an hour.
The duration of the climax lasts a couple of hours. It falls on the period of intensive digestion of food in the stomach, the entry of glucose into the blood as a result of the breakdown of complex carbohydrates. The rise in glycemia is compensated by fully delivered insulin if the dose has been set correctly.
A regularity has been established, which is as follows: an increase in dosage also affects the period of influence of a hypoglycemic agent, within the range specified in the instructions. In reality, fast hormones last up to four hours if the dosage is less than twelve units.
At a higher dose, the duration increases by another two hours. More than twenty units of ultrashort-acting insulin are not recommended to be administered at a time. There is a significant risk of hypoglycemia. Excess insulin will not be absorbed by the body, it will be useless and even harmful.
"Intermediate" and "long" types of funds are unclear, as they have added a prolongator. The type of ultrashort insulin differs. It is transparent and clean, without stains, inclusions and turbidity. Suchexternal property separates extended insulin and ultrashort.
Another significant difference between the types of insulin is the execution of the "short" intramuscularly, intravenously and subcutaneously, and the "long" - exclusively subcutaneously.
Prohibited activities
Diabetics should not:
- use a heavily expired product (more than 2-3 months);
- buy the drug in unverified places;
- freeze.
You need to be careful with an unknown, new manufacturer. It is advisable to store the drug in a refrigerator at a temperature of +2 to +8. Insulin for current use should be kept at room temperature suitable for preservation, not in the refrigerator.
Drug Comparison
Specialists most often prescribe the drugs Actrapid, Humulin, Homoral, Rapid, Insuman.
They are absolutely similar in their action to a natural hormone. They have only one difference - they can be used for both the first and second type of diabetes. In addition, they can be used by patients with ketoacytosis and after surgery, during pregnancy.
The most popular among the ultra-short insulins is Humalog, which rarely causes side effects, has proven to be a very effective drug.
Apidra and ultrashort insulin Novorapid are prescribed a little less often. They are insulin glulisine or lieproinsulin solution. In their action, they are all similar to organic. Immediately after administration, the blood glucose level decreases and the patient feels better.
Special Applications
Some people with a specific circadian rhythm produce a lot of hormones at dawn: cortisol, glucagon, adrenaline. They are antagonists of the insulin substance. Hormonal secretion due to individual characteristics can take place quickly and violently. A diabetic has hyperglycemia in the morning. This syndrome occurs frequently. It is almost impossible to eliminate it. The only way out of the situation is an injection of ultra-short insulin up to six units, made early in the morning.
Most often, ultra-fast remedies are made before meals. Due to the high efficiency, you can inject both during meals and immediately after. The short duration of the effect of insulin forces the patient to make many injections during the day, imitating the natural production of the pancreas for the intake of carbohydrate products. By the number of meals, up to 5-6 times.
To quickly eliminate significant metabolic disturbances in coma or pre-coma states, with infections and injuries, ultrashort preparations are used without combining with prolonged ones. By means of a glucometer, that is, a device for determining the level of sugar, they monitor glycemia and restore the decompensation of the disease.
Not everyone knows the names of ultrashort insulins. They are discussed in the article.
Features of calculating the dosage of ultra-rapid insulin
Determination of the dose depends on the function of the pancreas to produce its own insulin. Its capabilities are easy to test. It is believed that the endocrine organ in a he althy state produces such an amount of hormone per day that it takes 0.5 units per kilogram of weight. That is, if necessary, for a diabetic weighing 70 kg to compensate for 35 units or more, we can talk about a complete stoppage of pancreatic cells.
Ultra-short insulin in this case is needed, in conjunction with prolonged insulin, in the following ratios: 40 to 60 or 50 to 50.
The acceptable option is determined by the endocrinologist. If the pancreas has partially lost the ability to cope with such a function, a correct calculation is required.
The body's need for "superfast" during the day also changes. For breakfast in the morning, you need twice as much as the consumed bread units, in the afternoon - one and a half, in the evening - the same amount. It is necessary to take into account sports activities and physical work performed by the patient. If the load is small, the insulin dosage is most often unchanged.
When bodybuilding, for example, it is advisable to eat up to four additional bread units against the background of normal glycemia.
Application in bodybuilding
In the field of bodybuilding, such a property as a significant anabolic effect is actively used, which is as follows: cells absorb amino acids more actively; protein biosynthesis increases dramatically.
In bodybuilding, ultrashort-acting insulinalso used. The substance begins to act 5-10 minutes after administration. That is, the injection must be carried out before meals, or immediately after it. The maximum concentration of insulin is observed 120 minutes after its administration. The best drugs are Actrapid NM and Humulin Regular.
Ultra-short insulin in bodybuilding does not affect the functioning of the liver and kidneys, as well as potency.
Prevention of lipodystrophy
A diabetic should also take care of the prevention of lipodystrophy. It is based on failures of immune processes, leading to the destruction of fiber under the skin. The appearance of atrophied areas due to frequent injections is not associated with a large dose of the drug or poor compensation for diabetes.
Insulin edema, on the contrary, is a rare complication of endocrine diseases. In order not to forget the injection site, you can use the scheme where the abdominal area (arms, legs) is divided into sectors according to the days of the week. After a few days, the skin cover of the punctured area is restored quite safely.
What is good or bad about ultrashort insulin for diabetes?
Pros and cons
When compared with short human types of insulin, its ultra-short newer counterparts can be noted disadvantages and advantages. They have an earlier climax of action, but then their blood levels decrease more than if you make a simple injection of short insulin. Since ultrashort insulin has a more abrupt climax, it is difficult to know how much carbohydrate to eat in order tonormalization of blood sugar. The smooth effect of short-acting insulin is more in line with the absorption of food by the body than following a low-carbohydrate diet to control diabetes.
But there is another side. Injection of short insulin is done 40-45 minutes before a meal. If you start eating faster, then this type of insulin will not have time to act, and blood sugar will rise sharply. Ultrashort newest types of insulin act much faster, within 10-15 minutes after the injection, and this is very convenient, because a person does not know in advance exactly what time he needs to eat. For example, when eating in a restaurant. When following a low-carbohydrate diet, it is usually recommended to use short human insulin before meals. You should also keep ultra-short insulin on hand if the need arises. Practice shows that ultrashort insulin has a less stable effect on blood sugar than short insulin. Their action is less predictable even when injected at low doses, as in diabetic patients on a low-carbohydrate diet, and especially at standard high doses. In addition, you need to remember that ultra-short types of insulin are much more powerful than short ones. One unit of Humalog will reduce sugar approximately 2.5 times more actively compared to one unit of insulin short. Apidra and Novorapid are 1.5 times stronger than short insulin. Thus, the amount of "Humalog" should be equal to a quarter of the dosage of short insulin, "Apidra" or "NovoRapida" - two thirds. This is indicative informationrefined experimentally.
Now we know which insulins are ultrashort.
The main goal is to minimize or completely prevent a jump in sugar after a meal. To do this, the injection is given before meals with a margin of time sufficient for the onset of insulin action. On the one hand, people want to lower blood sugar just at the moment when digested foods begin to raise it. However, if the injection is too early, the sugar will fall faster than it is raised by food. Practice shows that it is desirable to inject short insulin about 40-45 minutes before a low-carbohydrate meal. The only exception is patients with the development of diabetic gastroparesis - reduced gastric emptying after eating. Rarely do diabetics come across in whom, for some reason, short-acting insulin is especially slowly absorbed into the bloodstream. They are forced to inject it an hour and a half before meals. It is very uncomfortable. In this case, you need to use the latest ultra-short preparations, among which the fastest is Humalog.
Ultra-short insulin price
The cost of such insulin is from 1700 rubles. for packing. It's quite expensive. The price depends on the region and the pharmacy chain.
