Currently, the level of development of medicine allows even in the presence of serious health problems to maintain a normal rhythm of life. Modern medicines come to the rescue. Impaired glucose metabolism is now a frequent diagnosis, but with diabetes you can live and work normally. People suffering from type 1 and type 2 disease cannot do without an insulin analogue. When physical activity and proper nutrition do not allow normalizing blood sugar levels, the Detemir insulin comes to the rescue. But before using this drug, a diabetes patient needs to understand important questions: how to properly administer the hormone when it is absolutely impossible to use it and what undesirable manifestations can it cause?
Insulin "Detemir": a description of the drug
The medicine is available in the form of a colorless transparent solution. In 1 ml of it contains the main component - insulin detemir 100 PIECES. In addition, there are additional components: glycerol, phenol, metacresol, zinc acetate, sodium hydrogen phosphate dihydrate, sodium chloride, hydrochloric acid qs or sodium hydroxide qs, water for injection up to 1 ml.
The drug is available in a syringe pen, which contains 3 ml of solution, an equivalence of 300 PIECES. 1 unit of insulin contains 0.142 mg of salt-free insulin detemir.
How does Detemir work?
Insulin Detemir (brand name) "Levemir") is produced using recombinant deoxyribonucleic acid (DNA) biotechnology using a strain called Saccharomyces cerevisiae. Insulin is the main component of the drug "Levemir flekspen" and it is an analogue of the human hormone that binds to peripheral cell receptors and activates all biological processes. It has several effects on the body:
- stimulates the use of glucose by peripheral tissues and cells;
- controls glucose metabolism;
- inhibits gluconeogenesis;
- increases protein synthesis;
- prevents lipolysis and proteolysis in fat cells.
It is thanks to the control of all these processes that the blood sugar level decreases. After administration of the drug, its main effect begins after 6-8 hours.
If you enter it twice a day, then a complete equilibrium of the sugar level can be achieved after two to three injections. The drug has the same effect on both women and men. Its average distribution volume is within 0.1 l / kg.
The half-life of insulin, which was injected under the skin, depends on the dose and is approximately 5-7 hours.
Features of the action of the drug "Detemir"
Detemir insulin (Levemir) has a much wider effect than insulin products such as Glargin and Isofan. Its long-term effect on the body is due to the vivid self-association of molecular structures when they dock with the side fatty acid chain with albumin molecules. Compared with other insulins, it disperses slowly throughout the body, but due to this, its absorption is significantly enhanced. Also, in comparison with other analogs, Detemir insulin is more predictable, and therefore it is much easier to control its effect. And this is due to several factors:
- the substance remains in a liquid state from the moment it is in the pen-syringe and before it is introduced into the body;
- its particles bind to albumin molecules in blood serum by a buffer method.
The drug affects the cell growth rate less, which can not be said about other insulins. It does not have genotoxic and toxic effects on the body.
How to use "Detemir"?
The dose of the drug is selected individually for each patient with diabetes. You can enter it once or twice a day, this is indicated by the instruction. Testimonials about the use of Detemir insulin insist that in order to optimize glycemic control, injections should be given twice a day: in the morning and in the evening, at least 12 hours should elapse between use.
For elderly people with diabetes and those suffering from liver and kidney dysfunction, the dose is selected with extreme caution.
Insulin is injected subcutaneously into the shoulder, thigh and umbilical region. The intensity of action depends on where the drug is administered. If the injection is made in one area, then the puncture site can be changed, for example, if insulin is injected into the skin of the abdomen, then this should be done 5 cm from the navel and in a circle.
It is important to get an injection right. To do this, you need to take a syringe pen with a room temperature drug, an antiseptic and cotton wool.
And carry out the procedure as follows:
- treat the puncture site with an antiseptic and allow the skin to dry;
- the skin is caught in a crease;
- the needle must be inserted at an angle, after which the piston is pulled back a little, if blood appears, the vessel is damaged, the injection site must be changed;
- the medicine should be administered slowly and evenly, in case the piston moves with difficulty, and at the puncture site the skin is inflated, the needle should be inserted deeper;
- after drug administration, it is necessary to linger for another 5 seconds, after which the syringe is removed with a sharp movement, and the injection site is treated with an antiseptic.
To make the injection painless, the needle should be as thin as possible, the skin fold should not be squeezed strongly, and the injection should be done with a confident hand without fear and doubt.
If the patient injects several types of insulin, then first he gets short, and then long.
What to look for before entering Detemir?
Before making an injection, you need to:
- carefully recheck the type of funds;
- disinfect the membrane with an antiseptic;
- carefully check the integrity of the cartridge, if suddenly it is damaged or there are doubts about its suitability, then you do not need to use it, you should return it to the pharmacy.
It is worth remembering that it is strictly forbidden to use frozen Detemir insulin or one that was stored incorrectly. In insulin pumps, the drug is not used, with the introduction it is important to observe several rules:
- enter only under the skin;
- the needle changes after each injection;
- the cartridge does not refill.
In what cases is the drug contraindicated?
Before using Detemir, it is very important to find out when it is strictly contraindicated:
- if the patient has an individual sensitivity to the components of the drug, an allergy can develop due to it, some reactions can even lead to death;
- for children under the age of 6, this drug is not recommended for use, it was not possible to check its effect on the kids, so it is impossible to predict how it will affect them.
In addition, there are also such categories of patients who are allowed to use the drug in treatment, but with special care and under constant supervision. This is indicated by the instructions for use. Detemir insulin in these patients with such pathologies requires dosage adjustment:
- Disorders in the liver. If those were described in the patient’s history, then the action of the main component may be distorted, so the dose must be adjusted.
- Failures in the kidneys. With such pathologies, the principle of action of the drug can be changed, but the problem can be solved if you constantly monitor the patient.
- Elderly people. After the age of 65, a lot of various changes take place in the body, which can be very difficult to track. In old age, organs do not function as actively as in young ones, therefore, it is important for them to choose the right dosage so that it helps to normalize glucose levels, and not harm.
If you take into account all these recommendations, then the risk of negative consequences can be reduced.
"Detemir" during pregnancy and during breastfeeding
Thanks to studies on whether the use of Insulin Detemir will harm the pregnant woman and her fetus, it was proved that the drug does not affect the development of the baby. But to say that it is completely safe, it is impossible, because during pregnancy hormonal changes occur in the woman’s body, and it is impossible to predict how the drug will behave in a particular case. That is why doctors, before prescribing it during pregnancy, assess the risks.
During treatment, you need to constantly monitor the level of glucose. Indicators can change dramatically, therefore, timely monitoring and dose adjustment is necessary.
It is impossible to say exactly whether the drug penetrates into breast milk, but even if it gets, it is believed that it will not bring harm.
Special instructions for use
Instructions for insulin "Detemir" warns that the use of the drug requires special precautions. In order for the therapy to give the desired result and be safe, you must follow these rules:
- Do not use the drug in the treatment of children under the age of 6 years;
- do not skip meals, there is a risk of hypoglycemia;
- Do not abuse physical activity;
- be sure to consider that due to the development of infection, the body will need more insulin;
- do not administer the drug intravenously;
- remember that the rate of reaction and impaired attention can change if hyper- and hypoglycemia occurs.
In order for the treatment to proceed correctly, every diabetic using insulin must know the rules. The attending physician must conduct a conversation, explaining not only how to inject and measure blood sugar, but also talking about changes in lifestyle and diet.
Interaction with other drugs
The effect of "Detemir" may be distorted due to sharing with other drugs. Most often, doctors try to avoid such combinations of drugs, but sometimes you just can not do without them when the patient has other chronic pathologies. In such cases, the risk can be reduced by changing the dosage. It is necessary to increase the dose if such drugs are prescribed to a diabetic:
- sympathomimetics;
- glucocorticosteroids;
- diuretics;
- contraceptives
- antidepressants.
They reduce the effect of insulin.
But it is necessary to reduce the dosage if such drugs are recommended:
- tetracyclines;
- carbonic anhydrase, ACE, MAO inhibitors;
- hypoglycemic drugs ;
- anabolics;
- beta-blockers;
- alcohol-containing tinctures.
If the dose is not adjusted, then taking these drugs can provoke hypoglycemia.
Analogues of the drug
Some patients have to look for Detemir insulin analogues with a composition of other components. For example, diabetics who have a particular sensitivity to the components of this drug. There are many analogues of Detemir, including Insuran, Rinsulin, Protafan and others.
But it is worth remembering that the analogue itself and its dosage should be selected by the doctor in each individual case. This applies to any medication, especially with such serious pathologies.
Drug cost
The price of insulin Detemir Danish production ranges from 1300-3000 rubles. But it is worth remembering that you can get it for free, but in this case, you must have a prescription in Latin written by the endocrinologist. Detemir insulin is an effective drug for the treatment of type 1 and type 2 diabetes, the main thing is to follow all the recommendations, and it will only benefit the diabetic.
Insulin Reviews
Diabetics and doctors respond positively to Detemir. It helps to reduce high blood sugar, has a minimum of contraindications and undesirable manifestations. The only thing to consider is the correctness of its administration and compliance with all recommendations if, apart from insulin, other drugs are recommended to the patient.
Diabetes mellitus is currently not a sentence, although the disease was considered almost fatal until synthetic insulin was obtained. By following the doctor’s recommendations and regularly monitoring the level of glucose in the blood, you can maintain a normal lifestyle.