The article will compare ultrashort insulin.
For almost a century, the release of hormones for patients with diabetes has been the most important industry in the pharmaceutical industry. A quarter century has more than fifty numerous types of hypoglycemic drugs. Why should a diabetic administer ultra-short-acting insulin injections several times a day? How do medicines differ from each other, how is the required dose calculated?
Insulin and their duration
Currently, a whole list of insulin is known. Important indicators of the synthesized product for diabetics are its category, type, manufacturing company and method of packaging.
The duration of action of ultrashort insulin on the human body is determined by several parameters: when the deployment of insulin begins after the injection; its maximum concentration; the total period of the funds from start to finish.
What does all of this mean? Let's figure it out.
Ultrashort insulin is one of the categories of the drug in addition to long-term, mixed and intermediate. If you study the influence curve of ultrafast hormone on the graph, you can see that it rises sharply and contracts strongly along the time axis.
In practice, the period of action of short and ultrashort insulin depends on various factors, not only on the area of administration:
- the area of penetration of the hypoglycemic drug (into the blood capillary, under the skin, into the muscle);
- skin massage in the injection zone (tingling and stroking increase the rate of absorption);
- ambient and body temperatures (lower makes processes slower, and higher, 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 drug.
Having determined the exact dose needed to compensate for carbohydrates taken in food, the patient may not take into account exposure to the sun or a warm shower, feel the symptoms of a drop in sugar concentration. Hypoglycemia has symptoms such as confused consciousness, dizziness, and a feeling of great 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, which can cause a coma, the diabetic should always have foods with fast carbohydrates, which contain sugar, bakery sweet products based on the highest grade of flour.
The effectiveness of the injection with the hormone of the pancreas is determined by the place of its implementation. From the abdomen, up to 90% is absorbed. So, for example, with a foot or arm - 20% less.
Below are the most popular ultra-short acting insulin names.
Dosage and timing
General-spectrum insulins produced by different companies can be used interchangeably. Ultrashort Humalog insulin is produced in India and the USA. Novorapid is produced by the joint Danish-Indian company Novo Nordiks. Both drugs are human types of insulin. The first has two packaging options: in a penny sleeve and in a bottle. The hormone Apidra is produced in Germany by Sanofi-Aventis, and is located in syringe pens. All devices in the form of special designs that look like an ink pen, have undoubted advantages over traditional syringes and bottles:
- they are necessary for people with low vision, since the dosage is determined by the audible clicks;
- through them, the drug can be administered through clothing, in any public place;
- the needle is thinner compared to the insulin.
Imported drugs entering Russia are labeled in Russian. Shelf life (up to two years - normal) and manufacturing dates are stamped on the bottle and packaging. Prospects from manufacturing firms speak of temporary properties. Instructions are in packages, theoretical values are indicated, and it is on them that diabetics should be guided.
When do they start to act?
Ultrashort insulins begin to act instantly, within a few minutes after an injection under the skin. In the “short” beginning - from 15 to 30 minutes. The duration of action is slightly increased. The patient will feel the maximum effect of the introduction of "ultrafast" drugs in an hour.
The climax lasts a couple of hours. It accounts for the period of intensive digestion of food in the stomach, glucose entering the bloodstream as a result of the breakdown of complex carbohydrates. The increase in the degree of glycemia is compensated by fully injected insulin, if the dose was set correctly.
The regularity is established, which consists in the following: an increase in dosage also affects the duration of the effect of a hypoglycemic agent, in the range of the framework indicated in the instructions. In reality, fast hormones last up to four hours if the dosage is less than twelve units.
With a larger dose, the duration increases by another two hours. More than twenty ultra-short-acting insulin units are not recommended for administration at a time. There is a significant risk of hypoglycemia. Excess insulin will not be absorbed by the body, it will be useless and may even harm.
"Intermediate" and "long" types of funds are unclear, since a prolongator has been added to them. The appearance of ultrashort insulin is different. It is transparent and clean, without spots, blotches and turbidity. This external property separates prolonged insulin and ultrashort.
Another significant difference between the types of insulin is the performance of the “short” intramuscularly, intravenously and subcutaneously, and the “long” - exclusively subcutaneous.
Prohibited Actions
Diabetics should not:
- use a very expired product (more than 2-3 months);
- buy the drug in unverified places;
- freeze.
You need to be careful about an unknown, new manufacturing company. It is desirable to store the drug in the refrigerator at a temperature of +2 to +8. Insulin for use at this time should be kept at room temperature, suitable for storage, and not in the refrigerator.
Drug Comparison
Specialists most often prescribe drugs "Actrapid", "Humulin", "Homoral", "Rapid", "Insuman".
They are in their action absolutely analogous to the natural hormone. They have only one difference - they can be used both in the first and in the second type of diabetes. In addition, they can be used by patients with ketoocytosis and after surgery, during pregnancy.
The most popular among ultrashort insulins is Humalog, which in rare cases causes side symptoms, has established itself as a very effective drug.
Apidra and ultra-short insulin Novorapid are prescribed a little less frequently. They are insulin glulisin or a solution of liproinsulin. In their action, they are all similar to organic. Immediately after administration, the blood glucose level decreases, the patient feels better.
Special Use Cases
Some people with a specific daily rhythm with dawn produce a lot of hormones: cortisol, glucagon, adrenaline. They are antagonists of the substance insulin. Hormonal secretion due to individual characteristics can pass quickly and rapidly. In diabetics, hyperglycemia is determined in the morning. Such a syndrome is common. It is almost impossible to eliminate. The only way out is an injection of ultra-short insulin up to six units, made early in the morning.
Most often, ultrafast remedies are made for meals. Due to its high efficiency, an injection can be given both during meals and immediately after. The short duration of the effect of insulin forces the patient to make many injections during the day, to imitate the natural production of the pancreas on the intake of carbohydrate products in the body. By the number of meals, up to 5-6 times.
In order to quickly eliminate significant metabolic disturbances in coma or precomatose states, with infections and injuries ultrashort drugs are used without connection with prolonged ones. Using a glucometer, that is, a device for determining sugar levels, they monitor glycemia and restore the decompensation of the disease.
The names of ultrashort insulin are not known to everyone. They are considered in the article.
Features of the calculation of the dosage of ultrafast insulin
Determining the dose depends on the function of the pancreas to produce its own insulin. Its capabilities are easy to verify. It is believed that an endocrine organ in a healthy state produces such an amount of the hormone per day, so that 0.5 units per kilogram of weight are necessary. That is, if necessary, for a diabetic with a mass of 70 kg to compensate for 35 units or more, we can talk about a complete stop of the activity of pancreatic cells.
In this case, ultrashort insulin is necessary, in combination with prolonged, in the following ratios: 40 to 60 or 50 to 50.
An acceptable option is determined by the endocrinologist. If the pancreas partially lost the ability to cope with such a function, a correct calculation is required.
The body's need for “ultrafast” throughout the day also changes. For breakfast in the morning it needs twice as much as the used bread units, in the afternoon - one and a half, in the evening - the same. It is necessary to take into account sports activities and physical work performed by the patient. If the load is small, the dosage of insulin 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.
Bodybuilding Application
In the field of bodybuilding, they actively use such a property as a significant anabolic effect, which is as follows: cells absorb amino acids more actively; protein biosynthesis increases dramatically.
Ultra-short-acting insulin is also used in bodybuilding. The substance begins to act 5-10 minutes after administration. That is, an 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 considered "Actrapid NM" and "Humulin regular."
Ultrashort insulin in bodybuilding does not interfere with 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. Its basis is malfunctions of the 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 place of the injection, you can use the scheme where the abdomen (arms, legs) is divided into sectors by the days of the week. After a few days, the skin cover of the cleaved area is restored quite safely.
Why is ultrashort insulin good or bad for diabetes?
Advantages and disadvantages
When compared with short human types of insulin, one can note its advantages and disadvantages in its ultra-short latest analogues. They have an earlier climax of action, but then their blood content decreases more than if you make a simple injection of short insulin. Since ultrashort insulin has a sharper climax, it is difficult to know how much carbohydrate with food you need to eat to normalize blood sugar. The smooth effect of short insulin is more consistent with the body’s absorption of food than with a low-carbohydrate diet to control diabetes.
But there is another side. Short insulin injection 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. The ultra-short latest types of insulin act much faster, already 10-15 minutes after the injection, and this is very convenient, since a person does not know in advance exactly what time he needs to eat. For example, at a meal in a restaurant. Subject to a low-carbohydrate diet, it is recommended in normal cases to use short human insulin before meals. Also, ultra-short insulin should be kept in stock if such a need arises. Practice shows that ultrashort insulin has a less stable effect on blood sugar than short. Their effect is less predictable, even if the injections are made in small doses, as in patients with diabetes on a low-carbohydrate diet, and especially at standard high doses. In addition, it must be remembered that ultrashort types of insulin are much more powerful than short ones. One unit of Humalog will reduce sugar by approximately 2.5 times more active compared with one unit of short insulin. 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 information that is being verified experimentally.
Now we know which insulins are ultrashort.
The main task is to minimize or completely prevent the jump in sugar after eating. To do this, an injection is done before meals with a margin of time sufficient to start the action of insulin. On the one hand, people want to lower blood sugar just at the moment when the digested products begin to increase it. However, with too early an injection, sugar will fall faster than it is raised by food. Practice shows that it is advisable to inject short insulin approximately 40-45 minutes before a low-carbohydrate meal. The only exception is patients with the development of diabetic gastroparesis - reduced gastric emptying after eating. Diabetics are rarely found in which, for some reason, short insulin is especially slowly absorbed into the blood. They are forced to stab him an hour and a half before eating. It is very uncomfortable. In this case, you need to use the latest ultrashort drugs, among which the fastest is Humalog.
The price of ultrashort insulin
The cost of such insulin is from 1700 rubles. for packing. It is quite expensive. The price depends on the region and the pharmacy chain.