Insulin syringes of various types, photos and videos. Use during pregnancy and breastfeeding. Choosing an insulin needle

Today, the cheapest and most common option for administering insulin into the body is the use of disposable syringes.

Due to the fact that less concentrated solutions of the hormone were previously produced, 1 ml contained 40 units of insulin, so in the pharmacy you could find syringes designed for a concentration of 40 units/ml.

Today, 1 ml of solution contains 100 units of insulin; appropriate insulin syringes of 100 units/ml are used for its administration.

Since both types of syringes are currently available for sale, it is important for diabetics to carefully understand the dosage and be able to correctly calculate the administered rate.

Otherwise, if they are used incorrectly, severe hypoglycemia may occur.

Markup features

So that diabetics can easily navigate, a graduation is applied to the insulin syringe, which corresponds to the concentration of the hormone in the bottle. Moreover, each marking division on the cylinder indicates the number of units, not milliliters of solution.

In this case, one insulin unit is 0.025 ml of the hormone. Thus, the U100 syringe has a reading of 100 units instead of 1 ml, and 50 units at the level of 0.5 ml.

For diabetes mellitus, it is important to use an insulin syringe only at the required concentration. To use insulin 40 units/ml you should buy a U40 syringe, and for 100 units/ml you need to use the corresponding U100 syringe.

What happens if you use the wrong insulin syringe? For example, if a solution with a concentration of 40 units/ml is drawn into a U100 syringe, instead of the expected 20 units, only 8 will be obtained, which is more than half the required dosage. Similarly, when using a U40 syringe and a solution of 100 units/ml, instead of the required dose of 20 units, 50 units will be drawn.

So that diabetics can accurately determine the required amount of insulin, the developers came up with an identification mark that can be used to distinguish one type of insulin syringe from another.

In particular, the U40 syringe, sold today in pharmacies, has a red protective cap, and the U 100 has an orange protective cap.

Insulin syringe pens, which are designed for a concentration of 100 units/ml, are similarly graduated. Therefore, in the event of a device failure, it is important to take this feature into account and purchase only U 100 syringes from the pharmacy.

Otherwise, if the wrong choice is made, a severe overdose is possible, which can lead to coma and even death of the patient.

Therefore, it is better to purchase a set of necessary tools in advance, which will always be kept at hand, and protect yourself from danger.

Needle length features

To avoid mistakes in dosage, it is also important to choose needles of the right length. As you know, they come in removable and non-removable types.

Today, insulin needles are available in lengths of 8 and 12.7 mm. They are not made shorter, since some insulin bottles still have thick stoppers.

Also, needles have a certain thickness, which is indicated by the symbol G with a number. The diameter of the needle determines how painful the insulin will be injected. When using thinner needles, the injection on the skin is practically not felt.

Determining the division price

Today you can buy an insulin syringe at the pharmacy, the volume of which is 0.3, 0.5 and 1 ml. The exact capacity can be found by looking at the back of the package.

Most often, diabetics use 1 ml syringes for insulin therapy, which can have three types of scales:

• Consisting of 40 units;
• Consisting of 100 units;
• Graduated in milliliters.

In some cases, syringes may be sold that are marked with two scales at once.

How is the division price determined?

The first step is to find out how much the total volume of the syringe is; these figures are usually indicated on the packaging.

In this case, only the intervals are counted. For example, for a U40 syringe the calculation is ¼=0.25 ml, and for U100 - 1/10=0.1 ml. If the syringe has millimeter graduations, no calculations are required, since the number placed indicates the volume.

After this, the volume of the small division is determined. For this purpose, you need to count the number of all small divisions between one large one. Next, the previously calculated volume of the large division is divided by the number of small ones.

After the calculations have been made, you can dial the required amount of insulin.

How to calculate dosage

The insulin hormone is available in standard packages and is dosed in biological units of action, which are designated as units. Typically, one 5 ml bottle contains 200 units of the hormone. If you make calculations, it turns out that 1 ml of solution contains 40 units of medicine.

Insulin administration is best done using a special insulin syringe, which indicates divisions in units. When using standard syringes, it is necessary to carefully calculate how many units of the hormone are included in each division.

To do this, you need to remember that 1 ml contains 40 units, based on this, you need to divide this indicator by the number of divisions.

So, with one division reading 2 units, the syringe is filled eight divisions to inject 16 units of insulin into the patient. Similarly, with an indicator of 4 units, four divisions are filled with the hormone.

One vial of insulin is intended for multiple use. The unused solution is stored in the refrigerator on a shelf, but it is important that the medicine does not freeze. When using long-acting insulin, before drawing it into the syringe, shake the bottle until a homogeneous mixture is obtained.

After removing from the refrigerator, the solution must be warmed to room temperature by keeping it indoors for half an hour.

diabeteshelp.org

Home page > Insulin > Marking of insulin syringes, calculation of insulin U-40 and U-100 Marking of insulin syringes, calculation of insulin U-40 and U-100

To calculate insulin and its dosage, it is worth considering that the bottles that are presented on the pharmaceutical markets of Russia and the CIS countries contain 40 units of insulin per 1 milliliter.
The bottle is labeled U-40 (40 units/ml). Regular insulin syringes used by diabetics are designed specifically for this insulin. Before use, it is necessary to make an appropriate calculation of insulin according to the principle: 0.5 ml of insulin - 20 units, 0.25 ml - 10 units, 1 unit in a syringe with 40 divisions - 0.025 ml. Each line on an insulin syringe marks a certain volume, the graduation into insulin units is a graduation by volume of solution, and is designed for U-40 insulin (Concentration 40 units/ml): 4 units of insulin - 0.1 ml of solution, 6 units of insulin - 0. 15 ml of solution, 40 units of insulin - 1 ml of solution.

In many countries around the world, insulin is used, which contains 100 units per 1 ml of solution (U-100). In this case, it is necessary to use special syringes.

chindolina.ru

I hope this information is useful and makes diabetic arithmetic easier for someone. Let's talk in this article about calculating the dose of insulin for diabetes.

Insulin dose calculation

Insulin is dosed in biological units of action (AU) and released in special vials. So, one 5 ml bottle contains 200 IU of insulin (there is a corresponding marking on the bottle), respectively, 1 ml contains 40 IU of the drug (200:5 = 40). It is better to inject a dose of insulin with a special syringe on which the units are indicated. When using regular insulin, before administering the drug, you need to find out how many units of insulin are in each division of the syringe. The calculation is made as follows: if 1 ml contains 40 units of insulin dose, this amount is divided by the number of divisions in 1 ml of the syringe and the amount of insulin dose in one division is obtained. For example, there are 20 divisions in 1 ml of a syringe, therefore there are 2 units in one division (40: 20 = 2). In the case when the patient needs to administer 16 units, eight divisions of the syringe are filled with the medicine. If there are 10 divisions in 1 ml of a syringe, then each division of the syringe corresponds to 4 units of insulin (40: 10 = 4). If it is necessary to administer 16 units of insulin, fill four divisions with the medicine.

Determination of the number of bread units

The main “marker” of the diet for patients with diabetes is carbohydrates. To determine their quantity in products, a conventional unit of calculation is used - a bread unit (XE). Conventionally, it contains 12 g of net carbohydrates and increases blood sugar by 1.7-2.7 mmol/l. To calculate the amount of carbohydrates in XE in the finished product, you need to divide the amount of carbohydrates in 100 g of product indicated on the original packaging by 12 and you will get the number of bread units for the same 100 g. For example, the packaging indicates that 100 g of this product contains 60 g carbohydrates. When dividing the indicated number by 12, it turns out that 100 g of this product contains 5 XE.

Glycemic load (GL) is an indicator that reflects the quantity and quality of carbohydrates contained in foods. To calculate it, the formula is used: GL = GI (%): 100 and multiplied by the amount of carbohydrates in grams. Where GI is the glycemic index, which reflects the rate of absorption of carbohydrates in the body. It allows you to roughly estimate how blood sugar will increase after consuming a particular product compared to the standard (glucose or white bread). This indicator is expressed as a percentage. For example, GI = 70 means that after consuming 50 g of this product, the blood sugar level will be 70% of what appears after consuming 50 g of pure glucose.

For example, the GI of boiled potatoes in their jackets is 65%, and 100 g of such potatoes contains 11.5 g of carbohydrates. After consuming this amount of potatoes, the glycemic load will be: GL = 65: 100 x 11.5 = 7.5. For comparison, let’s determine the same indicator for fried potatoes, the GI of which is 95%, and 100 g of it contains 23.4 g of carbohydrates - GI = 95:100 x 23.4 = 22.2.

Signs of diabetes

According to experts, a significant number of people are predisposed to this disease. You can find out if you have it by answering the questions of a simple test.

— Do you feel a constant, unquenchable thirst?

— Do you experience discomfort due to the frequent urge to urinate, especially when you have to leave home for a long time?

— Do dried drops of urine leave dense white stains on laundry, reminiscent of starch marks?

— Do you periodically experience weakness and drowsiness?

— Do you notice a deterioration in your vision: the contours of objects blur, as if you are looking through fog?

— Are you bothered by periodic sensations of numbness and tingling in your palms and soles?

—You can’t get rid of acne?

— Do you have very dry skin, and cuts and scratches do not heal well?

— Do you worry about itchy skin, especially in the perineal area?

— In recent months, have you lost 3-5 kg ​​without putting any effort into it?

— Do you constantly feel very hungry, eat and can’t get enough?

The more affirmative answers you gave, the higher the likelihood of diabetes. In this case, you should immediately consult a doctor and take a blood and urine test for sugar.

www.vashaibolit.ru

lechebnik.info

Syringe markings

To prevent patients from getting confused, the manufacturer applies a special graduation to the syringe, which indicates the concentration of insulin in the bottle of medicine. It is worth noting that each mark on the cylinder does not at all indicate milliliters of solution, it indicates the number of units.

Features of marking division:

• When a syringe is needed for U40 concentrate, on the marking line, where, as a rule, 0.5 ml is written, an indicator of 20 units is observed, and at the level of 1 ml, 40 units are written.
• With all this, 1 insulin unit equals 0.025 ml of insulin.
• The U100 syringe has a parameter of 100 units, not 1 ml, and 50 units - 0.5 ml.

Diabetes mellitus requires the use of an insulin syringe of the required concentration. If the patient uses the hormone 40 units/ml, then U40 is required, and when the hormone is 100 units/ml, then U100.

Many patients wonder what will happen if they make a mistake and use the wrong syringe? For example, when a liquid with a concentration of 40 units/ml is drawn into the U100, instead of the required 20 units, only 8 will be obtained. That is, the dosage will be half as much as what is needed in this situation.

Another analogue can be given, when U40 and a solution of 100 units/ml are used, but in reality only 50 units will be obtained, but 20 are needed.

So that a diabetic can easily choose the required insulin syringe, manufacturers have come up with a specific identification mark to help select the required syringe:

1. The 40 units syringe has a red protective cap.
2. The 100 unit syringe has an orange cap.

In a similar way, you can distinguish insulin pens, which are designed for 100 units. In this regard, if for some reason the pen breaks down or is lost, it is important to know how much volume is in the syringe or insulin pen, and how to distinguish them.

In situations where the patient purchased the wrong product, an insulin overdose cannot be ruled out, which can lead to serious consequences and even death.

How to choose a needle and determine the division price?

Patients are faced with the task of not only choosing the correct volume of the syringe, but also choosing a needle of the required length. The pharmacy sells two types of needles:

• Removable view.
• Non-removable view.

Medical experts advise choosing the second option, because removable needles have the ability to retain a certain amount of the medicinal substance, the volume of which can be up to 7 units.

Today, needles are produced whose length is 8 and 12.7 millimeters. They are not produced shorter than this length, because bottles of medicine with thick rubber stoppers are still sold.

In addition, the thickness of the needle is also important. The fact is that when insulin is injected with a thick needle, the patient will feel pain. And using the thinnest possible needle, the injection is absolutely not felt by the diabetic. At the pharmacy you can buy syringes with different volumes:

1. 0.3 ml.
2. 0.5 ml.
3. 1 ml.

In the vast majority of cases, patients prefer to opt for 1 ml, which is marked with three types of markings:

• U 40.
• U 100.
• Scale in milliliters.

In some situations, you can purchase an insulin syringe that has a double designation. Before injecting yourself with medicine, you need to determine the entire volume of the syringe. To do this, you need to do the following:

1. First, the volume of the 1st division is calculated.
2. Next, the entire volume (indicated on the packaging) is divided by the number of divisions in the product.
3. Important: you need to count only intervals.
4. Then you need to determine the volume of one division: all small divisions are counted among all large ones.
5. Then, the volume of the large division is divided by the number of small divisions.

How is the insulin dose calculated?

It was found out how much the volume of the syringe is, and when to choose a syringe for U40 or U100, you need to find out how to calculate the dose of the hormone.

The hormonal solution is sold in packaging manufactured according to medical standards, the dosage is indicated using BIA (biological units of action), which are designated “unit”.

Typically, a 5 ml vial contains 200 units of insulin. When you recalculate in a different way, it turns out that 1 ml of liquid contains 40 units of the drug.

Features of dosage administration:

• It is advisable to make the injection with a special syringe that has single divisions.
• If a standard syringe is used, then before administering the dose, you need to calculate the number of units included in each division.

The medicine bottle can be used many times. The medicine must be stored in a cold place, but not in the cold.

When using a hormone that has a prolonged effect, the bottle must be shaken before taking the medicine to obtain a homogeneous mixture. Before administration, the medicine must be warmed to room temperature.

To summarize, it is necessary to summarize that every diabetic should know what the syringe markings mean, which needle to choose correctly, and how to calculate the correct dosage. Only this knowledge will help to avoid negative consequences and maintain the patient’s health.

diabetik.com

Syringe - syringe is different

Doctors around the world began using a special syringe for insulin injection several decades ago. Several variants of syringe models for diabetics have been developed, which are easy to use independently, for example, a pen or a pump. But outdated models have not lost their relevance.

The main advantages of the insulin model include simplicity of design and accessibility.

The insulin syringe should be such that the patient can painlessly inject himself at any time, with minimal complications. To do this, you need to choose the right model.

What does pharmacology offer?

Pharmacy chains offer syringes of various modifications. By design they come in two types:

• Disposable, sterile, with replaceable needles.
• Syringes with a built-in (integrated) needle. The model does not have a “dead zone”, so there is no loss of medication.

It is difficult to answer which types are better. Modern pen syringes or pumps can be carried with you to work or school. The drug is filled in them in advance and remains sterile until use. They are comfortable and small in size.

Expensive models are equipped with electronic mechanisms that will remind you when it is necessary to give an injection, show how much medicine has been administered and the time of the last injection. Similar ones are shown in the photo.

Choosing the right syringe

The correct insulin syringe has transparent walls so that the patient can see how much medication has been drawn up and injected. The piston is rubberized and the drug is introduced smoothly and slowly.

When choosing a model for injection, it is important to understand the scale divisions. The number of divisions may vary on different models. One division contains the minimum volume of the drug that can be drawn into the syringe

Why is a graduation scale needed?

An insulin syringe must have marked divisions and a scale; if they are not there, we do not recommend purchasing such models. The divisions and scale show the patient how much concentrated insulin is inside. Typically, 1 ml of the drug equals 100 units, but there are expensive devices for 40 ml/100 units.

For any model of insulin syringe, the divisions have a small error, which is exactly ½ division of the total volume.

For example, if you administer a medicine with a syringe graduated in 2 units, the total dosage will be +- 0.5 units of the medicine. For the information of readers, 0.5 units of insulin can reduce blood sugar levels by 4.2 mmol/l. In a small child this figure is even higher.

Anyone with diabetes needs to understand this information. A small error, even 0.25 units, can lead to glycemia. The smaller the model’s error, the easier and safer it is to use the syringe. This is important to understand so that the patient can accurately administer the insulin dose on their own.

To administer the drug as accurately as possible, follow the rules:

• the smaller the division step, the more accurate the dosage of the administered drug will be;
• It is better to dilute the hormone before administration.

A standard insulin syringe has a capacity of no more than 10 units for administering the drug. The division step is marked with the following numbers:

• 0.25 Units
• 1 Unit
• 2 Units

Insulin labeling

On the market in our country and the CIS, the hormone is produced in bottles with a solution of 40 units of the drug per 1 ml. It is marked U-40. Standard disposable syringes are designed for this volume. Calculate how many ml in units. division is not difficult, since 1 Unit. 40 divisions equal 0.025 ml of the drug. Our readers can use the table:

Now let’s figure out how to calculate a solution with a concentration of 40 units/ml. Knowing how many ml are on one scale, you can calculate how many units of the hormone are produced in 1 ml. For the convenience of readers, we present the result for marking U-40 in the form of a table:

Insulin labeled U-100 is found abroad. The solution contains 100 units. hormone per 1 ml. Our standard syringes are not suitable for this medicine. Need special ones. Their design is the same as U-40, but the graduation scale is designed for U-100. The concentration of imported insulin is 2.5 times higher than our U-40. You need to calculate based on this figure.

How to use an insulin syringe correctly

We recommend using syringes for hormonal injections, the needles of which are not removable. They do not have a dead zone and the medication will be administered in a more precise dosage. The only drawback is that after 4-5 times the needles will become dull. Syringes with removable needles are more hygienic, but their needles are thicker.

It is more practical to alternate: use a disposable simple syringe at home, and at work or elsewhere a reusable one with a non-removable needle.

Before drawing the hormone into the syringe, the bottle must be wiped with alcohol. For short-term administration of a small dose, there is no need to shake the medication. A large dosage is available in the form of a suspension, so shake the bottle before taking it.

The piston on the syringe is pulled back to the required division and the needle is inserted into the bottle. Air is forced inside the bubble, the piston and the medicine under pressure inside are drawn into the device. The amount of medication in the syringe should slightly exceed the administered dose. If air bubbles get inside, you should lightly tap it with your finger.

It is correct to use different needles for drawing up the drug and administering it. To take the medication, you can use needles from a simple syringe. An injection can only be given using an insulin needle.

There are a number of rules that will tell the patient how to mix the drug correctly:

• First, short-acting insulin should be drawn into the syringe, then long-acting;
• Short-acting insulin or NPH should be used immediately after mixing or stored for no more than 3 hours.
• Intermediate-acting insulin (IAI) should not be mixed with long-acting suspension. The zinc filler converts the long hormone into a short one. And this is life-threatening!
• Detemir and long-acting insulin Glargine cannot be mixed with each other or with other types of hormones.

The place where the injection will be given is wiped with a solution of antiseptic liquid or a simple detergent. We do not recommend using an alcohol solution; the fact is that the skin of diabetic patients dries out. Alcohol will dry it out even more, causing painful cracks to appear.

Insulin must be injected under the skin, not into muscle tissue. The needle puncture is made strictly at an angle of 45-75 degrees, shallow. You should not pull out the needle after administering the drug; wait 10–15 seconds for the hormone to distribute under the skin. Otherwise, the hormone will partially come out into the hole from under the needle.

privivkainfo.ru

General calculation rules

An important rule in the algorithm for calculating the dose of insulin is that the patient needs no more than 1 unit of the hormone per kilogram of weight. If you ignore this rule, an overdose of insulin will occur, which can lead to a critical condition - hypoglycemic coma. But to accurately select the dose of insulin, it is necessary to take into account the degree of compensation of the disease:

• In the first stages of type 1 disease, the required dose of insulin is selected at the rate of no more than 0.5 units of the hormone per kilogram of weight.
• If type 1 diabetes is well compensated for a year, then the maximum dose of insulin will be 0.6 units of the hormone per kilogram of body weight.
• In severe cases of type 1 diabetes and constant fluctuations in blood glucose levels, up to 0.7 units of the hormone per kilogram of weight is required.
• In the case of decompensated diabetes, the insulin dose will be 0.8 U/kg;
• For gestational diabetes mellitus – 1.0 U/kg.

So, the insulin dose is calculated according to the following algorithm: Daily insulin dose (IU) * Total body weight/2.

Example: If the daily dose of insulin is 0.5 units, then it must be multiplied by body weight, for example 70 kg. 0.5*70 = 35. The resulting number 35 must be divided by 2. The resulting number is 17.5, which must be rounded down, that is, 17. It turns out that the morning dose of insulin will be 10 units, and the evening dose – 7.

What dose of insulin is needed for 1 unit of bread?

A bread unit is a concept that was introduced to make it easier to calculate the administered dose of insulin immediately before a meal. Here, not all products that contain carbohydrates are taken into account in the calculation of bread units, but only those that are “counted”:

• potatoes, beets, carrots;
• grain products;
• sweet fruits;
• sweets.

In Russia, one unit of bread corresponds to 10 grams of carbohydrates. One unit of bread is equal to a slice of white bread, one medium-sized apple, two teaspoons of sugar. If one bread unit enters the body, which is unable to independently produce insulin, then the glycemic level increases in the range from 1.6 to 2.2 mmol/l. That is, these are exactly the indicators by which glycemia decreases if one unit of insulin is administered.

It follows from this that for each unit of bread taken, about 1 unit of insulin must be administered in advance. That is why it is recommended that all diabetics acquire a table of bread units in order to make the most accurate calculations. In addition, before each injection it is necessary to control glycemia, that is, find out the level of sugar in the blood using a glucometer.

If the patient has hyperglycemia, that is, high sugar, the required number of units of the hormone must be added to the corresponding number of bread units. In case of hypoglycemia, the dose of the hormone will be less.

Example: If a diabetic has a sugar level of 7 mmol/l half an hour before meals, and he plans to eat 5 XE, he needs to administer one unit of short-acting insulin. Then the initial blood sugar will decrease from 7 mmol/l to 5 mmol/l. Also, to compensate for 5 bread units, you need to introduce 5 units of the hormone, for a total insulin dose of 6 units.

How to choose the dose of insulin in a syringe?

To fill a regular syringe with a volume of 1.0-2.0 ml with the required amount of medicine, you need to calculate the cost of dividing the syringe. To do this, you need to determine the number of divisions in 1 ml of the instrument. The domestically produced hormone is sold in 5.0 ml bottles. 1 ml is 40 units of the hormone. 40 units of the hormone must be divided by the number that is obtained by counting the divisions in 1 ml of the instrument.

Example: There are 10 divisions in 1 ml syringe. 40:10 = 4 units. That is, 4 units of insulin are placed in one division of the syringe. The dose of insulin that needs to be injected should be divided by the price of one division, thus you will get the number of divisions on the syringe that must be filled with insulin.

There are also pen syringes that contain a special flask filled with hormone. By pressing or turning the syringe button, insulin is injected subcutaneously. Before the injection, the required dose must be set in pen syringes, which will enter the patient’s body.

How to administer insulin: general rules

Insulin is administered according to the following algorithm (when the required volume of medication has already been calculated):

1. Hands should be disinfected and medical gloves should be worn.
2. Roll out the bottle of medicine in your hands so that it is evenly mixed, and disinfect the lid and stopper.
3. Fill the syringe with air in the amount in which the hormone will be injected.
4. Place the bottle of medicine vertically on the table, remove the cap from the needle and insert it into the bottle through the stopper.
5. Press the syringe so that the air from it enters the bottle.
6. Turn the bottle upside down and fill the syringe with 2-4 units more than the dose that should enter the body.
7. Remove the needle from the bottle, release the air from the syringe, adjusting the dose to the required level.
8. Disinfect the place where the injection will be given twice with a piece of cotton wool and an antiseptic.
9. Inject insulin subcutaneously (with a large dose of the hormone, the injection is done intramuscularly).
10. Treat the injection site and the instruments used.

For rapid absorption of the hormone (if the injection is subcutaneous), it is recommended to give an injection in the stomach. If the injection is given in the thigh, absorption will be slow and incomplete. An injection into the buttocks, the shoulder has an average absorption speed.

You can get more information about the insulin injection technique here: http://diabet.biz/lechenie/tradicionnaya/insulin/tehnika-vvedenija-insulina.html.

Extended insulin and its dose (video)

Long-acting insulin is prescribed to patients to maintain normal fasting blood glucose levels so that the liver has the opportunity to produce glucose constantly (and this is necessary for brain function), because with diabetes the body cannot do this on its own.

Extended insulin is administered once every 12 or 24 hours, depending on the type of insulin (two effective types of insulin are used today - Levemir and Lantus). A diabetes control specialist explains in this video how to correctly calculate the required dose of extended-release insulin:

The ability to correctly calculate insulin doses is a skill that every insulin-dependent diabetic should master. If you choose the wrong dose of insulin, an overdose may occur, which, if assistance is not provided in a timely manner, can result in death. The correct doses of insulin are the key to the well-being of a diabetic.

There are no restrictions on the use of insulin during pregnancy, since insulin does not penetrate the placental barrier. Moreover, if diabetes mellitus is not treated during pregnancy, it creates a danger to the fetus. Therefore, diabetes therapy must be continued during pregnancy.

Both hypoglycemia and hyperglycemia, which can develop in cases of insufficiently selected therapy, increase the risk of fetal malformations and intrauterine fetal death. Pregnant women with diabetes should be monitored throughout pregnancy and have increased blood glucose monitoring; The same recommendations apply to women who are planning a pregnancy.

Insulin requirements usually decrease in the first trimester of pregnancy and gradually increase in the second and third trimesters.

After childbirth, insulin requirements quickly return to pre-pregnancy levels.

There are also no restrictions on the use of the drug Protafan NM during lactation. Carrying out insulin therapy for nursing mothers does not pose a danger to the child. However, the mother may need to adjust the dosage regimen of Protafan NM and/or diet.

Side effect

Hypoglycemic conditions, allergic reactions, lipodystrophy (with long-term use).

Release form

Suspension for subcutaneous administration, 100 IU/ml (bottles). In hydrolytic class 1 glass bottles, sealed with bromobutyl/polyisoprene rubber stoppers and plastic caps, 10 ml each; in a cardboard pack 1 fl.

Interaction with other drugs

The hypoglycemic effect is enhanced by acetylsalicylic acid, alcohol, alpha and beta-blockers, amphetamine, anabolic steroids, clofibrat, cyclophosphamide, phenfluramine, fluoxetine, ifopamide, Mao, methyldop inhibitors, tetracycyclines, tritotoxiline, trifospamide, weaken- weaken chlorop thyxen, diazoxide, diuretics (especially thiazides), glucocorticoids, heparin, hormonal contraceptives, isoniazid, lithium carbonate, nicotinic acid, phenothiazines, sympathomimetics, tricyclic antidepressants.

Compound

Active substance: insulin isophane (human genetically engineered);

Excipients: zinc chloride; glycerin (glycerol); metacresol; phenol; sodium hydrogen phosphate dihydrate; protamine sulfate; sodium hydroxide and/or hydrochloric acid (to adjust pH); water for injections

Storage conditions

In a place protected from light, at a temperature of 2-8 °C (do not freeze). Store the used bottle at room temperature not exceeding 30 °C for 6 weeks. Protect from heat and sunlight.

Overdose

Symptoms: development of hypoglycemia (cold sweat, palpitations, tremors, hunger, agitation, irritability, pallor, headache, drowsiness, uncertainty of movements, speech and vision disturbances, depression). Severe hypoglycemia can lead to temporary or permanent impairment of brain function, coma, and death.

Treatment: sugar or glucose solution orally (if the patient is conscious), subcutaneous, intramuscular or intravenous - glucagon or intravenous - glucose.

special instructions

If the dose is incorrectly selected or therapy is discontinued, hyperglycemia may develop, especially in patients with type 1 diabetes. The first symptoms of hyperglycemia usually appear gradually over several hours or days. These symptoms include nausea, vomiting, severe drowsiness, red, dry skin, dry mouth, increased urine output, thirst, loss of appetite, and the smell of acetone on the breath.

If left untreated, hyperglycemia in type 1 diabetes can lead to life-threatening diabetic ketoacidosis. In cases of significant improvement in glycemic control, for example, due to intensified insulin therapy, the usual warning symptoms of hypoglycemia may also change, about which patients should be warned.

With concomitant diseases, especially infections and febrile conditions, patients' need for insulin usually increases. If a patient is switched from one type of insulin to another, the early warning symptoms of hypoglycemia may change or become less pronounced than those noted with the introduction of the previous insulin.

Transferring patients to another type of insulin or to insulin from another manufacturer should only be done under medical supervision. If the biological activity changes, the manufacturer, type, species (animal, human, analogue of human insulin) and/or manufacturing method change, a change in dosage regimen may be required.

If dose adjustments are necessary, this can be done at the time of the first dose or during the first weeks or months of therapy.

Skipping meals or unplanned strenuous exercise can cause hypoglycemia.

If the patient is traveling across time zones, he should consult with his doctor, as he will have to change the timing of insulin administration and meals.

Protafan NM cannot be used in insulin pumps for prolonged subcutaneous administration of insulin.

The drug Protafan NM contains metacresol, which can cause allergic reactions.

Impact on the ability to drive a car and operate machinery

Patients' ability to concentrate and react quickly may be impaired during hypoglycemia and hyperglycemia, which can be dangerous in situations where these abilities are especially needed (for example, when driving a car or working with machinery). Patients should be advised to take measures to prevent the development of hypoglycemia and hyperglycemia when driving a car and working with machinery. This is especially important for patients with no or decreased severity of symptoms that are warning signs of developing hypoglycemia or who suffer from frequent episodes of hypoglycemia. In these cases, the advisability of driving should be considered.

Contraindications

Hypoglycemia, insulinoma.

Best before date

Product description

The suspension for subcutaneous administration is white; when standing, it separates, forming a white precipitate and a colorless or almost colorless supernatant; When stirring, the sediment should resuspend.

pharmachologic effect

Hypoglycemic. Protafan HM interacts with a specific plasma membrane receptor and penetrates the cell, where it activates the phosphorylation of cellular proteins, stimulates glycogen synthetase, pyruvate dehydrogenase, hexokinase, inhibits adipose tissue lipase and lipoprotein lipase. In combination with a specific receptor, it facilitates the penetration of glucose into cells, enhances its absorption by tissues and promotes conversion into glycogen. Increases glycogen reserves in muscles, stimulates peptide synthesis.

Pharmacokinetics

The effect develops 1.5 hours after subcutaneous administration, reaches a maximum after 4–12 hours and lasts 24 hours. In insulin-dependent diabetes mellitus, Protafan NM Penfill is used as basal insulin in combination with short-acting insulin; in non-insulin-dependent diabetes mellitus, it is used as monotherapy , and in combination with fast-acting insulins.

Indications for use

Diabetes mellitus type I, diabetes mellitus type II (with resistance to sulfonylurea derivatives, intercurrent diseases, operations and in the postoperative period, during pregnancy).

Directions for use and doses

Subcutaneously. The drug is intended for subcutaneous administration. Insulin suspensions cannot be administered intravenously.

The dose of the drug is selected individually, taking into account the needs of the patient. Typically, insulin requirements range from 0.3 to 1 IU/kg/day. The daily requirement for insulin may be higher in patients with insulin resistance (for example, during puberty, as well as in obese patients), and lower in patients with residual endogenous insulin production.

Protafan® NM can be used both in monotherapy and in combination with rapid or short-acting insulin.

Protafan® NM is usually administered subcutaneously into the thigh area. If it is convenient, injections can also be made into the anterior abdominal wall, into the gluteal region or into the deltoid muscle of the shoulder. When the drug is administered to the thigh area, slower absorption is observed than when administered to other areas. If the injection is made into a retracted skin fold, the risk of accidental intramuscular injection of the drug is minimized.

The needle should remain under the skin for at least 6 seconds to ensure complete delivery of the dose. It is necessary to constantly change injection sites within the anatomical region to prevent the development of lipodystrophies.

Protafan® NM Penfill® is designed for use with Novo Nordisk insulin injection systems and NovoFine® or NovoTwist® needles. Detailed recommendations for use and administration of the drug should be followed.

Dose adjustment

Concomitant diseases, especially infectious ones and those accompanied by fever, usually increase the body's need for insulin. Dose adjustment of the drug may also be required if the patient has concomitant diseases of the kidneys, liver, dysfunction of the adrenal glands, pituitary gland or thyroid gland. The need for dose adjustment may also arise when the patient's physical activity or usual diet changes. Dose adjustment may be required when transferring a patient from one type of insulin to another

The first insulin preparations contained only one unit of insulin per 1 ml of solution. Later their concentration was increased. Most insulin preparations in vials used in Russia contain 40 units of insulin per 1 ml. The bottle is usually marked U-40 or 40 units/ml. The insulin syringes that we use are designed specifically for this kind of insulin and are graduated precisely for its concentration: if we draw 0.5 ml of insulin, it means we have collected 20 units, if we have collected 0.25 ml, that is 10 units, etc. . Each mark on an insulin syringe represents a certain volume, and we know that such and such a volume contains a certain number of units. Consequently, calibration of syringes by units of insulin is nothing more than graduation by volume of solution, designed specifically for U-40 insulin: 4 units. insulin corresponds to 0.1 ml of solution, 6 units. - 0.15 ml, etc., up to 40 units, corresponding to 1 ml of solution (we emphasize once again: at an insulin concentration of 40 units/ml!).

In many countries, insulin containing 100 units per ml (U-100) is used. There are insulin syringes for it, which outwardly look the same as syringes for U-40 insulin, but are graduated differently, taking into account this particular concentration, which, as can be easily calculated, is 2.5 times higher than the standard (100 units /ml: 40 units/ml = 2.5). What does this mean for the patient? The insulin dose, of course, remains the same, because... it reflects the physiological need of the body for a specific amount of the hormone. That is, if a patient used U-40 insulin and received 40 units per day, he will need to receive 40 units per day when treated with U-100 insulin. However, the volume of administered insulin U-100 should be 2.5 times less. In other words, if 40 units of U-40 insulin were contained in 1 ml of solution, then 40 units of U-100 insulin will be contained in only 0.4 ml of solution, i.e., the volume (but not the dose!) of insulin administered will decrease. It is this difference in volume that is taken into account in insulin syringes specifically designed for U-100 insulin.

Unfortunately, many doctors and especially patients with diabetes are not aware of this. The first problems appeared when some patients began to use insulin injectors (syringe pens), which use special cartridges (penfills) with U-100 insulin. If the pen is broken or the special needles for it are out of stock, some patients draw up U-100 insulin from penfills with regular insulin syringes designed for U-40 insulin. If you draw insulin with a concentration of 100 units/ml into such a syringe to the mark, for example, “20 units” (and this corresponds to 0.5 ml in such a syringe), then it turns out that the collected volume (0.5 ml) already contains 100 U/ml x 0.5 = 50 units of insulin! Thus, when drawing U-100 insulin into regular insulin syringes and focusing on the “unit” marks, we will each time draw a dose that is 2.5 times higher than that marked near this division of the syringe. If the patient or doctor does not pay attention to this error in time, cases of severe hypoglycemia due to an overdose of insulin are possible, which we have repeatedly observed in practice.

On the other hand, sometimes insulin syringes intended for U-100 insulin and calibrated specifically for it came into our country through humanitarian aid channels. By mistake, these syringes can be filled with the usual U-40 insulin from a bottle, and then the dose of insulin in the syringe will be 2.5 times less than what is indicated next to the corresponding division of the syringe. As a consequence of this, you can expect an “unexplained” increase in blood sugar - inexplicable, however, if you do not know the following rule: the appropriate syringe must be used for each insulin concentration!

To improve the quality of life, every insulin-dependent diabetic should be able to independently calculate the daily doses of insulin he needs, and not shift this responsibility to doctors, who may not always be nearby. By mastering the basic formulas for calculating insulin, you can avoid an overdose of the hormone and also take control of the disease.

General calculation rules

An important rule in the algorithm for calculating the dose of insulin is that the patient needs no more than 1 unit of the hormone per kilogram of weight. If you ignore this rule, an overdose of insulin will occur, which can lead to a critical condition - hypoglycemic coma. But to accurately select the dose of insulin, it is necessary to take into account the degree of compensation of the disease:

• In the first stages of type 1 disease, the required dose of insulin is selected at the rate of no more than 0.5 units of the hormone per kilogram of weight.
• If type 1 diabetes is well compensated for a year, then the maximum dose of insulin will be 0.6 units of the hormone per kilogram of body weight.
• In severe cases of type 1 diabetes and constant fluctuations in blood glucose levels, up to 0.7 units of the hormone per kilogram of weight is required.
• In the case of decompensated diabetes, the insulin dose will be 0.8 U/kg;
• For gestational diabetes mellitus – 1.0 U/kg.

So, the insulin dose is calculated according to the following algorithm: Daily insulin dose (IU) * Total body weight/2.

Example: If the daily dose of insulin is 0.5 units, then it must be multiplied by body weight, for example 70 kg. 0.5*70 = 35. The resulting number 35 must be divided by 2. The resulting number is 17.5, which must be rounded down, that is, 17. It turns out that the morning dose of insulin will be 10 units, and the evening dose – 7.

What dose of insulin is needed for 1 unit of bread?

A bread unit is a concept that was introduced to make it easier to calculate the administered dose of insulin immediately before a meal. Here, not all products that contain carbohydrates are taken into account in the calculation of bread units, but only those that are “counted”:

• potatoes, beets, carrots;
• grain products;
• sweet fruits;
• sweets.

In Russia, one unit of bread corresponds to 10 grams of carbohydrates. One unit of bread is equal to a slice of white bread, one medium-sized apple, two teaspoons of sugar. If one bread unit enters the body, which is unable to independently produce insulin, then the glycemic level increases in the range from 1.6 to 2.2 mmol/l. That is, these are exactly the indicators by which glycemia decreases if one unit of insulin is administered.

It follows from this that for each unit of bread taken, about 1 unit of insulin must be administered in advance. That is why it is recommended that all diabetics acquire a table of bread units in order to make the most accurate calculations. In addition, before each injection it is necessary to control glycemia, that is, find out the level of sugar in the blood using a glucometer.

If the patient has hyperglycemia, that is, high sugar, the required number of units of the hormone must be added to the corresponding number of bread units. In case of hypoglycemia, the dose of the hormone will be less.

Example: If a diabetic has a sugar level of 7 mmol/l half an hour before meals, and he plans to eat 5 XE, he needs to be administered one unit of short-acting insulin. Then the initial blood sugar will decrease from 7 mmol/l to 5 mmol/l. Also, to compensate for 5 bread units, you need to introduce 5 units of the hormone, for a total insulin dose of 6 units.

How to choose the dose of insulin in a syringe?

To fill a regular syringe with a volume of 1.0-2.0 ml with the required amount of medicine, you need to calculate the cost of dividing the syringe. To do this, you need to determine the number of divisions in 1 ml of the instrument. The domestically produced hormone is sold in 5.0 ml bottles. 1 ml is 40 units of the hormone. 40 units of the hormone must be divided by the number that is obtained by counting the divisions in 1 ml of the instrument.

Example: There are 10 divisions in 1 ml syringe. 40:10 = 4 units. That is, 4 units of insulin are placed in one division of the syringe. The dose of insulin that needs to be injected should be divided by the price of one division, thus you will get the number of divisions on the syringe that must be filled with insulin.

There are also pen syringes that contain a special flask filled with hormone. By pressing or turning the syringe button, insulin is injected subcutaneously. Before the injection, the required dose must be set in pen syringes, which will enter the patient’s body.

How to administer insulin: general rules

Insulin is administered according to the following algorithm (when the required volume of medication has already been calculated):

1. Hands should be disinfected and medical gloves should be worn.
2. Roll out the bottle of medicine in your hands so that it is evenly mixed, and disinfect the lid and stopper.
3. Fill the syringe with air in the amount in which the hormone will be injected.
4. Place the bottle of medicine vertically on the table, remove the cap from the needle and insert it into the bottle through the stopper.
5. Press the syringe so that the air from it enters the bottle.
6. Turn the bottle upside down and fill the syringe with 2-4 units more than the dose that should enter the body.
7. Remove the needle from the bottle, release the air from the syringe, adjusting the dose to the required level.
8. Disinfect the place where the injection will be given twice with a piece of cotton wool and an antiseptic.
9. Inject insulin subcutaneously (with a large dose of the hormone, the injection is done intramuscularly).
10. Treat the injection site and the instruments used.

For rapid absorption of the hormone (if the injection is subcutaneous), it is recommended to give an injection in the stomach. If the injection is given in the thigh, absorption will be slow and incomplete. An injection into the buttocks, the shoulder has an average absorption speed.

Extended insulin and its dose (video)

Long-acting insulin is prescribed to patients to maintain normal fasting blood glucose levels so that the liver has the opportunity to produce glucose constantly (and this is necessary for brain function), because with diabetes the body cannot do this on its own.

Extended insulin is administered once every 12 or 24 hours, depending on the type of insulin (two effective types of insulin are used today - Levemir and Lantus). A diabetes control specialist explains in this video how to correctly calculate the required dose of extended-release insulin:

The ability to correctly calculate insulin doses is a skill that every insulin-dependent diabetic should master. If you choose the wrong dose of insulin, an overdose may occur, which, if assistance is not provided in a timely manner, can result in death. The correct doses of insulin are the key to the well-being of a diabetic.

Insulin dose calculation: find out everything you need to know. Learn to manage with minimal doses and keep sugar 3.9-5.5 mmol/l stable 24 hours a day. It is possible to stop spikes in blood glucose levels even in severe type 1 diabetes in adults and children. And even more so, keep your sugar at normal levels, like healthy people, with type 2 diabetes. Understand how to select the optimal dose of insulin, taking into account the individual course of diabetes.

Read the answers to the questions:

You need to observe the behavior of blood sugar in a diabetic at different times for several days, and then select an insulin therapy regimen.

Please note that large doses of insulin are unstable and unpredictable. The strength of their action on different days may differ by ±56%. To have good diabetes control, you need to manage this problem. The main remedy is switching to, which reduces the dosage by 2-8 times.

Diabetics who limit their carbohydrate intake should not inject more than 8 units of insulin at a time. If you need a higher dose, divide it into 2-3 approximately equal injections. Do them one after another in different places with the same syringe.

Treatment of diabetes with insulin - where to start:

Many diabetics who are treated with insulin believe that episodes of low blood sugar cannot be avoided. They think that terrible hypoglycemia attacks are an inevitable side effect. In fact, You can keep your blood sugar at a stable level even with severe autoimmune disease. And even more so with relatively mild type 2 diabetes. There is no need to artificially increase your blood glucose levels to protect yourself from dangerous hypoglycemia. Watch a video that discusses this issue. Learn how to balance your diet and insulin doses.

Below are answers to questions that patients often have.

What foods contain insulin?

No foods contain insulin. Also, there are no tablets containing this hormone yet. Because when administered orally, it is destroyed in the gastrointestinal tract, does not enter the bloodstream and does not affect glucose metabolism. Today, insulin to lower blood sugar can only be introduced into the body through injections. Inhalation aerosols are available, but they should not be used because they do not provide an accurate and stable dosage. The good news is that the needles on insulin syringes and pens are so thin that you can learn how to use them.

At what blood sugar levels are insulin injections prescribed?

Except for the most severe cases, diabetics need to first switch to it and sit on it for 3-7 days, monitoring their blood sugar. It may turn out that you don't need insulin injections at all.

Read about tablets containing metformin:

After switching to a healthy diet and starting to take metformin, you need to collect information about the behavior of sugar during each day for 3-7 days. Having accumulated this information, it is used to select optimal doses of insulin.

Diet, metformin and physical activity should together bring glucose levels back to normal, as in healthy people - 3.9-5.5 mmol/l consistently 24 hours a day. If such indicators cannot be achieved, add more insulin injections.

Don’t agree to live with a sugar level of 6-7 mmol/l, much less higher! These numbers are officially considered normal, but in reality they are elevated. With them, complications of diabetes develop, albeit slowly. Hundreds of thousands of diabetics who suffer from problems with their legs, kidneys and vision bitterly regret that at one time they were too lazy or afraid to inject themselves with insulin. Don't repeat their mistake. Use low, carefully measured doses to achieve levels consistently below 6.0 mmol/L.

It is often necessary to inject extended-release insulin at night in order to have normal blood sugar the next morning on an empty stomach. Read. First of all, figure out whether you need injections of extended-release medications. If they are necessary, start doing them.

Read about long-acting insulin preparations:

Tresiba is such an outstanding drug that the site administration has prepared a video about it.

Once you start injecting insulin, don’t even think about giving up your diet. If you are overweight, continue taking the pills. Try to find time and energy to exercise.

Measure your sugar before each meal and 3 hours after it. It is necessary to determine within a few days after which meals the glucose level regularly increases by 0.6 mmol/l or more. Before these meals you need to inject short or ultra-short insulin. This supports the pancreas in situations where it does not cope well on its own. Read more about choosing the optimal dosage before meals.

Important! All insulin preparations are very fragile and easily spoil. Study them and follow them diligently.

Sugar levels of 9.0 mmol/l and higher may be detected, even despite strict adherence to the diet. In this case, you need to immediately start giving injections, and only then add other medications. Also, people with type 1 diabetes and thin people who have been diagnosed with type 2 diabetes start using insulin immediately after a low-carb meal, bypassing the pill.

If blood glucose levels are high, insulin therapy should be started immediately; it is harmful to procrastinate.

What is the maximum dose of insulin per day?

There are no restrictions on the maximum daily dose of insulin. It can be increased until the glucose level of a diabetic patient returns to normal. Professional journals describe cases where patients with type 2 diabetes received 100-150 units per day. Another issue is that high doses of the hormone stimulate fat deposits in the body and worsen the course of diabetes.

The site teaches you how to keep your blood sugar consistently normal 24 hours a day and still manage with minimal doses. Read more and. First of all, you should go to . Diabetics who are already being treated with insulin, after switching to a new diet, should immediately reduce the dosage by 2-8 times.

How much insulin is needed for 1 bread unit (XE) of carbohydrates?

It is believed that for one unit of bread (XE) eaten for lunch or dinner, you need to inject 1.0-1.3 units of insulin. For breakfast - more, up to 2.0-2.5 units. In fact, this information is not accurate. It is better not to use it for actual calculation of insulin doses. Because different diabetics have different sensitivity to this hormone. It depends on the patient's age and weight, as well as other factors listed in the table below.

A pre-meal dose of insulin that would be appropriate for an adult or teenager may kill a small diabetic child. On the other hand, a tiny dose that would be sufficient for a child would have virtually no effect on an overweight adult with type 2 diabetes.

You need to carefully figure out through trial and error how many grams of carbohydrates eaten are covered by 1 unit of insulin. Approximate data is given in. They need to be clarified individually for each diabetic, accumulating statistics on the effect of injections on his body. - this is a real and serious danger. To avoid it, treatment begins with obviously low, insufficient doses. They are slowly and carefully increased at intervals of 1-3 days.

Diet options depending on diagnosis:

The website explains how to use it to treat diabetes. By switching to this diet, you can stop spikes in glucose levels and keep your blood sugar at a stable 3.9-5.5 mmol/l, like in healthy people.

Diabetics who follow a healthy diet count their carbohydrate intake in grams rather than grain units. Because grain units only cause confusion without bringing any benefit. On a low-carbohydrate diet, the maximum carbohydrate intake does not exceed 2.5 XE per day. Therefore, it makes no sense to calculate insulin doses by bread units.

How much does 1 unit of insulin reduce blood sugar?

Materials from the Federal State Budgetary Institution “Endocrinological Research Center” of the Ministry of Health of the Russian Federation say that 1 unit of insulin reduces blood sugar by an average of 2.0 mmol/l. This figure is clearly underestimated. Using this information is useless and even dangerous. Because insulin works differently for all diabetics. It has a much stronger effect on thin adults, people with type 1 diabetes, and children. Except in cases where storage rules were violated and the insulin deteriorated.

Different preparations of this hormone differ significantly in strength. For example, ultra-short types of insulin Humalog, NovoRapid and Apidra are approximately 1.5 times stronger than short-acting Actrapid. The types of extra-long-acting, extended-acting, intermediate-acting, short-acting and ultra-short-acting insulin each work differently. They affect blood sugar differently. The purposes of their administration and the methods for calculating dosages are not at all similar. It is impossible to use any average performance indicator for all of them.

Read about short-acting and ultra-short-acting insulin preparations:

Example. Let's say you have determined through trial and error that 1 unit of NovoRapid reduces your glucose level by 4.5 mmol/l. After that, you learned about the miraculous and switched to it. says that short-acting insulin is better suited for a low-carbohydrate diet than ultra-fast insulin. Therefore, you are going to change NovoRapid to Actrapid, which is approximately 1.5 times weaker. To calculate your starting dose, you assume that 1 unit will lower your blood sugar by 4.5 mmol/L / 1.5 = 3.0 mmol/L. Then, within a few days, you will clarify this figure based on the results of the first injections.

Each diabetic needs to use trial and error to find out exactly how much 1 unit of insulin he injects reduces his glucose level. It is not advisable to use an average figure taken from the Internet to calculate your individual doses. However, you have to start somewhere. You can use the following information provided by Dr. Bernstein to calculate your starting dose.

approximately by 3 mmol/l. The more the patient weighs and the higher the fat content in his body, the weaker the insulin works. The relationship between body weight and the strength of insulin is inversely proportional and linear. For example, in an obese patient with type 2 diabetes weighing 126 kg, 1 unit of Humalog, Apidra or NovoRapid will reduce sugar approximately by 1.5 mmol/l.

To calculate the appropriate dose, you need to make a proportion taking into account the body weight of the diabetic. If you don't know how to make a proportion and can't count without making mistakes, it's better not to even try. Seek help from someone advanced in arithmetic. Because an error in the dosage of potent rapid insulin can have serious consequences, even kill the patient.

Training example. Let's say a diabetic weighs 71 kg. His rapid insulin is, for example, NovoRapid. By calculating the proportion, you can find out that 1 unit of this drug will reduce sugar by 2.66 mmol/l. Did your answer match this figure? If yes, then it's ok. Let us repeat that this method is only suitable for calculating the first, starting dose. The figure you get by calculating the portion needs to be clarified based on the results of the injections.

How much sugar reduces 1 unit depends on body weight, age, level of physical activity of the person, the drug used and many other factors.

Factors affecting insulin sensitivity

The higher the sensitivity, the more each administered unit (IU) of insulin lowers sugar. Approximate figures are given in, as well as in. This data can only be used to calculate the starting dosage. Then they need to be clarified individually for each diabetic based on the results of previous injections. Don’t be lazy, carefully select the optimal dosage to keep your glucose level 4.0-5.5 mmol/l stable 24 hours a day.

How many units of insulin are needed to reduce sugar by 1 mmol/l?

The answer to this question depends on the following factors:

• age of the diabetic;
• body mass;
• level of physical activity.

Several other important factors are listed in the table above. Having accumulated information over 1-2 weeks of injections, you can calculate how much 1 unit of insulin lowers sugar. The results will be different for long-acting, short-acting and ultra-short-acting drugs. Knowing these numbers, it is easy to calculate the dose of insulin that will reduce blood sugar by 1 mmol/l.

Keeping a diary and doing calculations is a hassle and takes up some time. However, this is the only way to select optimal dosages, maintain stable normal glucose levels and protect against diabetes complications.

When will the results of the injection appear?

This question requires a detailed answer because different types of insulin take effect at different rates.

Insulin preparations are divided into:

• extended - Lantus, Tujeo, Levemir, Tresiba;
• medium - Protafan, Biosulin N, Insuman Bazal GT, Rinsulin NPH, Humulin NPH;
• fast acting - Actrapid, Apidra, Humalog, NovoRapid, domestic.

There are also two-phase mixtures - for example, Humalog Mix, NovoMix, Rosinsulin M. However, it is not recommended to use them. They are not discussed on this site. To achieve good control of diabetes, you need to switch from these drugs to the simultaneous use of two types of insulin - long-acting and fast (short or ultra-short).

It is further assumed that the diabetic follows and receives low doses of insulin that correspond to it. These doses are 2-7 times lower than those to which doctors are accustomed. Treatment of diabetes with insulin according to Dr. Bernstein's methods allows you to achieve stable blood sugar levels of 3.9-5.5 mmol/l. This is real even with severe disorders of glucose metabolism. However, low-dose insulin starts working later and stops working sooner than standard high-dose insulin.

Fast (short and ultra-short) insulin begins to act 10-40 minutes after the injection, depending on the drug administered and dose. However, this does not mean that after 10-40 minutes the glucometer will show a decrease in sugar. For the effect to appear, you need to measure your glucose level no earlier than after 1 hour. It is better to do this later - after 2-3 hours.

Study the details. You should not inject large doses of these drugs to get a quick effect. You will almost certainly inject yourself with more of the hormone than you should, and this will lead to hypoglycemia. There will be hand trembling, nervousness and other unpleasant symptoms. Even loss of consciousness and death are possible. Handle rapid-acting insulin with care! Before using, thoroughly understand how it works and how to determine the appropriate dosage.

Medium- and long-acting insulin preparations begin to work 1-3 hours after the injection. They give a smooth effect that is difficult to track with a glucometer. A single sugar measurement may not reveal anything. You need to self-monitor your blood glucose levels several times every day.

Diabetics who give themselves long-acting insulin injections in the morning see their results in the evening, based on the results of the whole day. It is useful to build visual graphs of sugar levels. On the days when extended-release insulin was given, they will differ significantly for the better. Of course, if the dose of the drug is correctly selected.

An injection of extended-release insulin given at night gives results the next morning. Fasting sugar levels improve. In addition to measuring in the morning, you can also monitor your glucose levels in the middle of the night. It is advisable to check your sugar at night in the first days of treatment, when there is a risk of overdoing the starting dose. Set an alarm to wake up at the right time. Measure your sugar, record the result and continue sleeping.

Research before starting diabetes treatment with this remedy.

How much insulin should be injected if a diabetic's blood sugar is very high?

The required dose depends not only on blood sugar, but also on body weight, as well as on the individual sensitivity of the patient. There are many factors that affect insulin sensitivity. They are listed above on this page.

It will be useful to you. Short-acting and ultra-short-acting drugs are administered to diabetics when they need to quickly reduce high sugar levels. Long-acting and intermediate-acting insulin should not be used in such situations.

In addition to insulin injections, diabetics will benefit from drinking plenty of water or herbal tea. Of course, without honey, sugar and other sweets. Drinking liquid dilutes the blood, reduces the concentration of glucose in it, and also helps the kidneys remove some of the excess glucose from the body.

A diabetic needs to determine exactly how much 1 unit of insulin reduces his glucose level. This can be learned over a period of days or weeks through trial and error. Each time the dose is calculated, the resulting figure must be adjusted for weather, infectious diseases and other factors.

There are situations when sugar has already jumped, you need to bring it down urgently, but you have not yet had time to accumulate accurate data by trial and error. How to calculate the insulin dose in this case? You will have to use indicative information.

You can use the dose calculation method below at your own peril and risk. An overdose of insulin can cause unpleasant symptoms, impaired consciousness and even death.

In an adult with a body weight of 63 kg, 1 unit of ultra-short insulin Humalog, Apidra or NovoRapid lowers blood sugar approximately by 3 mmol/l. The greater your body weight and the higher your body fat content, the weaker your insulin is. For example, in an obese patient with type 2 diabetes weighing 126 kg, 1 unit of Humalog, Apidra or NovoRapid will reduce sugar approximately by 1.5 mmol/l. It is necessary to make a proportion taking into account the body weight of the diabetic.

If you don’t know how to make a proportion, and you’re not sure that you can calculate it accurately, then it’s better not to even try. Seek help from someone competent. An error in the dosage of short-term or ultra-fast insulin can have serious consequences, even kill the patient.

Let's say a diabetic weighs 71 kg. His rapid insulin is for example Apidra. Having drawn up the proportion, you calculated that 1 unit will reduce sugar by 2.66 mmol/l. Let's say the patient's blood glucose level is 14 mmol/l. It needs to be reduced to 6 mmol/l. Difference with target: 14 mmol/l - 6 mmol/l = 8 mmol/l. Required insulin dose: 8 mmol/l / 2.66 mmol/l = 3.0 units.

Let us repeat once again that this is an approximate dose. It is guaranteed not to be a perfect fit. You can inject 25-30% less to reduce the risk of hypoglycemia. This calculation method should only be used if the patient has not yet accumulated accurate information through trial and error.

The drug Actrapid is approximately 1.5 times weaker than Humalog, Apidra or NovoRapid. It also takes effect later. However, Dr. Bernstein recommends using it. Because short-term insulin is better compatible with a low-carbohydrate diet than ultra-short insulin.

The insulin dose calculation method given above is not suitable for diabetic children. Because their sensitivity to insulin is several times higher than that of adults. An injection of rapid insulin in a dose calculated according to the indicated method will most likely cause severe hypoglycemia in the child.

What are the features of calculating the dose of insulin for diabetic children?

In diabetic children before adolescence, insulin sensitivity is several times higher than in adults. Therefore, children require negligible doses compared to adult patients. As a rule, parents who control diabetes in their children have to dilute insulin with saline solution purchased at the pharmacy. This helps to accurately inject doses of 0.25 units.

Above, we discussed how to calculate the insulin dose for an adult with a body weight of 63 kg. Let's say a diabetic child weighs 21 kg. It can be assumed that he will need a dose of insulin 3 times less than an adult, with the same blood glucose levels. But this assumption will be incorrect. A suitable dose will most likely be not 3, but 7-9 times less.

Diabetic children are at significant risk of episodes of low blood sugar caused by insulin overdose. To avoid an overdose, start insulin injections with deliberately low doses. Then they are slowly increased until the blood glucose level becomes stably normal. It is undesirable to use potent drugs Humalog, Apidra and NovoRapid. Try Actrapid instead.

Children under 8-10 years old can start injecting insulin with a dose of 0.25 units. Many parents doubt that such a “homeopathic” dose will have any effect. However, most likely, you will notice the effect from the first injection based on the glucometer readings. If necessary, increase the dose by 0.25-0.5 units every 2-3 days.

The information on calculating insulin doses given above is suitable for diabetic children who strictly adhere to the dose. Fruits and others should be excluded completely. The child needs to be explained the consequences of eating junk food. There is no need to use an insulin pump. However, it is advisable to wear a continuous glucose monitoring system if you can afford it.