How to understand short-acting and long-acting insulin. Indications for the use of long-acting insulin. Instructions for use

Several types of insulin are used in the treatment of diabetes mellitus, one of them is long-acting insulin, or long-acting insulin. The drug must be dosed and controlled.

Insulin is a drug taken against diabetic conditions, injections of which lower the concentration of glucose in the blood, increasing its absorption by tissues (liver and muscles). Long-acting insulin is so called because its duration of action exceeds that of other versions of the drug, and this requires less frequency of administration.

Action of long-acting insulin

Examples of drug names:

• Lantus;
• Insulin Ultralente;
• Insulin Ultralong;
• Insulin Ultratard;
• Levemir;
• Levulin;
• Humulin.

Available in the form of suspensions or solutions for injection.

Long-acting insulin reduces the concentration of glucose in the blood, enhances its absorption by muscles and liver, accelerates the synthesis of protein products, and reduces the rate of glucose production by hepatocytes (liver cells).

If you correctly calculate the amount of long-acting insulin, then its activation begins 4 hours after the injection. Peak effectiveness should be expected after 8-20 hours (depending on individual characteristics person and the amount of insulin administered). Insulin activity in the body is reduced to zero 28 hours after administration. Deviations from these time frames reflect external and internal pathologies human body.

Subcutaneous administration allows insulin to remain for some time in adipose tissue, which promotes slow and gradual absorption into the blood.

Indications for the use of long-acting insulin

1. Having type 1 diabetes mellitus.
2. Having type 2 diabetes mellitus.
3. Immunity to oral medications to reduce the amount of glucose in the blood plasma.
4. Use as complex therapy.
5. Operations.
6. Gestational diabetes in pregnant women.

Mode of application

The amount of hormone administered is determined by the attending physician individually for each patient. You can calculate the dose yourself only after consulting a specialist and conducting laboratory tests.

Shaking insulin is prohibited. You just need to roll it in your palms before injection. This promotes the formation of a homogeneous composition and simultaneous uniform heating of the medicine from the heat of the hands.

After the injection, do not immediately remove the needle. It is necessary to leave it under the skin for a few seconds for the dose to be fully administered.

Correction is subject to the transition from insulin of animal origin to human one. The dose is selected again. Also, switching from one type of insulin to another should be accompanied by medical supervision and more frequent checking of blood sugar concentrations. If the transition has resulted in the administered dose exceeding 100 units, the patient should be sent to the hospital.

All insulin medications are administered subcutaneously, and each subsequent injection must be given in a different location. Insulin preparations cannot be mixed or diluted.

Let's calculate extended insulin

In order for the blood glucose level to remain within the 24-hour range, normal quantity, it is necessary to administer a background dose of insulin, or basal dose. Basis is insulin extended or average duration action, which is designed to maintain blood sugar without eating or on an empty stomach, as in healthy person basal secretion.

With normal functioning of pancreatic cells, a person produces 24-26 IU of insulin per day. This is approximately 1 unit per hour. This means that the final amount of insulin is the level of the basis or long-acting insulin to be entered.

If surgery, hunger, emotional and physical stress are planned, then the level of required extended-release insulin should be doubled.

Test for basal insulin

You can figure out whether the basis level is selected correctly on your own. This is the responsibility of every diabetic, since even the insulin dosage prescribed by your doctor may not be correct for your particular case. Therefore, as they say, trust, but verify, especially if it directly concerns your health and well-being.

To check, you need to choose a specific day, it is better that it is a weekend, since careful monitoring of glucose will be required. So, how can you check whether the dosage of extended-release insulin is prescribed to you?

1. You cannot eat food for 5 hours.
2. Every hour you need to measure your sugar with a glucometer.
3. During this entire time, there should be no hypoglycemia or a glucose jump of 1.5 mmol/l.
4. A decrease or increase in sugar indicates the need to adjust the basal insulin.

This test must be performed repeatedly. For example, you checked your basal insulin level in the morning, but at lunchtime or in the evening the situation with glucose changes. Therefore, choose another day to check your evening and even nighttime insulin.

You just need to remember: so that short-term insulin administered in the evening does not have an effect on blood sugar levels, the test should be carried out 6 hours after its administration (even if it is late at night).

Checkpoints

Also exist for various drugs long-acting or intermediate-acting insulin control point. If it turns out that when checking sugar at exactly these “points” it will be increased or decreased, then you should carry out the basal test described above.

With Lantus, at any time of the day, glucose should not exceed 6.5 mmol/l on an empty stomach.

Protafan NM, Humalin NPH, Insumal Bazal, Levemir. For these drugs, the monitoring point should be before dinner if the dose is administered in the morning. If the dose is administered in the evening, it should be monitored in the morning on an empty stomach. In both the first and second cases, the glucose value on an empty stomach should not exceed 6.5 mmol/l.

If you notice that there is a decrease or increase in sugar on an empty stomach, then you should not adjust the insulin dose yourself!

A basal test should be performed. And only then change the dosage or consult a doctor about it. Such surges can occur as a result of dawn syndrome or incorrect dosage of evening insulin.

Overdose Even a small increase in insulin concentration that does not meet the body's needs can lead to hypoglycemia, which, in the absence of the necessary medical intervention may lead to the death of the patient or.

severe complications In case of hypoglycemia, the patient needs to take fast carbohydrates, which a short time

will increase the amount of glucose in the blood.

Can lead to seizures, nervous disorders and even coma. In the future, medical supervision and correction of nutrition and administered doses of long-term insulin are necessary.

Lantus The drug Lantus is an analogue of human insulin. It is obtained in the laboratory from the genetic apparatus of a bacterium, coli

Lantus, like any other insulin, is prohibited from mixing with other types of insulin and, especially, with glucose-lowering drugs. Mixing will lead to incorrect and untimely absorption of insulin by the body. The most dangerous side effect of mixing will be precipitation.

Since Lantus insulin has human antibodies, its absorption and sensitivity by the body is much better than its analogues. However, in the first week you should pay more attention to the body’s reaction to this type of insulin, especially after switching from another type.

Lantus is used subcutaneous injections. Intravenous administration is unacceptable, as there is a risk of acute hypoglycemia.

Since insulin has some contraindications for use ( childhood, renal failure), accurate side effects With these limitations, it was not possible to identify them because no studies were conducted.

For pregnant and breastfeeding women, the use of long-acting insulin is possible, but under the supervision of a specialist and using aids: glucose-lowering pills, diet.

Contraindications

1. Hypoglycemia.
2. Sensitivity to the components of the drug.
3. Children under 6 years old.
4. Pregnancy.

After consulting a specialist, these contraindications may not be decisive, since the positive effect is much higher than the risks possible complications. It is only necessary to correctly calculate the dose of insulin administered.

Side effect

1. Hypoglycemia.
2. Comatose and precomatose state.
3. Redness and itching at the injection site.
4. Allergy.
5. Destruction of body lipids.

Special instructions and precautions

Extended-release insulin is not intended to treat ketoacidosis. Ketone bodies are removed from the body only with intravenous administration of short-acting insulin.

For type 1 diabetes mellitus, both long-acting and long-acting insulin are used. short acting. The prolonged one acts as a base, that is, it maintains the amount of insulin in the blood that the pancreas should produce in a normal state.

Different injection sites do not differ in the final result, that is, the concentration of the drug in the blood will be the same in any case. You just need to change the location for each subsequent injection.

When switching from medium to long insulin, you should be under the supervision of a doctor and a glucometer, since the dose of insulin administered will be adjusted and will require additional measures to lower blood sugar (pills, short-acting insulin).

To prevent hypoglycemia at night and after waking up, it is recommended to reduce the concentration of long-term insulin and increase short-term insulin during meals. Only the doctor himself must calculate the dose.

The dose of long-acting insulin is adjusted when:

• changes in nutrition;
• with increased physical activity;
• diseases of infectious nature;
• operations;
• bearing a child;
• diseases of the endocrine system;
• kidney disease (especially kidney failure);
• diabetes mellitus in elderly people (65 or more);
• with significant weight loss or weight gain;
• alcohol consumption;
• other reasons that affect the concentration of glucose in the blood.

Those who have glycosylated hemoglobin below normal should also be careful. Such people may experience hypoglycemia both during the day and at night for no apparent reason.

How to store

You need to find a place where the temperature averages from + 2°C to + 8°C. Usually these are the side shelves of the refrigerator. It is important not to allow insulin to freeze, which means that both the injections themselves and the container should not be stored in the freezer.

Keep out of reach of children.

After opening and starting to use, the storage temperature should not exceed +25 degrees. Please note that the shelf life of insulin after opening is 4 weeks.

If the expiration date has expired, use of the drug is prohibited.

You can purchase extended-release insulin only at a pharmacy and only with a doctor's prescription.

Patients with severe deficiency of their own insulin require lifelong injections of drugs containing this hormone. Short-acting insulin is used as component complex therapy for diabetes mellitus. If medicines, dosages and administration times are selected correctly, blood sugar can be normalized to long term, which allows you to avoid multiple complications of the “sweet” disease.

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Also, short-acting insulin can be used to control sugar in a patient during periods increased need in the hormone: for serious infections and injuries. When used, it may be the only drug prescribed.

Which insulins are classified as short insulins?

Short-term insulin is designed to repeat the physiological secretion of the hormone in response to an increase in blood glucose. It is usually injected half an hour before meals. During this time, it manages to be absorbed into the blood from fatty tissue and begin working to reduce sugar. The short-acting insulin molecule has the same structure as the hormone produced in the body, which is why this group of drugs is called human insulin. There are no additives in the bottle other than preservatives. Short-acting insulin is characterized by a rapid but short-lasting effect. As soon as the drug enters the bloodstream, blood sugar drops sharply, after which the hormone is destroyed.

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Diabetics inject short-acting insulin subcutaneously, from where it is absorbed into the blood. In intensive care conditions they use intravenous administration. This method allows you to quickly stop acute complications of diabetes and respond in time to the rapidly changing need for the hormone during the recovery period.

Indications for prescribing short-acting insulin

As a standard, short-acting insulin is combined with medium- and long-acting drugs: short-acting insulin is administered before meals, and long-acting insulin is administered in the morning and before bedtime. The number of hormone injections is not limited and depends only on the patient’s needs. To reduce skin damage, the standard is 3 injections before each meal and a maximum of 3 adjustments. If the sugar rises shortly before a meal, the corrective administration is combined with a scheduled injection.

When do you need short-acting insulin?

1. Type 1 diabetes.
2. Type 2 of the disease, when glucose-lowering drugs are no longer effective enough.
3. With high level glucose. For mild stage Usually 1-2 injections of long-acting insulin are sufficient.
4. Surgical interventions into the pancreas, which led to disruption of hormone synthesis.
5. Therapy acute complications diabetes: and.
6. Periods of increased need for insulin: diseases with high temperature, heart attack, organ damage, severe injuries.

Pharmacokinetics of short-acting insulin

Most the best way administration of insulin in the daily treatment of diabetes mellitus - subcutaneous. The rate and completeness of absorption in this case are most predictable, which allows you to accurately determine the required amount of the drug. The glucose-lowering effect is observed faster if the injection is given in the abdomen, a little slower in the shoulder and thigh, and even slower in the buttocks.

Short-acting insulins begin to work half an hour after administration, with maximum effectiveness occurring within 2 hours. After the peak, the effect quickly weakens. The residual effect depends on the single dose administered. If 4-6 units of the drug enter the blood, a decrease in sugar is observed within 6 hours. At a dose of more than 16 units, the effect can last up to 9 hours.

Insulin is allowed during pregnancy and breastfeeding, as it does not enter the baby’s bloodstream and breast milk.

After performing its functions, short insulin is broken down to form amino acids: 60% of the hormone is utilized in the kidneys, 40% in the liver, and a small portion unchanged ends up in the urine.

Short-acting insulin preparations

Short-acting insulin is obtained in two ways:

1. Genetically engineered, the hormone is synthesized by bacteria.
2. Semi-synthetic, using transformation with pig hormone enzymes.

Both types of the drug are called human, since their amino acid composition completely replicates the hormone that is formed in our pancreas.

Common drugs:

Short-acting insulin is released in the form of a solution with a concentration of 100, less often 40 units per milliliter. For administration using a syringe, the drug is packaged in glass bottles with a rubber stopper, for use in syringe pens - in cartridges.

Ultra-short insulin

Compared to the hormone that is synthesized in the body, short-acting insulin is characterized by more late start And longer duration actions. To eliminate these shortcomings, ultra-short-acting drugs were created. The molecule of these insulins is modified; it differs from human ones in the arrangement of amino acids.

Advantages of ultra-rapid insulin:

• rapid hypoglycemic effect.
• administration immediately before meals.
• Can be used immediately after meals. This is especially important in the treatment of childhood diabetes, since it is not known in advance whether the child will handle the entire portion.
• facilitating normalization of glycemia in non-standard situations.
• opportunity to increase the amount in the diet fast carbohydrates without compromising diabetes compensation.
• reducing the likelihood of hypoglycemia.
• best sugar levels after meals.

Patients with decompensated diabetes and a tendency to nocturnal diabetes are transferred to ultra-short insulin. It is also recommended for young children with changing appetites and adolescents during active periods. hormonal changes.

Names of ultra-short-acting insulin:

Methods for calculating short-acting insulin

The amount of short-acting insulin needed to reduce sugar to normal after a meal depends on the carbohydrate content of the dish. For convenience of calculation, the concept “ grain unit" This is equal to 12 g of carbohydrates or approximately 1 slice of bread. The dose of insulin to compensate for one XE is individual. It also changes throughout the day. In the morning the need is highest: for 1 XE - 1.5-2.5 units of the drug. During the day and evening it decreases and amounts to 1-1.3 units. The exact coefficients for a particular patient can only be selected experimentally.

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Calculation example: during breakfast it is planned to eat 200 g of porridge, which will require 40 g oatmeal and a ham sandwich, a slice of bread weighs 25 g. The patient’s morning insulin ratio per 1 XE is 2 units. In 100 g of flakes - 60 g of carbohydrates, in 40 - 24 g = 2 XE. In 100 g of bread there are 50 g of carbohydrates, in 25 - 12.5 g = 1 XE. Ham contains practically no carbohydrates, so we do not take it into account. To normalize sugar you will need 3 XE*2=6 units of the drug.

The above calculation allows you to compensate only for the increase in glycemia after eating food. If sugar before meals is higher than normal, the dose of short-acting insulin needs to be increased. It is believed that to reduce sugar by 2 mmol/l, 1 additional unit of the hormone is needed.

Calculation example: To compensate for breakfast you need 6 units. drug. Glycemia before meals is 9 mmol/l, normal is 6 mmol/l. You need to enter (9-6)/2=1.5 additional units of insulin, 7.5 units in total.

For more accurate calculation For a corrective dose, Forsham's formula can be used. To convert mmol/l to mg% they need to be multiplied by 18.

Daily dose of insulin

The maximum permitted daily dose of insulin has not been established. Main criteria proper treatment diabetes – normal sugar on an empty stomach and glycated hemoglobin, and not the amount of hormone required for this.

If insulin requirements significantly exceed average level, this indicates insulin resistance. You can overcome it with the help medicines, which are prescribed by an endocrinologist.

The share of short-acting insulin in total number of the drug is 8-50% depending on the chosen treatment regimen. In insulin pump therapy, only short and ultra-short insulin is used.

How to administer short-acting insulin

How to inject insulin —

How to give the injection correctly (instructions):

1. Select the injection site. The stomach is most often used, no closer than 3 cm from the navel.
2. Remove the bottle and disposable syringe from the packaging.
3. Pierce the rubber cap of the bottle and draw the pre-calculated dose of the drug into the syringe.
4. Press the rod to remove all air from the syringe.
5. Gather the skin at the insertion site into the fold so that only skin and subcutaneous fat are included. The muscles should not be affected.
6. Insert a needle into the fold and inject all the insulin.
7. Without removing the needle or removing the fold, wait a few seconds.
8. Slowly remove the needle, then release the skin.

The distance from the previous injection site should not be less than 2 cm. Neither the skin nor the needle is treated with alcohol, as it can significantly weaken the effect of insulin.

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In pharmacological science, insulins are called special steroid drugs, making it possible to regulate the number of glucose molecules in the patient’s blood. IN modern world in the field of pharmaceutical production it is produced a large number of various insulin agents. The most common are short and long insulin. Their main differences include: the type of characteristics of the raw materials from which this product is produced, the methods of producing the substance and the duration of action. Today, short-acting insulin is the most popular.

The duration of its effect is up to 8 hours. This remedy is intended to quickly stop peaks in food intake, as well as - combination therapy primary diabetes mellitus.

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

People who are faced with primary diabetes mellitus for the first time are naturally interested in the following questions: how to choose the correct insulin and which insulin is best for administration? These points are very serious, since it is from correct selection hormone and the calculation of its dose depends future life and patient health.

For any insulin-dependent diabetic, using the correct dose is vital. insulin drug.

It should be noted that quality selection correct dosage hormone appropriate for a particular patient is only possible in a hospital setting.

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

1. It is necessary to check the number of sugar molecules in the blood several times a day. The following indicators are considered normal: on an empty stomach – 5-6 mmol/l and after a couple of hours after eating – 8 mmol/l. The maximum deviation from the last indicator is an excess of 3 mmol/l.
2. It is necessary to select this hormone taking into account the time of day, the amount of carbohydrate compounds consumed, and the patient’s level of mobility before and after eating.
3. Additionally, you should pay attention to the patient’s weight, the presence of other acute or chronic course, time and form of use of other medications. These indicators are of particular importance at the time of prescribing a constant course of injections of a long-acting insulin drug. The reason for this is that the injections do not depend on the time of food intake, since its use creates a constant supply of this hormone in the patient’s blood serum.
4. Very important point When choosing a good dosage of a medicine, keep a special diary. In such a diary, indicators of the content of glucose molecules in the patient’s blood, the approximate number of carbohydrate units consumed during meals and the dose of a short-acting insulin drug are entered. The analysis is usually done on an empty stomach. Often, the amount of injected drug and consumed carbohydrate units is in a ratio of 2 to 1. If the number of glucose molecules in the blood exceeds the permissible level, an additional injection of a short drug must be made.
5. The process of selecting an insulin dose begins with night injections. When the hormone is administered in the amount of 10 units, immediately before going to bed, provided that this dose is appropriate, the blood glucose level in the morning will not exceed 7 mmol/l. When, after the first dose injection, the patient experiences excessive sweating, appetite increases, it is necessary to reduce the nightly dose by a couple of units. The balance between insulin doses administered day and night should be 2:1.

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

What insulin is best to use?

For determining the best insulin for a particular patient it is necessary to select basal preparation. In order to simulate basal production, long-term insulin preparations are often used. Currently, the pharmaceutical industry produces two types of insulin:

• average duration working until 17:00. Such drugs include Biosulin, Insuman, Gensulin, Protafan, Humulin.
• ultra-long duration, their effect is up to 30 hours. These are: Levemir, Tresiba, Lantus.

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

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

The dosage of a long-acting insulin drug should be selected so that the drug can keep the glucose concentration between meals within acceptable limits.

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

The first injections of long-term insulin are carried out at night with sugar measurements taken every 3 hours. If there is a significant change in glucose levels, the dosage is adjusted. To identify the cause of the nocturnal increase in glucose, it is necessary to study the time period between 00.00 and 03.00. If the indicators decrease, the dose of insulin at night must be reduced.

The most accurate determination of the required volume of basal insulin is possible in the complete absence of glucose and short-term insulin in the blood. Therefore, when assessing nighttime insulin, it is necessary to avoid dinner.

To get a more informative picture, you should not use short-acting insulin, and you should not eat protein or fatty foods.

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

Almost all long-acting insulins are administered once every 12 hours. Only Lantus does not lose its influence throughout the day.

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

Such dosage checks must be carried out each time they are changed. To understand how sugar behaves over time, just three-day tests are enough. And only based on the results obtained, the doctor is able to prescribe a clear dosage of a particular drug.

For the purpose of assessing the basic hormone in daytime and identification the best drug, you must wait five hours from the moment you consumed the previous meal. Diabetics using short-acting insulin are required to withstand a period of 6 hours. The group of short insulins is represented by Gensulin, Humulin, Actrapid. Ultra-short insulins include: Novorapid, Apidra, Humalog. The ultra-short hormone has the same effect as the short one, but most of the disadvantages are removed. At the same time, this remedy is not able to satisfy the body's need for insulin.

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

In pharmacological science, insulins are special steroid drugs that make it possible to regulate the number of glucose molecules in the patient’s blood. In the modern world, a large number of different insulin products are produced in the field of pharmacological production. The most common are short and long insulin. Their main differences include: the type of characteristics of the raw materials from which this product is produced, the methods of producing the substance and the duration of action. Today, short-acting insulin is the most popular.

The duration of its effect is up to 8 hours. This remedy is intended to quickly stop peaks in food intake, as well as combination therapy for primary diabetes mellitus.

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

People who are faced with primary diabetes mellitus for the first time are naturally interested in the following questions: how to choose the right insulin and which insulin is best for administration? These points are very serious, since the patient’s future life and health depend on the correct selection of the hormone and calculation of its dose.

Clinical picture

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Selecting the best insulin drug

For any insulin-dependent diabetic, using the correct dose of insulin is vital.

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

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

• It is necessary to check the number of sugar molecules in the blood several times a day. The following indicators are considered normal: on an empty stomach – 5-6 mmol/l and after a couple of hours after eating – 8 mmol/l. The maximum deviation from the last indicator is an excess of 3 mmol/l.
• It is necessary to select this hormone taking into account the time of day, the amount of carbohydrate compounds consumed, and the patient’s level of mobility before and after eating.
• Additionally, you should pay attention to the patient’s weight, the presence of other acute or chronic diseases, the time and form of use of other medications. These indicators are of particular importance at the time of prescribing a constant course of injections of a long-acting insulin drug. The reason for this is that the injections do not depend on the time of food intake, since its use creates a constant supply of this hormone in the patient’s blood serum.
• A very important point when choosing a good dosage of a medicine is keeping a special diary. In such a diary, indicators of the content of glucose molecules in the patient’s blood, the approximate number of carbohydrate units consumed during meals and the dose of a short-acting insulin drug are entered. The analysis is usually done on an empty stomach. Often, the amount of injected drug and consumed carbohydrate units is in a ratio of 2 to 1. If the number of glucose molecules in the blood exceeds the permissible level, an additional injection of a short drug must be made.
• The process of selecting an insulin dose begins with night injections. When the hormone is administered in the amount of 10 units, immediately before going to bed, provided that this dose is appropriate, the blood glucose level in the morning will not exceed 7 mmol/l. When, after the injection of the first dose, the patient experiences excessive sweating and increased appetite, it is necessary to reduce the nightly dose by a couple of units. The balance between insulin doses administered day and night should be 2:1.

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

What insulin is best to use?

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According to WHO, every year 2 million people die from diabetes and its complications around the world. In the absence of qualified support for the body, diabetes leads to various kinds complications, gradually destroying the human body.

The most common complications are: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can also lead to the development cancerous tumors. In almost all cases, a diabetic either dies fighting a painful disease or becomes a real disabled person.

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To determine the best insulin for a particular patient, it is necessary to select a basal drug. In order to simulate basal production, long-term insulin preparations are often used. Currently, the pharmaceutical industry produces two types of insulin:

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

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

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

The dosage of a long-acting insulin drug should be selected so that the drug can keep the glucose concentration between meals within acceptable limits.

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

Our readers write

Subject: Conquered diabetes

From: Lyudmila S ( [email protected])

To: Administration my-diabet.ru

At the age of 47, I was diagnosed with type 2 diabetes. In a few weeks I gained almost 15 kg. Constant fatigue, drowsiness, feeling of weakness, vision began to fade. When I turned 66, I was already steadily injecting myself with insulin, everything was very bad...

And here is my story

The disease continued to develop, periodic attacks began, and the ambulance literally brought me back from the other world. I always thought that this time would be the last...

Everything changed when my daughter gave me an article to read on the Internet. You can’t imagine how grateful I am to her for this. This article helped me completely get rid of diabetes, supposedly incurable disease. Over the last 2 years I have started to move more, in the spring and summer I go to the dacha every day, my husband and I drive active image life, we travel a lot. Everyone is surprised how I manage to do everything, where so much strength and energy comes from, they still can’t believe that I’m 66 years old.

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

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The first injections of long-term insulin are carried out at night with sugar measurements taken every 3 hours. If there is a significant change in glucose levels, the dosage is adjusted. To identify the cause of the nocturnal increase in glucose, it is necessary to study the time period between 00.00 and 03.00. If the indicators decrease, the dose of insulin at night must be reduced.

The most accurate determination of the required volume of basal insulin is possible in the complete absence of glucose and short-term insulin in the blood. Therefore, when assessing nighttime insulin, it is necessary to avoid dinner.

To get a more informative picture, you should not use short-acting insulin, and you should not eat protein or fatty foods.

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

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

Such dosage checks must be carried out each time they are changed. To understand how sugar behaves over time, just three-day tests are enough. And only based on the results obtained, the doctor is able to prescribe a clear dosage of a particular drug.

In order to assess the basic hormone in the daytime and identify the best drug, it is necessary to wait five hours from the moment of absorption of the previous meal. Diabetics using short-acting insulin are required to withstand a period of 6 hours. The group of short insulins is represented by Gensulin, Humulin, Actrapid. Ultra-short insulins include: Novorapid, Apidra, Humalog. The ultra-short hormone has the same effect as the short one, but most of the disadvantages are removed. At the same time, this remedy is not able to satisfy the body's need for insulin.

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

Drawing conclusions

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

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

If all drugs were given, it was only a temporary result; as soon as the use was stopped, the disease sharply intensified.

The only drug that gave significant result- this is Difort.

At the moment, this is the only drug that can completely cure diabetes. Especially strong effect Difort pointed to early stages development of diabetes mellitus.

We made a request to the Ministry of Health:

And for readers of our site there is now an opportunity
receive Difort FOR FREE!

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