Human insulin: what is it obtained from for diabetics. Human insulin injection neutral (human insulin injection neutral)

Insulin is vital drug, he made a real revolution in the lives of many people suffering from diabetes.

In the entire history of medicine and pharmacy of the 20th century, perhaps only one group of medicines of the same importance can be distinguished - these are antibiotics. They, like insulin, very quickly entered medicine and helped save many lives.

The Day of the fight against diabetes is celebrated at the initiative of the World Health Organization every year since 1991 on the birthday of the Canadian physiologist F. Banting, who discovered the hormone insulin together with J. J. Macleod. Let's take a look at how this hormone is made.

How do insulin preparations differ from each other?

1. The degree of purification.
2. The source of receipt is porcine, bovine, human insulin.
3. Additional components included in the solution of the drug - preservatives, prolongers of action and others.
4. Concentration.
5. solution pH.
6. Possibility of mixing short and long-acting preparations.

Insulin is a hormone produced by special cells in the pancreas. It is a double-stranded protein with 51 amino acids.

About 6 billion units of insulin are used annually in the world (1 unit is 42 micrograms of a substance). The production of insulin is high-tech and is carried out only by industrial methods.

Sources of insulin

Currently, depending on the source of production, porcine insulin and human insulin preparations are isolated.

Pork insulin now has a very high degree of purification, has a good hypoglycemic effect, and there are practically no allergic reactions to it.

Human insulin preparations fully comply with chemical structure human hormone. They are usually produced by biosynthesis using genetic engineering technologies.

Large manufacturing firms use such production methods that guarantee that their products meet all quality standards. Big differences in the action of human and porcine monocomponent insulin (that is, highly purified) have not been identified, in relation to immune system, according to many studies, the difference is minimal.

Auxiliary components used in the production of insulin

The drug vial contains a solution containing not only the hormone insulin itself, but also other compounds. Each of them plays a specific role:

• prolongation of the action of the drug;
• solution disinfection;
• the presence of buffer properties of the solution and maintaining a neutral pH (acid-base balance).

Extending the action of insulin

To create long-acting insulin, one of two compounds, zinc or protamine, is added to a solution of regular insulin. Depending on this, all insulins can be divided into two groups:

• protamine-insulins - protafan, insuman basal, NPH, humulin N;
• zinc-insulins - insulin-zinc-suspensions mono-tard, tape, humulin-zinc.

Protamine is a protein, but allergic reactions to it are very rare.

To create a neutral environment for the solution, a phosphate buffer is added to it. It must be remembered that insulin containing phosphates is strictly forbidden to combine with insulin-zinc suspension (ICS), since zinc phosphate precipitates, and the effect of zinc-insulin is shortened in the most unpredictable way.

Disinfectants

Some of the compounds that, according to pharmaco-technological criteria, should already be introduced into the preparation have a disinfecting effect. These include cresol and phenol (both of which have a specific odor), as well as methyl parabenzoate (methylparaben), which has no odor.

The introduction of any of these preservatives causes the specific smell of some insulin preparations. All preservatives in the amount in which they are in insulin preparations do not have any negative effect.

Protamine insulins usually include cresol or phenol. Phenol cannot be added to ICS solutions, because it changes physical properties hormone particles. These drugs include methylparaben. Zinc ions in solution also have an antimicrobial effect.

Thanks to this multi-stage antibacterial protection with the help of preservatives, the development of possible complications, the cause of which could be bacterial contamination with repeated insertion of the needle into the vial with the solution.

Due to the presence of such a protection mechanism, the patient can use for subcutaneous injection the same syringe for 5 to 7 days (provided that only he uses the syringe). Moreover, preservatives make it possible not to use alcohol to treat the skin before injection, but again only if the patient injects himself with a syringe with a thin needle (insulin).

Calibration of insulin syringes

In the first preparations of insulin, one ml of the solution contained only one unit of the hormone. Later the concentration was increased. Most of insulin preparations in vials used in Russia, contains 40 units in 1 ml of solution. The vials are usually marked with the symbol U-40 or 40 units / ml.

They are intended for wide use just for such insulin and their calibration is made according to following principle: when typing 0.5 ml of a solution with a syringe, a person gains 20 units, 0.35 ml corresponds to 10 units, and so on.

Each mark on the syringe is equal to a certain volume, and the patient already knows how many units this volume contains. Thus, the calibration of syringes is a graduation in terms of the volume of the drug, calculated on the use of U-40 insulin. 4 units of insulin are contained in 0.1 ml, 6 units in 0.15 ml of the drug, and so on up to 40 units, which correspond to 1 ml of solution.

In some countries, insulin is used, 1 ml of which contains 100 units (U-100). For such drugs, special insulin syringes are produced that are similar to those discussed above, but they have a different calibration.

It takes into account exactly this concentration (it is 2.5 times higher than the standard one). In this case, the dose of insulin for the patient, of course, remains the same, since it satisfies the body's need for a specific amount of insulin.

That is, if the patient previously used the U-40 preparation and injected 40 units of the hormone per day, then he should receive the same 40 units with injections of U-100 insulin, but inject it in an amount 2.5 times less. That is, the same 40 units will be contained in 0.4 ml of the solution.

Unfortunately, not all doctors, let alone diabetic patients, know about this. The first difficulties began when some of the patients switched to the use of insulin injectors (pen-syringes), which use penfills (special cartridges) containing U-40 insulin.

If you draw a solution labeled U-100 into such a syringe, for example, up to the mark of 20 units (that is, 0.5 ml), then this volume will contain as many as 50 units of the drug.

Every time you fill up with U-100 insulin conventional syringes and while looking at the cut-off units, a person will gain a dose 2.5 times greater than that shown at the level of this mark. If neither the doctor nor the patient notices this error in a timely manner, then there is a high probability of developing severe hypoglycemia due to a constant overdose of the drug, which often happens in practice.

On the other hand, sometimes there are insulin syringes calibrated specifically for the U-100 preparation. If such a syringe is mistakenly filled with the usual U-40 solution, then the dose of insulin in the syringe will be 2.5 times less than that written near the corresponding mark on the syringe.

As a result of this, a seemingly inexplicable increase in blood glucose is possible. In fact, of course, everything is quite logical - for each concentration of the drug, you must use a suitable syringe.

In some countries, such as Switzerland, there has been an elaborate plan to make a smart transition to U-100-labeled insulin preparations. But this requires close contact of all stakeholders: doctors of many specialties, patients, nurses from any department, pharmacists, manufacturers, authorities.

In our country, it is very difficult to implement the transition of all patients to only the use of U-100 insulin, because, most likely, this will lead to an increase in the number of errors in dose determination.

Combined use of short-acting and extended-acting insulins

AT modern medicine treatment of diabetes mellitus, especially type 1, usually occurs using a combination of two types of insulin - short-acting and long-acting.

It would be much more convenient for patients if drugs with different durations of action could be combined in the same syringe and administered simultaneously to avoid double skin puncture.

Many doctors do not know what determines the possibility of mixing different insulins. This is based on the chemical and galenic (compositionally determined) compatibility of long-acting and extended-release insulins. short action.

It is very important that when the two types of preparations are mixed, the rapid onset of action of short-acting insulin does not stretch or disappear.

It has been proven that a short-acting preparation can be combined in one injection with protamine-insulin, while the onset of short-acting insulin is not delayed, because soluble insulin does not bind to protamine.

In this case, the manufacturer of the drug does not matter. For example, it can be combined with humulin H or protafan. Moreover, mixtures of these preparations can be stored.

With regard to zinc-insulin preparations, it has long been established that insulin-zinc suspension (crystalline) cannot be combined with short insulin, as it binds to an excess of zinc ions and transforms into prolonged insulin, sometimes partially.

Some patients first inject a short-acting drug, then, without removing the needle from under the skin, slightly change its direction, and inject zinc-insulin through it.

Very little has been done with this method of administration. scientific research therefore, it cannot be ruled out that in some cases, with this method of injection, a complex of zinc-insulin and a short-acting preparation can form under the skin, which leads to a violation of the absorption of the latter.

Therefore, it is better to administer short insulin completely separately from zinc insulin, to make two separate injections into skin areas that are at least 1 cm apart from each other. This is not convenient, which cannot be said about the standard intake.

Combined insulins

Now the pharmaceutical industry produces combined preparations containing short-acting insulin together with protamine-insulin in a strictly defined percentage. These drugs include:

• mixtard,
• actrafan,
• insuman comb.

The most effective are combinations in which the ratio of short and extended insulin is 30:70 or 25:75. This ratio is always indicated in the instructions for use of each specific drug.

Such drugs are best suited for people who observe constant mode meals with regular motor activity. For example, they are often used by elderly patients with type 2 diabetes.

Combination insulins are not suitable for so-called "flexible" insulin therapy, when it becomes necessary to constantly change the dosage of short-acting insulin.

For example, this should be done when changing the amount of carbohydrates in food, reducing or increasing physical activity, etc. At the same time, the dose of basal insulin (prolonged) remains practically unchanged.

The human pancreas, due to various reasons, often cannot produce insulin. Then you need to use gene engineering insulin which replaces human insulin.

The human form of insulin is obtained either by synthesis coli, or from porcine insulin by replacing one amino acid.

To imitate normal work human pancreas, produce insulin injections. The type of insulin is chosen based on the type of disease and the patient's well-being. Insulin can be administered intravenously or intramuscularly. For lifelong and long-term therapy, subcutaneous injections are most often used.

Features of insulin

Insulin-dependent diabetes mellitus requires lifelong treatment. Human life depends on the availability of insulin. The disease is recognized as a non-communicable epidemic and ranks third in terms of distribution in the world.

Insulin was first created from the pancreas of a dog. A year later, the drug was introduced into widespread use. After 40 years, it became possible to synthesize the hormone chemically.

Some time later, types of insulin were invented with a high degree cleaning. Work is also underway to synthesize human insulin. Since 1983, this hormone began to be produced on an industrial scale.

Previously, diabetes was treated with drugs created from animals. These drugs are now banned. In pharmacies, only genetic engineering products can be purchased; the creation of these drugs is based on the transplantation of a gene product into a cell of a microorganism.

For these purposes, yeast or a non-pathogenic type of E. coli bacteria are used. As a result, microorganisms begin to produce the hormone insulin for humans.

The modern insulin preparation is different:

• exposure time, there are short, ultrashort and long-acting,
• amino acid sequence.

There are also combined preparations, which are called "mixes". These drugs include long-acting and short-acting insulin.

Receiving insulin may be indicated for diagnoses such as:

1. Lactic acid, diabetic and hypermolar coma,
2. Insulin type 1 diabetes mellitus,
3. For infections, surgical interventions exacerbations of chronic diseases,
4. Diabetic nephropathy and / or abnormal liver function, pregnancy and childbirth,
5. Non-insulin dependent type 2 diabetes mellitus with resistance to antidiabetic oral agents,
6. Dystrophic skin lesions
7. Severe asthenization in various pathologies,
8. Prolonged infectious process.

Duration of insulin action

Sugar level

According to the duration and mechanism of action, insulins are distinguished:

1. ultrashort,
2. short,
3. medium duration,
4. prolonged action.

Ultrashort insulins act immediately after injection. Maximum effect reached in an hour and a half.

The duration of action reaches 4 hours. This type of insulin can be administered either before a meal or immediately after a meal. Receiving this insulin does not require pauses between injection and meals.

Ultrashort insulin does not require additional use food at the peak of action, which is more convenient compared to other types. These insulins include:

• Apidra,
• Humalog.

Short insulins begin to act after half an hour. The peak of action begins after 3 hours. The action lasts approximately 5 hours. This type of insulin is administered before meals, you need to pause between the injection and the meal. Eating is allowed after 15 minutes.

Using short-acting insulin, you need to have a snack a few hours after the injection. The time of eating should coincide with the time of peak action of the hormone. Short insulins are:

1. Himulin Regular,
2. Actrapid,
3. Monodar (K50, K30, K15),
4. Insuman Rapid,
5. Humodar and others.

Intermediate-duration insulins are drugs that last 12-16 hours. In type 1 diabetes, human insulin is used as background or basal insulin. Sometimes you need to do injections 2 or 3 times a day in the morning and evening time with a break of 12 hours.

Such insulin begins to work after 1-3 hours, reaching a peak after 4-8 hours. Duration is 12-16 hours. Intermediate drugs include:

• Humodar br,
• Protafan,
• Humulin NPH,
• Novomix.
• Insuman Bazal.

Long-acting insulins are background or basal insulin. A person may need one or two injections per day. They are used in the treatment of type 2 diabetes.

The drugs have a cumulative effect. The effect of the dosage is maximally manifested after 2-3 days. Long-acting insulins work 4-6 hours after injection. Their peak of action occurs in 11-14 hours, the action itself lasts about a day.

Among these drugs there are insulins that do not have a peak of action. Such funds act gently and for the most part imitate the effect natural hormone in a healthy person.

These insulins include:

1. lantus,
2. Monodar Long,
3. Monodar ultralong,
4. ultralente,
5. ultralong,
6. Humulin L and others,
7. lantus,
8. Levemir.

Side effects and dosage violations

With an overdose of insulin preparations, a person may experience:

• Weakness,
• Cold sweat,
• Pallor,
• Shiver,
• frequent heartbeat,
• Headache,
• Hunger,
• Seizures.

All of the above are considered symptoms of hypoglycemia. If the condition has just begun to form and is in the early stages, you can remove the symptoms yourself. For these purposes, take products with sugar and large quantity easily digestible carbohydrates.

You can also inject a solution of dextrose and glucagon into the body. If the patient has fallen into a coma, a modified dextrose solution should be administered. It is used until the condition improves.

Some patients may develop allergies to insulin. Among the main symptoms:

1. Prostration,
2. puffiness,
3. Hives,
4. Rash,
5. Fever,
6. decline blood pressure.

Hyperglycemia occurs due to low dosages or with the development infectious disease, as well as non-compliance with the diet. Sometimes a person develops lipodystrophy where the drug is injected.

When using the drug may also occur on a temporary basis:

• puffiness,
• Drowsiness,
• Loss of appetite.

Getting a hormone replacement instead of human insulin is excellent remedy in the treatment of diabetes mellitus. The substance helps to reduce the level of glucose in the blood, due to the fact that glucose is better absorbed by cells, the process of its transportation changes. These drugs replace human insulin, but should only be taken as directed by a doctor as they may negative consequences for good health.

Important instructions for use

Women with diabetes should inform their doctor about planning or pregnancy. This category of women often requires a change in dosage during lactation, as well as dietary nutrition.

Investigating the toxicity of insulin preparations, scientists have not found a mutagenic effect.

It is worth noting that the need for the hormone may decrease if a person has kidney failure. Switching a person to a different type of insulin or to a drug with a different brand name is possible only under close medical supervision.

The dosage must be adjusted if the activity of insulin, its type or species is changed. The need for insulin may decrease with the following diseases:

1. Insufficient function of the adrenal glands, thyroid gland or pituitary gland
2. Liver and kidney failure.

With emotional stress or certain diseases, the need for insulin increases. Dosage adjustment is also required when increasing physical activity.

Symptoms of hypoglycemia, if human insulin is administered, may be less pronounced, or different from that which was with the introduction of insulin of animal origin.

When blood sugar levels are normalized, for example, as a result of intensive treatment with insulin, all or some of the manifestations of hypoglycemia may disappear, of which people should be informed.

Harbingers of hypoglycemia may change or be mild with long-term treatment diabetes or when using beta-blockers.

A local allergic reaction may be caused by causes that are not related to the action of the drug, such as skin irritation chemicals or improper injection.

In some cases, the formation of a permanent allergic reaction requires immediate therapy. Desensitization or an insulin change may also be required.

With hypoglycemia in a person, the concentration of attention and the speed of the psychomotor reaction may decrease. This can be dangerous in cases where these functions are vital. An example is driving a car or various mechanisms.

This is extremely important for people who have unexpressed symptoms that are a harbinger of hypoglycemia. In these cases, the attending physician needs to assess the need for autodriving by the patient. The video in this article will talk about the types of insulin.

Sugar level

Recent discussions.

Ideal hormonal level is the basis for full development human body. One of the key hormones in the human body is insulin. Its deficiency or excess leads to negative consequences. Diabetes mellitus and hypoglycemia are the two extremes that become constant unpleasant companions of the human body, ignoring information about what insulin is and what its level should be.

The hormone insulin

The honor of creating the first works that paved the way for the discovery of the hormone belongs to the Russian scientist Leonid Sobolev, who in 1900 proposed using the pancreas to produce an antidiabetic drug and gave the concept of what insulin is. More than 20 years were spent on further research, and after 1923, industrial production of insulin began. Today, the hormone is well studied by science. He takes part in the processes of splitting carbohydrates, being responsible for the metabolism and synthesis of fats.

Which organ produces insulin

The insulin-producing organ is the pancreas, where conglomerates of B-cells, known scientific world known as the islets of Lawrence or pancreatic islets. The specific mass of cells is small and amounts to only 3% of the total mass of the pancreas. Insulin is produced by beta cells, the proinsulin subtype is isolated from the hormone.

What is the insulin subtype is not fully known. The hormone itself, before taking the final form, enters the Golgi cell complex, where it is refined to the state of a full-fledged hormone. The process is completed when the hormone is placed in special granules of the pancreas, where it is stored until a person eats. The resource of B-cells is limited and quickly depleted when a person abuses simple carbohydrate foods, which is the cause of the development of diabetes mellitus.

Action

What is the hormone insulin? This is the most important regulator of metabolism. Without it, the glucose that enters the body with food will not be able to enter the cell. The hormone increases permeability cell membranes resulting in glucose being absorbed into the cell body. At the same time, the hormone promotes the conversion of glucose into glycogen, a polysaccharide that contains a store of energy that is used by the human body as needed.

Functions

The functions of insulin are diverse. It ensures the work of muscle cells, affecting the processes of protein and fat metabolism. The hormone plays the role of an informant of the brain, which, according to the receptors, determines the need for fast carbohydrates: if there is a lot of it, the brain concludes that the cells are starving and it is necessary to create reserves. The effect of insulin on the body:

1. Prevents the breakdown of essential amino acids simple sugars.
2. Improves protein synthesis - the basis of life.
3. Does not allow proteins in the muscles to break down, prevents muscle atrophy - anabolic effect.
4. Limits the accumulation of ketone bodies, an excessive amount of which is deadly to humans.
5. Promotes the transport of potassium and magnesium ions.

The role of insulin in the human body

The deficiency of the hormone is associated with a disease called diabetes mellitus. Those suffering from this disease are forced to regularly inject additional insulin doses into the blood. The other extreme is an excess of the hormone, hypoglycemia. This disease leads to an increase in blood pressure and a decrease in the elasticity of blood vessels. It enhances the increase in insulin secretion, the hormone glucagon, produced by the alpha cells of the islets of Langerhans of the pancreas.

Insulin dependent tissues

Insulin stimulates the production of protein in the muscles, without which muscle unable to develop. The formation of adipose tissue, which normally performs vital important features, impossible without a hormone. Patients who develop diabetes face ketoacidosis, a form of metabolic disorder in which shock intracellular starvation occurs.

blood insulin level

The functions of insulin include maintaining the required amount of glucose in the blood, regulating the metabolism of fats and proteins, transforming nutrients before muscle mass. At normal level substances, the following occurs:

• protein synthesis for building muscles;
• the balance of metabolism and catabolism is maintained;
• stimulates the synthesis of glycogen, which increases endurance and regeneration muscle cells;
• amino acids, glucose, potassium enter the cells.

Norm

Insulin concentration is measured in mcU / ml (0.04082 mg is taken per unit crystalline substance). Healthy people have an indicator equal to 3-25 such units. For children, a decrease to 3-20 mcU / ml is allowed. In pregnant women, the norm is different - 6-27 mcU / ml, in older people over 60 years old, this figure is 6-35. A change in the norm indicates the presence serious illnesses.

elevated

Long-term excess normal indicators insulin threatens with irreversible pathological changes. This condition occurs due to a drop in sugar levels. You can understand the excess of insulin concentration by signs: trembling, sweating, heart palpitations, sudden attacks hunger, nausea, fainting, coma. The following indicators affect the increase in hormone levels:

• intense physical activity;
• chronic stress;
• diseases of the liver and pancreas;
• obesity;
• violation of cell resistance to carbohydrates;
• polycystic ovaries;
• malfunction of the pituitary gland;
• cancer and benign tumors adrenal glands.

Reduced

A decrease in insulin concentration occurs due to stress, intense physical exertion, nervous exhaustion, daily consumption a large number refined carbohydrates. Lack of insulin blocks the flow of glucose, increasing its concentration. As a result, there is a strong thirst, anxiety, sudden attacks of hunger, irritability, frequent urination. Because of similar symptoms low and high insulin diagnosis is carried out special studies.

What is insulin for diabetics made of?

The issue of raw materials for the manufacture of the hormone worries many patients. Insulin in the human body is produced by the pancreas, and artificially obtained the following types:

1. Pork or bovine - animal origin. The pancreas of animals is used for production. In the preparation of pork raw materials, there is proinsulin, which cannot be separated, it becomes a source of allergic reactions.
2. Biosynthetic or porcine modified - a semi-synthetic drug is obtained by replacing amino acids. Among the advantages are compatibility with the human body and the absence of allergies. Disadvantages - shortage of raw materials, complexity of work, high cost.
3. Genetically engineered recombinant - otherwise called "human insulin", because it is completely identical to the natural hormone. The substance is produced by enzymes of yeast strains and genetically modified Escherichia coli.

Instructions for use of insulin

The functions of insulin are very important for the human body. If you are a diabetic, you have a doctor's referral and a prescription for free medicines at pharmacies or hospitals. When urgent need it can be bought without a prescription, but the dosage must be observed. To avoid overdose, read the instructions for use of insulin.

Indications for use

According to the instructions enclosed in each package of insulin preparation, indications for its use are type 1 diabetes mellitus (it is also called insulin-dependent) and in some cases type 2 diabetes mellitus (non-insulin dependent). These factors include intolerance to oral hypoglycemic agents, the development of ketosis.

Insulin administration

The doctor prescribes the medication after diagnosis and blood tests. Drugs used to treat diabetes different duration action: short and long. The choice depends on the severity of the course of the disease, the condition of the patient, the speed of the onset of action of the remedy:

1. The short-acting drug is intended for subcutaneous, intravenous or intramuscular injection. It is characterized by a quick short-term sugar-lowering effect, it is administered 15-20 minutes before meals several times / day. The effect occurs in half an hour, a maximum of two hours, in total it lasts about six hours.
2. Long or prolonged action - has an effect lasting 10-36 hours, allows you to reduce daily amount injections. Suspensions are administered intramuscularly or subcutaneously, but not intravenously.

Syringes are used to facilitate administration and dosage compliance. One division corresponds to a certain number of units. Rules for insulin therapy:

• store the drugs in the refrigerator, and the started ones at room temperature, warm the product before entering, because the cool one is weaker;
• it is better to inject a short-acting hormone under the skin of the abdomen - introduced into the thigh or above the buttock acts more slowly, even worse - into the shoulder;
• a long-acting drug is injected into the left or right thigh;
• do each injection in a different zone;
• with insulin injections, capture the entire area of ​​\u200b\u200bthe body part - this way you can avoid soreness and seals;
• retreat at least 2 cm from the place of the last injection;
• do not treat the skin with alcohol, it destroys insulin;
• if the liquid flows out, the needle was inserted incorrectly - you need to hold it at an angle of 45-60 degrees.

Side effects

With subcutaneous administration of drugs, lipodystrophy may develop at the injection site. Very rarely, but there are allergic reactions. If they occur, it is required symptomatic therapy and replacement tool. Contraindications for admission are:

• acute hepatitis, cirrhosis of the liver, jaundice, pancreatitis;
• nephritis, urolithiasis disease;
• decompensated heart disease.

The price of insulin

The cost of insulin depends on the type of manufacturer, the type of drug (short/long duration of action, starting material) and the volume of packaging. The price of 50 ml of Insulinum is approximately 150 rubles in Moscow and St. Petersburg. Insuman with a syringe pen - 1200, Protafan suspension has a price of about 930 rubles. How much insulin costs is also affected by the level of the pharmacy.

Video

The role of insulin in the body cannot be overestimated. Any degree of lack of insulin is fraught with serious endocrine disease- diabetes mellitus. Even 40 years ago, diabetics lived no more than 10-15 years.

Modern medicine uses soluble human genetically engineered insulin to normalize blood glucose levels. Thanks to this drug, diabetes has ceased to be a sentence, giving patients a chance for a full and long life.

Why insulin is called "genetically engineered"

Some patients are intimidated by the term "genetically engineered", reminding them of "ominous GMOs".

In fact, it is the invention this drug saved millions of lives of people with diabetes.

In the beginning, doctors used insulin isolated from the body of animals (mainly pigs and cows). However, this hormone was not only alien to humans, but also entered the bloodstream with lightning speed, provoking glucose spikes and causing a lot of complications.

Soluble insulin has been developed to meet all the needs of a diabetic patient, minimizing various allergic reactions. After the end of its action, it breaks down into ordinary amino acids and is excreted from the body.

Main pharmacological properties

Soluble human insulin refers to short-acting insulin replacement drugs.

Together with the cell wall receptor, the drug forms an insulin receptor complex that stimulates intracellular processes:

1. Isolation of enzymes for the full processing and absorption of glucose by tissues;
2. Increase intracellular transport and absorption of glucose;
3. Decreased rate of glycogen formation in the liver;
4. Stimulation of the production of proteins and fats.

When administered subcutaneously, the drug begins to act within 20-30 minutes, reaching its maximum within 1-3 hours, lasting about 5-8 hours.

This drug is distributed differently in tissues: for example, it does not penetrate the placental barrier and does not enter breast milk. After the end of its action, human insulin is excreted through the kidneys (about 80%) after its destruction by insulinase.

Indications for use

Usually, doctors prescribe soluble insulin in cases of:

Contraindications

This drug is usually well tolerated by the body, as it does not differ from the natural pancreatic enzyme.

Insulin is contraindicated for use in:

• Decreased blood glucose levels (hypoglycemia);
• Increasing the body's sensitivity to insulin.

Adverse reactions

Despite being well tolerated, insulin may have side effects side effects when used as:

Sometimes the start of taking the drug goes in parallel with the adaptive reaction of the body in the form of edema or visual disturbances. These symptoms usually resolve after a few weeks of treatment.

Combination with other drugs

When using human insulin with some drugs, there is an increase or decrease in its hypoglycemic effect.

The hypoglycemic effect can be enhanced when taking insulin with:

Nicotine and alcohol contribute to the increase in the hypoglycemic properties of insulin.

Reduce the hypoglycemic effect of the drug can interact with:

Also, in combination with insulin, drugs can lower or enhance the hypoglycemic effect:

Application and dosage selection

The dose and method of administration of human insulin is always determined individually by an endocrinologist, taking into account the necessary indicators of blood glucose and urine of the patient.

This drug is administered in diabetes in several ways: subcutaneously (sc), intramuscularly (IM) or intravenously (IV). More often, insulin is injected subcutaneously. To do this, use the zones:

Intravenously, the drug is usually administered with acute conditions provoked by diabetes: ketoacidosis, diabetic coma.

Insulin is advised to be administered 15-30 minutes before meals, 3 times a day. Sometimes 5-6 single injections of the drug are also allowed.

The insulin dose is usually calculated in the proportion of 0.5-1 units per 1 kg of body weight. If insulin is administered more than 0.6 mg per kg of weight, then the drug must be administered at least 2 times a day. Average daily dose is about 30-40 units (in children 8 units).

Pregnant women are usually prescribed a dose of 0.6 units per kg of body weight. Injections are usually made 3-5 times a day, in accordance with the number of meals.

Often insulin fast action combined with longer-acting insulin.

Rules for administering insulin

Even diabetics with experience make mistakes when administering insulin.

Most important rules insulin therapy are:

1. Checking the period and storage conditions of the drug: it should not be subjected to overheating or hypothermia.
2. Keep spare vials of insulin in the refrigerator. It is enough to keep the started bottle in a dark place at room temperature.
3. Reconciliation of the dosage of the drug with the instructions and recommendations of the doctor.
4. Releasing air from the syringe before injection. It is not necessary to wipe the skin with alcohol. Infection with insulin therapy is extremely rare, and alcohol reduces the effect of the drug.
5. Choice right place for an introduction. For short-acting insulin, this area is the abdomen. When injected into the shoulder or gluteal fold, the drug acts more slowly.
6. Prevention of complications at the injection site by using the entire surface area. For the introduction of short-acting insulin, the entire abdomen is used: from the top of the costal margins to the inguinal fold, with the lateral surfaces of the body. It is important to retreat about 2 cm from the sites of old injections, introducing the syringe at an angle of 45-60 degrees so that the medicine does not leak out.
7. Before the introduction of the drug, it is better to take the skin into a fold large and index fingers. When injected into the muscle, the drug will reduce its activity. After inserting the needle, hold the syringe for about 5-10 seconds.
8. In the stomach, short-acting insulin is best administered 20 minutes before meals. In other places, the medicine is administered half an hour before meals.

Trade name of the drug

Insulin is produced as a solution for injection and sold in pharmacies.

Genetically engineered human insulin can be produced under the following brand names:

• Biosulin;
• Actrapid;
• Actrapid NM;
• Gensulin;
• Let's exalt;
• Penfill.

Thanks to modern gene technologies, artificial (recombinant) human insulin has been created. It is he who is active substance drugs: Humodar, Humulin, Insuman, Gansulin, Humalog, Apidra SoloStar, Mikstard. These drugs differ from the original in the reverse amino acid sequence, which adds new properties to them (for example, a longer two-phase effect), which is extremely important for patients with diabetes.

Adverse reactions

Despite being well tolerated, this medicine side effects may occur in the form of:

Sometimes at the beginning of taking the drug there are manifestations in the form of various visual impairments (double vision, clouding, etc.) or the appearance of edema. But they are an adaptive reaction of the body and disappear after a few weeks of treatment.

Overdose

It happens that the introduction of insulin in some cases leads to hyperglycemia.

The main symptoms of hyperglycemia are manifestations in the form of:

At the onset of similar symptoms, the patient should immediately take some easily digestible carbohydrate food (usually candy, a piece of sugar or sweet tea).

In case of deterioration of health, the patient should urgently call " ambulance". Usually, doctors inject glucagon or a 40% dextrose solution into the muscle (intravenously). Delay in this case is extremely dangerous and can lead to coma or death.

Complications

Long-term treatment with insulin can lead to various complications. The main ones are.