What kind of substance is this - insulin, which is so often written and talked about in connection with the now widespread diabetes mellitus? Why at some point does it cease to be produced in the required quantities or, conversely, is synthesized in excess?
Insulin - biologically active substance(BAV), protein hormone, which controls blood glucose levels. This hormone is synthesized by beta cells belonging to the islet apparatus (islets of Langerhans) of the pancreas, which explains the risk of developing diabetes mellitus if it is disrupted functional abilities. In addition to insulin, other hormones are synthesized in the pancreas, in particular, the hyperglycemic factor (glucagon), produced by the alpha cells of the islet apparatus and also involved in maintaining a constant glucose concentration in the body. 
The normal levels of insulin in the blood (plasma, serum) of an adult are in the range from 3 to 30 µU/ml (or up to 240 pmol/l).
In children under 12 years of age, indicators should not exceed 10 µU/ml(or 69 pmol/l).
Although somewhere the reader will encounter a norm of up to 20 µU/ml, somewhere up to 25 µU/ml - in different laboratories the norm may differ slightly, so always, when donating blood for analysis, you need to focus on the exact data (reference values) of that laboratory, which conducts research and not on the values given in various sources.
Increased insulin may indicate a pathology, for example, the development of a pancreatic tumor (insulinoma), and physiological state(pregnancy).
Decreased insulin levels may indicate development or simply physical fatigue.
The main role of the hormone is hypoglycemic
The action of insulin in the human body (and not only the human body, in this regard, all mammals are similar) lies in its participation in metabolic processes:
- This hormone allows sugar obtained from food to freely penetrate into the cells of muscle and fat tissue, increasing the permeability of their membranes:
- It is an inducer of glucogen production from glucose in liver and muscle cells:
- Insulin promotes the accumulation of proteins, increasing their synthesis and preventing the breakdown, and fatty products (it helps adipose tissue to capture glucose and convert it into fat (this is where excess fat reserves come from and why excessive love of carbohydrates leads to obesity);
- Increasing the activity of enzymes that enhance the breakdown of glucose ( anabolic effect), this hormone interferes with the work of other enzymes seeking to break down fats and glycogen ( anti-catabolic effect of insulin).
Insulin is everywhere, it is involved in all metabolic processes occurring in the human body, but the main purpose of this substance is to ensure carbohydrate metabolism, since it is the only hypoglycemic hormone, while its “opponents,” hyperglycemic hormones that strive to increase blood sugar, are noticeably more numerous (adrenaline, growth hormone, glucagon).
First of all, the mechanism for the formation of insulin by β-cells of the islets of Langerhans is triggered by an increased concentration of carbohydrates in the blood, but before this the hormone begins to be produced as soon as a person, having chewed a piece of something edible, swallows it and delivers it to the stomach (and it is not at all necessary that the food product was carbohydrate). Thus, food (any) causes an increase in the level of insulin in the blood, and hunger without food, on the contrary, reduces its content.
In addition, the process of insulin formation is stimulated by other hormones, increased concentrations of certain trace elements in the blood, for example, potassium and calcium, increased amounts fatty acids. The growth hormone somatotropin (GH) inhibits insulin production to the greatest extent. Other hormones also reduce insulin production to some extent, for example, somatostatin, synthesized by the delta cells of the islet apparatus of the pancreas, but its effect still does not have the effect of somatotropin.
It is obvious that fluctuations in the level of insulin in the blood depend on changes in the glucose content in the body, so it is understandable why, when studying insulin using laboratory methods, they also carry out a determination.
Video: insulin and its functions - medical animation
Insulin and sugar sickness of both types
Most often, the secretion and functional activity of the described hormone changes in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus - NIDDM), which often develops in middle-aged and elderly people who are overweight. Patients often wonder why excess weight is a risk factor for the development of diabetes. And this happens as follows: the accumulation of fat reserves in excess quantities is accompanied by an increase in the blood, which, in turn, contribute to a reduction in the number of receptors for the hormone and a change in affinity for it. The result of such disorders is a decrease in insulin production and, accordingly, a decrease in its level in the blood, which leads to an increase in the concentration of glucose, which cannot be utilized in a timely manner due to insulin deficiency.
By the way, some people, having learned the results of their tests (hyperglycemia, ), upset for a while about this, begin to actively look for ways to prevent a terrible disease - they urgently “go on” a diet that reduces body weight. And they do it very right! Such experience can be very useful for all patients at risk for diabetes: timely measures can delay the development of the disease itself and its consequences, as well as dependence on drugs that lower blood sugar in the blood serum (plasma) for an indefinite period.
A slightly different picture is observed in type 1 diabetes mellitus, which is called insulin-dependent diabetes mellitus (IDDM). In this case, there is more than enough glucose around the cells; they simply bathe in a sugar environment, but they cannot absorb important energy material due to an absolute deficiency of the conductor - there is no insulin. Cells cannot take in glucose, and as a result of such circumstances, disruption of other processes in the body begins to occur:
- Reserve fat, without being completely burned in the Krebs cycle, is sent to the liver and participates in the formation of ketone bodies;
- A significant increase in blood sugar leads to incredible thirst, a large amount of glucose begins to be excreted in the urine;
- Carbohydrate metabolism is directed along an alternative pathway (sorbitol), forming an excess of sorbitol, which begins to be deposited in various places, forming pathological conditions: cataracts (in the eye lens), polyneuritis (in nerve conductors), (in the vascular wall).
The body, trying to compensate for these disorders, stimulates the breakdown of fats, as a result of which the content of cholesterol in the blood increases, but the level of the beneficial fraction of cholesterol decreases. Atherogenic dysproteinemia reduces the body's defenses, which is manifested by changes in other laboratory parameters (fructosamine and glycosylated hemoglobin increase, the electrolyte composition of the blood is disrupted). In this state of absolute insulin deficiency, patients become weaker, constantly thirsty, and produce large amounts of urine.
In diabetes mellitus, a lack of insulin ultimately affects almost all organs and systems, that is, its deficiency contributes to the development of many other symptoms that enrich clinical picture"sweet" disease.
What excesses and deficiencies “tell”
Increased insulin, that is, an increase in its level in blood plasma (serum), can be expected in the case of certain pathological conditions:
- Insulinomas are tumors of the tissue of the islets of Langerhans that produce hypoglycemic hormone uncontrollably and in large quantities. This neoplasm produces a fairly high level of insulin, while the fasting glucose level is reduced. To diagnose this type of pancreatic adenoma, the ratio of insulin and glucose (I/G) is calculated using the formula: quantitative value of the hormone in the blood, µU/ml: (sugar content determined in the morning on an empty stomach, mmol/l - 1.70).
- The initial stage of the formation of non-insulin-dependent diabetes mellitus, later level insulin will begin to fall, and sugar will rise.
- Obesity. Meanwhile, here and in the case of some other diseases, it is necessary to distinguish between cause and effect: in the first stages, it is not obesity that causes increased insulin, but, on the contrary, a high level of the hormone increases appetite and promotes the rapid transformation of glucose supplied with food into fat. However, everything is so interconnected that it is not always possible to clearly trace the root cause.
- Liver diseases.
- Acromegaly. In healthy people, high insulin levels quickly reduce blood glucose, which significantly stimulates the synthesis of somatotropin; in patients with acromegaly, an increase in insulin levels and subsequent hypoglycemia does not cause any particular reaction from growth hormone. This feature is used as a stimulation test when monitoring hormonal balance ( intravenous injection insulin does not cause a significant increase in growth hormone either one hour or 2 hours after insulin administration).
- Itsenko-Cushing syndrome. Impaired carbohydrate metabolism in this disease is caused by increased secretion of glucocorticoids, which suppress the process of glucose utilization, which, despite the high level of insulin, remains in the blood in high concentrations.
- Insulin is elevated in muscular dystrophy, which is the result of various metabolic disorders.
- Pregnancy proceeding normally, but with increased appetite.
- Hereditary intolerance to fructose and galactose.
Injecting insulin (fast-acting) under the skin causes a sharp jump in the hormone in the patient's blood, which is used to bring the patient out of a hyperglycemic coma. The use of the hormone and glucose-lowering drugs to treat diabetes mellitus also leads to an increase in insulin in the blood.
It should be noted that although many people already know that there is no cure for elevated insulin levels, there is a treatment for a specific disease in which a similar “disorder” occurs in the hormonal status and disruption of various metabolic processes.
A decrease in insulin levels is observed in both type 1 and type 2 diabetes mellitus. The only difference is that in NIDDM the hormone deficiency is relative and is caused by factors other than the absolute deficiency in IDDM. In addition, a decrease in the quantitative values of the hormone in the blood leads to stressful situations, intense physical activity or exposure to other adverse factors.
Why is it important to know your insulin levels?
Absolute insulin levels obtained in laboratory tests do not in themselves have much diagnostic value, since without quantitative values of glucose concentration they do not say much. That is, before judging any disorders in the body associated with the behavior of insulin, its relationship to glucose should be studied.
For this purpose (to increase the diagnostic significance of the analysis), glucose stimulation test for insulin production(stress test), which shows that in people with latent diabetes mellitus, the hypoglycemic hormone produced by the beta cells of the pancreas is delayed, its concentration grows more slowly, but reaches higher values than in healthy people.
In addition to the glucose loading test, the diagnostic search uses provocative test or, as it is called, a fasting test. The essence of the test is to determine the quantitative values of glucose, insulin and C-peptide (the protein part of the proinsulin molecule) in the patient’s blood on an empty stomach, after which the patient is limited in food and drink for a day or more (up to 27 hours), conducting a study of the indicators every 6 hours, of interest (glucose, insulin, C-peptide).
So, if insulin is increased predominantly when pathological conditions, with the exception of normal pregnancy, where an increase in its level is attributed to physiological phenomena, then identifying a high concentration of the hormone, along with a decrease in blood sugar, plays an important role in diagnosis:
- Tumor processes localized in the tissue of the islet apparatus of the pancreas;
- Hyperplasia of islet tissue;
- Glucocorticoid deficiency;
- Severe liver pathology;
- Diabetes mellitus at the initial stage of its development.
Meanwhile, the presence of such pathological conditions as Itsenko-Cushing syndrome, acromegaly, muscular dystrophy, and liver diseases require a study of insulin levels, not so much for diagnostic purposes, but to monitor the functioning and preservation of the functionality of organs and systems.
How do they take and pass the test?
Before the study, the patient is explained the significance of the analysis and its features. The reaction of the pancreas to food, drinks, medications, and physical activity is such that the patient should fast for 12 hours before the study, not engage in heavy physical work, and avoid taking hormonal medications. If the latter is impossible, that is, the medications cannot be ignored, then an entry is made on the analysis form that the test is being carried out against the background of hormone therapy.
Half an hour before venipuncture (blood is taken from a vein), the person waiting in line for the test is asked to lie down on the couch and relax as much as possible. The patient should be warned that failure to comply with the rules may affect the results and then a return to the laboratory, and, therefore, repeated restrictions will be inevitable.
Insulin injection: only the first injection is scary, then it becomes a habit
Since so much attention has been paid to the hypoglycemic hormone produced by the pancreas, it would be useful to briefly dwell on insulin as a drug prescribed for various pathological conditions and, first of all, for diabetes mellitus.
The administration of insulin by patients themselves has become commonplace; even children can cope with it of school age, whom the attending physician teaches all the intricacies (to use a device for administering insulin, observe the rules of asepsis, navigate the properties of the drug and know the effect of each type). Almost all patients with type 1 diabetes and patients with severe non-insulin-dependent diabetes mellitus are on insulin injections. In addition, some emergency conditions or complications of diabetes, in the absence of effect from other medications, are treated with insulin. True, in cases of type 2 diabetes, after stabilization of the patient’s condition, the hypoglycemic hormone in injection form is replaced by other means used internally, so as not to bother with syringes, make calculations and depend on an injection, which can be quite difficult to give to yourself without habit, even if you have some skills in carrying out simple medical procedures.
The best medicine with a minimum of side effects and without serious contraindications is recognized as an insulin solution, which is based on human insulin substance.
In its structure, the hypoglycemic hormone of the pig pancreas is most similar to human insulin, and in most cases it has saved humanity long years before obtaining (using genetic engineering) semi-synthetic or DNA-recombinant forms of insulin. Currently, only human insulin is used to treat diabetes mellitus in children.
Insulin injections have the task of maintaining normal blood glucose concentrations, preventing extremes: jumps up (hyperglycemia) and falling levels below acceptable values (hypoglycemia).
Prescribing types of insulin, calculating their dose in accordance with the characteristics of the body, age, and concomitant pathology performed only by a doctor on a strictly individual basis. He also teaches the patient how to inject insulin on his own, without resorting to outside help, designates areas for insulin administration, gives advice on nutrition (food intake should be consistent with the flow of the hypoglycemic hormone into the blood), lifestyle, daily routine, and physical activity. In general, in the endocrinologist’s office, the patient receives all the necessary knowledge on which the quality of his life depends; the patient himself can only use it correctly and strictly follow all the doctor’s recommendations.
Video: about administering an insulin injection
Types of insulins
Patients receiving hypoglycemic hormone in injection form will have to find out what types of insulins there are, at what time of day (and why) they are prescribed:
Long-acting and extra-long-acting insulins are administered once a day; they are not suitable for emergency situations (until they reach the blood). Of course, in case of coma, ultra-short-acting insulins are used, which quickly restore insulin and glucose levels, bringing them closer to normal values.
When prescribing different types of insulin to a patient, the doctor calculates the dose of each, the method of administration (under the skin or into the muscle), indicates the mixing rules (if necessary) and the hours of administration in accordance with food intake. Probably, the reader has already realized that treatment of diabetes (with insulin, in particular) will not tolerate a frivolous attitude towards diet. Meals (main) and “snacks” are very closely related to the level of insulin at the time of the meal, therefore they must be strictly controlled by the patient himself - his health depends on this.
Video: about the action of insulin and its types
Insulin is a protein hormone produced by the pancreas. It has a great influence on metabolic processes in almost all tissues of the body. One of its main tasks is to control blood glucose levels.
Thanks to insulin, the process of glucose absorption by fat and muscle cells accelerates, inhibits the formation of new glucose cells in the liver. Creates a supply of glycogen - a form of glucose - in cells, promotes the preservation and accumulation of other energy sources, such as fats and proteins. Thanks to insulin, their breakdown and utilization are inhibited.
If the pancreatic function is not impaired and the gland is in order, it constantly produces the amount of insulin necessary for the normal functioning of the entire body. After eating, the volume of insulin increases, this is necessary for the high-quality processing of incoming proteins, fats and carbohydrates.
In the event that there are functional deviations in the activity of the pancreas, a malfunction occurs in the functioning of the whole organism. This disease is called diabetes mellitus.
When insulin production is insufficient, type 1 diabetes mellitus occurs. In this disease, the beta cells of the pancreas, which produce insulin, are destroyed. The body is not able to properly assimilate incoming food.
To maintain the functioning of the body in a normal state, such a patient is given insulin “for food” before meals. The volume that should cope with the high-quality processing of incoming food. Insulin is also administered between meals. The purpose of these injections is to ensure normal functioning of the body in between meals.
When insulin is produced in the body in the required volume, but its quality is impaired, type 2 diabetes mellitus occurs. With this type of disease, the quality of insulin is reduced and it cannot have the desired effect on the body's cells. In fact, such insulin is of no use. It is unable to process glucose in the blood. With this type, drugs are used to stimulate insulin to act.
Blood insulin level is normal
Insulin. Norm for women by age (table)
The level of normal insulin in the blood of both men and women is approximately the same, there are slight differences in certain situations.
When the glucose level in the body increases, the pancreas begins to produce insulin more actively. Such moments in healthy female body occur during puberty, pregnancy and old age.
All these situations are clearly reflected in the tables below:
The level of insulin in a woman’s blood varies depending on her age. Over the years it has increased noticeably.
Normal blood insulin levels in men
In men, just like in women, the amount of insulin in the body changes depending on age.
In old age, additional energy is required, so after sixty, in men, as in women, the volume of insulin produced becomes greater and reaches 35 mcad/l.
Insulin in the blood. Normal in children and adolescents
Children and teenagers make up special category. Children do not need additional energy, so their production of this hormone is slightly reduced. But during puberty the picture changes dramatically. Against the backdrop of a general hormonal surge, insulin levels in the blood of adolescents become higher.
When insulin levels fluctuate within the above indicated numbers, this means that the person is healthy. In a situation where the hormone is higher than the indicated indicators, upper diseases may develop over the years. respiratory tract and other organs, these processes may become irreversible.
Insulin is a hormone with character. Its level can be affected by many factors - stress, physical strain, pancreatic disease, but most often the disorder is caused by a person's existing diabetes.
Symptoms indicating that there is an increase in insulin are itching, dry mouth, long-healing wounds, increased appetite, but at the same time a tendency to lose weight.
A situation where insulin is below the prescribed norm signals a long-term physical activity or that the person has type 1 diabetes. Diseases of the pancreas should also not be excluded. Pallor, palpitations, fainting, irritability, and sweating are often added to the above symptoms.
How to find out your insulin level?
An analysis is required to determine insulin levels. There are two main types of analysis - after a glucose load and on an empty stomach. In order to make a diagnosis of diabetes, both of these tests must be performed. Such a study can be carried out exclusively in a clinical setting.
This analysis is carried out on an empty stomach in the morning, so that the results most clearly reflect reality; it is recommended not to eat at least 12 hours before blood sampling. That's why this analysis prescribed in the morning, which allows you to prepare well for donating blood.
The day before the analysis, all fatty foods and sweets are excluded from the patient’s menu, and you should also abstain from alcoholic beverages. Otherwise, the result obtained may not correspond to reality, which will complicate the procedure for correct diagnosis.
In addition to menu adjustments, it is necessary to lead a calmer lifestyle on the eve of the test - give up active sports, heavy physical work, try to avoid emotional experiences. It would be a good idea to quit smoking a day before the test. 
After sleep, before donating blood for analysis, you should not eat or drink anything except clean, still water. Blood is taken from a finger; in rare cases, venous blood is taken, also on an empty stomach.
In addition to blood tests, doctors often prescribe ultrasound examination pancreas, which allows us to find out the reasons for improper insulin production.
Results may be lower than in the table above. So the normal indicator for an adult will be parameters from 1.9 to 23 µC/l. for children under 14 years of age, this figure can vary from 2 to 20 mCed/L. in pregnant women this figure will be from 6 to 27 mCed/l.
Insulin norm during glucose load
To understand how quickly and how well the body is able to produce insulin, a test is performed to determine this hormone after an insulin load. Preparation for this diagnostic method is carried out in exactly the same way as in the previous case. You should not eat for at least 8 hours; you should avoid smoking, alcohol and physical activity.
Before testing the level of insulin in the patient’s blood, two hours before blood sampling, he is given a glucose solution to drink - 75 ml for adults and 50 ml for children. After the solution is drunk, the body begins the processes of producing insulin and its work to neutralize glucose.
During the entire time you must not perform active physical activities or smoke. After two hours, the blood is taken for analysis, measuring insulin levels.
During collection, the patient is required to remain calm, otherwise the result may be incorrect.
After such an analysis, the following parameters will be normal indicators: for an adult, the numbers will be from 13 to 15 mKed/l; for a woman carrying a baby, the normal indicators will be numbers from 16 to 17 mKed/L; for children under the age of 14, the normal values will be numbers from 10 up to 11 mcad/l. 
In some cases, it may be advisable to conduct a double analysis to determine the insulin content in human plasma. The first test is performed on an empty stomach in the morning, after which the patient is given glucose to drink and blood sampling is repeated two hours later. The combined analysis will provide an expanded picture of the action of insulin.
How do insulin levels change after eating?
After eating, proteins, fats and carbohydrates enter the body, the pancreas begins to actively produce hormones for the proper absorption of all this diversity. That is, the volume of insulin increases sharply, which is why it is impossible to correctly determine the norm of insulin content in the human body after eating. As food is processed, insulin levels return to normal.
One of the best drugs for diabetics in terms of price and effectiveness is insulin Humulin, produced by the American company Eli Lily and its subsidiaries in other countries. The range of insulins produced under this brand includes several items. There is both a short hormone designed to reduce sugar after meals and a drug average duration, designed to normalize fasting glycemia.
Ready-made combinations of the first two insulins with an effect of up to 24 hours are also available on sale. All types of Humulin have been used in the treatment of diabetes for decades, and judging by the reviews, they will be produced for a long time. The drugs provide excellent glycemic control and are characterized by consistency and predictability of action.
Types and forms of release of Humulin
Insulin Humulin is a hormone whose structure, arrangement of amino acids and molecular weight completely replicates insulin synthesized in the human body. It is recombinant, that is, produced using genetic engineering methods. Correctly calculated doses of this drug can restore carbohydrate metabolism in people with diabetes and avoid complications.
Types of Humulin:
- Humulin Regular- This is a solution of pure insulin and is a short-acting drug. Its purpose is to help blood sugar get into cells, where it is used by the body for energy. It is usually used in conjunction with intermediate- or long-acting insulin. It can be administered alone if the patient has diabetes mellitus.
- Humulin NPH– a suspension made from human insulin and protamine sulfate. Thanks to this supplement, the glucose-lowering effect begins more slowly than with short-acting insulin and lasts significantly longer. Two administrations per day are enough to normalize glycemia between meals. Most often, Humulin NPH is prescribed together with short-acting insulin, but in type 2 diabetes it can be used independently.
- is a two-phase drug containing 30% Regular insulin and 70% NPH. Humulin M2 is less common on sale; it has a ratio of 20:80. Due to the fact that the proportion of the hormone is set by the manufacturer and does not take into account the individual needs of the patient, blood sugar cannot be controlled with its help as effectively as when using short- and medium-term insulin separately. Humulin M3 can be used by diabetics who are recommended traditional.
Action time according to instructions:
All Humulin insulin currently produced has a concentration of U100, so it is suitable for modern insulin syringes and syringe pens.
Release forms:
- glass bottles with a volume of 10 ml;
- cartridges for syringe pens, holding 3 ml, there are 5 of them in a package.
Insulin Humulin is administered subcutaneously, or, in extreme cases, intramuscularly. Intravenous administration is only permitted for Humulin Regular, it is used for elimination and should be carried out only under medical supervision.
Indications and contraindications
According to the instructions, Humulin can be prescribed to all patients with severe insulin deficiency. It is usually observed in people with type 1 or long-term type 2 diabetes. Temporary insulin therapy is possible when carrying a child, since glucose-lowering drugs are prohibited during this period.
Humulin M3 is prescribed only to adult patients for whom the use of an intensified insulin administration regimen is difficult. Due to the increased risk of diabetes complications before age 18, Humulin M3 is not recommended.
Possible side effects:
- due to an overdose of insulin, unaccounted physical activity, lack of carbohydrates in food.
- Allergy symptoms such as rash, swelling, itching, redness around the injection site. They can be caused either by human insulin itself or by the auxiliary components of the drug. If the allergy does not go away within a week, Humulin will have to be replaced with insulin with a different composition.
- Muscle pain or spasms and increased heart rate may occur when the patient has a significant lack of potassium. Symptoms disappear after eliminating the deficiency of this macronutrient.
- Changes in the thickness of the skin and subcutaneous tissue at sites of frequent injections.
Stopping regular insulin administration is deadly, so even if discomfort Insulin therapy should be continued until consultation with your doctor.
Most patients prescribed Humulin do not experience any side effects other than mild hypoglycemia.
Humulin - instructions for use
Dose calculation, preparation for injection and administration of Humulin are identical to other insulin preparations of similar duration of action. The only difference is the time before eating. For Humulin Regular it is 30 minutes. You should prepare for the first self-administration of the hormone in advance by reading the instructions for use in detail.
Preparation
Insulin must be removed from the refrigerator in advance so that the temperature of the solution equal to room temperature. The cartridge or bottle of a mixture of the hormone with protamine (Humulin NPH, Humulin M3 and M2) needs to be rolled between the palms several times and turned up and down so that the suspension at the bottom is completely dissolved and the suspension acquires a uniform milky color without inclusions. Do not shake it vigorously to avoid excessive saturation of the suspension with air. Humulin Regular does not require such preparation; it is always transparent.
The length of the needle is selected in such a way as to ensure subcutaneous injection and not get into the muscle. Syringe pens suitable for Humulin insulin - Humapen, BD-Pen and their analogues.
Introduction
Insulin is injected into areas with developed fatty tissue: abdomen, thighs, buttocks and top part hands The most rapid and uniform absorption into the blood is observed when injected into the stomach, so Humulin Regular should be injected there. In order for the effect of the drug to comply with the instructions, blood circulation should not be artificially increased at the injection site: rub, wrap excessively, or immerse in hot water.
When administering Humulin, it is important not to rush: carefully collect a fold of skin without grabbing the muscle, slowly inject the drug, and then hold the needle in the skin for a few seconds so that the solution does not begin to flow out. To reduce the risk of lipodystrophy and inflammation, needles are changed after each use.
Cautions
The initial dose of Humulin should be selected in conjunction with the attending physician. An overdose can lead to a severe drop in sugar and. An insufficient amount of the hormone is fraught with various angiopathy and neuropathy.
Different brands of insulin differ in effectiveness, so you should switch from Humulin to another drug only if side effects occur or insufficient compensation for diabetes mellitus. The transition requires recalculation of the dose and additional, more frequent monitoring of glycemia.
The need for insulin may increase during periods of hormonal changes in the body, when taking certain medications, infectious diseases, stress. Patients with hepatic and, especially, renal failure.
Overdose
If more insulin is administered than is necessary for the absorption of consumed carbohydrates, a diabetic patient will inevitably experience hypoglycemia. It is usually accompanied by shaking, chills, weakness, hunger, increased heart rate, profuse sweating. For some diabetics, the symptoms are erased; such a decrease in sugar is especially dangerous, since it cannot be prevented in time. Frequent hypoglycemia and may lead to a weakening of symptoms.
Immediately after hypoglycemia occurs, it is easily relieved with fast carbohydrates - sugar, fruit juice, glucose tablets. Severely exceeding the dose can lead to severe hypoglycemia, even to the onset of hypoglycemia. At home, it can be quickly eliminated by administering glucagon; there are special kits for emergency assistance people with diabetes, for example, GlucaGen HypoKit. If your liver's glucose stores are low, this drug will not help. The only thing effective treatment in this case - intravenous administration glucose in a medical facility. The patient must be taken there as soon as possible, since the coma quickly worsens and causes irreparable harm to the body.
Storage rules for Humulin
All types of insulin are needed special conditions storage The properties of the hormone change significantly when frozen, exposed to ultraviolet radiation and temperatures above 35°C. The supply is stored in the refrigerator, in the door or on a shelf far from the back wall. Shelf life according to the instructions for use: 3 years for Humulin NPH and M3, 2 years for Regular. An open bottle can be kept at a temperature of 15-25°C for 28 days.
Effect of drugs on Humulin
Medicines can change how insulin works and increase the risk of side effects. Therefore, when prescribing a hormone, the doctor must provide full list medications taken, including herbs, vitamins, dietary supplements, sports supplements and contraceptives.
Possible consequences:
| Effect on the body | List of drugs |
| Increased sugar levels require an increase in insulin dose. | Oral contraceptives, glucocorticoids, synthetic androgens, thyroid hormones, selective β2-adrenergic agonists, including the commonly prescribed terbutaline and salbutamol. Anti-tuberculosis drugs, nicotinic acid, lithium preparations. Thiazide diuretics used to treat hypertension. |
| Reduced sugar. To avoid hypoglycemia, the dose of Humulin will have to be reduced. | Tetracyclines, salicylates, sulfonamides, anabolics, beta-blockers, hypoglycemic agents for the treatment of type 2 diabetes. Often used to treat hypertension ACE inhibitors(for example, enalapril) and AT1 receptor blockers (losartan). |
| Unpredictable effects on blood glucose. | Alcohol, pentacarinate, clonidine. |
| Reducing the symptoms of hypoglycemia, which makes it difficult to eliminate in time. | Beta blockers, eg metoprolol, propranolol, some eye drops to treat glaucoma. |
Features of use during pregnancy
To avoid diabetes during pregnancy, it is important to constantly maintain normal blood glucose levels. Hypoglycemic drugs are prohibited at this time, as they interfere with the flow of nutrition to the child. The only approved remedy at this time is long and short insulin, including Humulin NPH and Regular. The introduction of Humulin M3 is not advisable, since it is not capable of well compensating for diabetes mellitus.
During pregnancy, the need for the hormone changes several times: it decreases in the 1st trimester, increases significantly in the 2nd and 3rd trimester, and drops sharply immediately after childbirth. Therefore, all doctors involved in pregnancy and childbirth should be notified of the presence of diabetes mellitus in a woman.
Insulin Humulin can be used without restrictions during breastfeeding, since it does not penetrate into milk and does not affect the baby’s blood sugar.
Analogues
How can you replace Humulin insulin if side effects occur:
| A drug | Price for 1 ml, rub. | Analogue | Price for 1 ml, rub. | ||
| bottle | cartridge for syringe pen | bottle | cartridge | ||
| Humulin NPH | 17 | 23 | Biosulin N | 53 | 73 |
| Insuman Bazal GT | 66 | — | |||
| Rinsulin NPH | 44 | 103 | |||
| Protafan NM | 41 | 60 | |||
| Humulin Regular | 17 | 24 | Actrapid NM | 39 | 53 |
| Rinsulin R | 44 | 89 | |||
| Insuman Rapid GT | 63 | — | |||
| Biosulin R | 49 | 71 | |||
| 17 | 23 | Mixtard 30 NM | Currently not on sale | ||
| Gensulin M30 | |||||
This table lists only complete analogues - genetically engineered human insulins with a similar time of action.
Manufacturer: Eli Lilly, Eli Lilly
Name: Humulin M ®*, ®*
Compound:
Humulin M1 is a suspension of human insulin in the proportion of 10% soluble insulin and 90% isophane insulin.
Suspension of human insulin in the proportion: 20% soluble insulin and 80% isophane insulin.
Suspension of human insulin in the proportion: 30% soluble insulin and 70% isophane insulin.
Sterile suspension of human insulin in the proportion: 40% soluble insulin and 60% isophane insulin.
The active ingredients of the drug are neutral soluble insulin, identical to human insulin, and isophane, the prototype of insulin, identical to human insulin.
Pharmachologic effect: Humulin M is a medium-acting insulin preparation.
The onset of action of the drug is 30 minutes after administration, the maximum effect is between 1 and 8.5 hours, the duration of action is 14-15 hours.
Individual differences in insulin activity depend on factors such as dose, choice of injection site, and physical activity of the patient.
Indications for use: Diabetes mellitus if there are indications for insulin therapy; newly diagnosed diabetes mellitus; pregnancy with type 2 diabetes mellitus (non-insulin dependent).
Mode of application: PC. For a patient whose hyperglycemia and glucosuria are not eliminated by diet for 2–3 days, at the rate of 0.5–1 U/kg, and then the dose is adjusted in accordance with the glycemic and glucosuric profile; for pregnant women in the first 20 weeks, the insulin dose is 0.6 U/kg. The frequency of administration can be different (usually 3–5 times are used when selecting a dose), while the total dose is divided into several parts (depending on the number of meals) proportionally energy value: breakfast - 25 parts, second breakfast - 15 parts, lunch - 30 parts, afternoon snack - 10 parts, dinner - 20 parts. Injections are made 15 minutes before meals. In the future, double administration is possible (the most convenient for patients).
Side effects:
- visual impairment
- insulin resistance (daily requirement exceeds 200 units)
- allergic reactions: skin rashes with itching, sometimes accompanied by dyspnea and hypotension
- anaphylactic shock
- local reactions: redness, swelling and soreness of the skin and subcutaneous tissue (go away on their own within a few days - weeks)
- post-injection lipodystrophy (increased fat formation at the injection site - hypertrophic form, or fat atrophy - atrophic form), accompanied by impaired absorption of insulin, the occurrence of pain when atmospheric pressure changes.
Contraindications: Hypersensitivity, hypoglycemia, liver and/or kidney disease (cumulation is possible), breastfeeding (exists high risk insulin excretion in breast milk).
Drug interactions: The effect is enhanced by oral antidiabetic drugs, alcohol, androgens, anabolic steroid, disopyramide, guanethidine, MAO inhibitors, salicylates (in large doses), etc. NSAIDs, beta-blockers (mask the symptoms of hypoglycemia - tachycardia, increased blood pressure, etc.), reduce - ACTH, glucocorticoids, amphetamines, baclofen, estrogens, oral contraceptives , hormones thyroid gland, thiazide and other diuretics, triamterene, sympathomimetics, glucagon, phenytoin. The concentration in the blood increases (accelerates absorption) nicotine-containing drugs and tobacco smoking.
Pregnancy and lactation: In patients with diabetes mellitus during lactation ( breastfeeding) may require adjustments in insulin dose, diet, or both.
In in vitro and in vivo genetic toxicity studies, human insulin did not have a mutagenic effect.
Storage conditions: The drug should be stored in the refrigerator at a temperature of 2° to 8°C, do not allow freezing, and protect from direct exposure to light. Shelf life - 2 years.
The drug in use in a bottle or cartridge should be stored at room temperature (from 15° to 25°C) for no more than 28 days.
Additionally: Before taking insulin from the vial, you must check the transparency of the solution. When foreign bodies If the substance becomes cloudy or precipitates on the glass of the bottle, the drug solution cannot be used. The temperature of the administered insulin should be at room temperature.
