In the face of a wide variety of clinical insulin preparations, you are not some silly points is not clear, the classification and features
In the face of a wide variety of clinical insulin preparations, you are not some silly points is not clear, the classification and features of insulin preparations used are summarized, to facilitate memory and understanding, we believe that after no further before confused!
Source: Medical Endocrinology channel
First of all, through a few small problems to understand some of the little knowledge of insulin.
1, according to different sources of insulin, insulin can be divided into several?
Answer: according to the source of insulin, can be divided into human insulin, bovine insulin, porcine insulin.
2, according to the different preparation process, insulin can be divided into several?
Answer: according to the different preparation process, can be divided into: the animal pancreatic extract or appropriate purified porcine and bovine insulin; the semi synthetic and synthetic human insulin and insulin analogues;; the additive is added after the treatment of insulin suspension.
3. What is the concept of insulin, biosynthetic human insulin and insulin analogues?
Answer: half adult insulin: pig insulin as raw material, after enzymatic modification of human insulin.
Biosynthetic human insulin: human insulin produced by recombinant DNA technology, also known as recombinant human insulin.
Insulin analogues: the use of recombinant DNA technology, were modified to generate the amino acid sequence of human insulin, a kind of material to simulate normal insulin secretion and role, is different from ordinary insulin structure, physicochemical properties and pharmacokinetics. At present in the clinical application of insulin, insulin aspart, preserved on insulin glargine and detemir.
4, according to the characteristics of the preparation, which can be divided into several types of insulin?
Answer: insulin can be divided into 2 types according to the characteristics of the preparation and the suspension type.
Solution: the regular insulin, soluble neutral or acidic solution is colorless and transparent, including soluble insulin, regular insulin, unmodified insulin, is in urgent situations of short acting insulin intravenous infusion.
Suspension type: a suspension made of structural modifications of insulin to prolong the action of insulin, a milky white turbid liquid, a long-acting insulin preparation.
5, what is premixed insulin?
A: it is also called double phase insulin, which is a mixture of 2 kinds of insulin, which can be used as a short acting and long-acting insulin.
As we all know, insulin can be divided into two groups according to the duration of action: ultra short acting insulin, short acting insulin, medium acting insulin, long-acting insulin, long acting insulin and premixed insulin. Below we introduce in this order.
1 types: short acting insulin are insulin analogues, including insulin lispro and aspart.
2 characteristics: subcutaneous injection of insulin aspart 10 ~ 20min after onset, maximum time is 1 ~ 3H after injection, the hypoglycemic effect lasts 3 to 5h. Insulin lispro subcutaneous injection of 15 ~ 20min after the onset, peak time of 30 ~ 60min, 4 ~ 5h continuous hypoglycemic effect.
Compared with the conventional insulin has the following characteristics: the first is more consistent with the physiological insulin secretion pattern, meal before the injection of rapid absorption, absorption of insulin subcutaneous is 3 times faster, the peak time is short, can effectively control the postprandial blood glucose. The second is the use of time is flexible, before or after meals medication can reach and immediately before the meal 30min injection is (often) the same gauge insulin hypoglycemic effect, conducive to patient compliance, usually with the effect or the combined use of long-acting insulin.
3, note: generally must be immediately adjacent to the injection, medication 10min must eat carbohydrate containing foods, otherwise easily lead to hypoglycemia.
Short acting insulin
1, categories: including animal derived common insulin: regular insulin, neutral insulin, soluble insulin, recombinant human insulin.
2, characteristics: animal insulin subcutaneous injection, 0.5 ~ 1H onset, from to 4h peak, the role of maintaining the 6 ~ 8h; subcutaneous insulin injection, 0.5h onset, from 1 to 3H peak, the duration of about 8h. Generally used for subcutaneous injection of 30min before meals. It is usually used in combination with medium or long acting insulin, and 30min is required to eat carbohydrate containing foods.
The disadvantages of this kind of insulin are as follows: because there is an absorption process in the skin, it is not as sharp as the ultra short effect insulin peak, and there are some differences in the normal physiological secretion pattern. Before meals 30min medication is not easy to grasp, easy to lead to poor blood glucose control in advance, eating time delay prone to hypoglycemia.
Intermediate acting insulin
1, is the most common type: Protaphane, refers to the insulin mixed suspension and protamine zinc phosphate buffer in the complexes, including animal derived isophane insulin and recombinant human insulin.
2, characteristics: subcutaneous injection of low protamine zinc insulin, the average 1.5h onset, from 4 to 12h peak, the role of maintaining the 18 ~ 24h. The advantage is that it is slow and steady release after subcutaneous injection, and the risk of hypoglycemia is shorter.
The effect of insulin in the daily breakfast before 0.5 ~ 1H subcutaneous injection, if the daily dosage of more than 40u, then divided into two injections. In addition, the effect of insulin is most commonly used in the subcutaneous insulin intensive treatment program before going to bed to control fasting blood glucose.
1, type: mainly animal derived protamine zinc insulin.
2, features: protamine zinc insulin is based on the low protamine zinc plus the proportion of fish sperm protein, so that the human body is closer to the pH value, solubility is lower, the release of more stable and slow, the role of longer duration.
Commonly used for daily injections once, to meet the basic needs of insulin in patients with diabetes. Before breakfast 0.5 ~ 1H subcutaneous injection, subcutaneous injection after the onset of 4H ~ 3, ~ 20h peak, the role of maintaining 24~36h. General and short acting insulin with. The disadvantage is that the long-acting formulations are mostly suspensions, which may cause instability of absorption and efficacy.
Long acting insulin
1 types: including insulin glargine and detemir.
2, features: generally used for injection once a day, subcutaneous injection onset time of 1.5h, effective time of up to 22h, no significant peak appears, the effect is stable, suitable for the use of insulin replacement therapy.
1, type: mainly including premixed human insulin and premixed insulin analogues.
(1) premixed human insulin is defined as a mixture of short acting insulin and medium acting insulin in a certain proportion. Including low premixed human insulin and premixed human insulin.
Low premixed human insulin was mainly 70/30 (30% short acting +70%). The onset time was 0.5h, the peak time was 2 ~ 12h, the duration of action was from 14 to 24h.
The premixed insulin was mainly 50/50 (50% short acting +50%). The onset time was 0.5h, the peak time was 2 ~ 3H, the duration of action was from 10 to 24h.
(2) pre mixed insulin analogues refers to insulin aspart (lispro or aspart) and protamine zinc insulin aspart insulin in certain proportion and become, including low premixed insulin analogues and premixed insulin analogues.
Low premixed insulin analogues are mainly 75/25 dosage and 70/30 dosage form, such as 25% +75% insulin lispro protamine zinc insulin lispro, aspart 30% + 70% protamine zinc insulin aspart. The onset time was 15min, the peak time was 30 ~ 70min, the duration of action was from to 24h, and the onset time was from 10 to 20min, and the peak time was from to 4h, and the duration was from 14 to 24h.
Premixed insulin analogues are mainly 50/50 formulations, such as 50% +50% insulin lispro protamine zinc insulin lispro and 50% insulin aspart protamine zinc insulin aspart +50%. The onset time of the former is 15min, the peak time is 30 ~ 70min, the duration of action is from to 24h, and the onset time of the latter is from 10 to 20min, the peak time is from to 4h, and the duration of action is from 14 to 24h.
2, the characteristics of which the short acting component of rapid onset, can be a good control of postprandial hyperglycemia, sustained release of the active ingredient, mainly to provide basic insulin supplement.
The advantages of pre mixed insulin injection times is relatively small, easy to use, to use every regular insulin and insulin zinc protamine 2 hybrid scheme can reduce the injection mixing may be caused by inaccurate dose and avoid the relatively complex operation. The disadvantage is that due to the pre mixing, only a limited mixing scheme is difficult to achieve for some special mixing requirements.