Author: Gcplive
Source: Center for Drug Evaluation< /p>
Insulin is the most effective hypoglycemic drug. When the patient’s pancreatic islet function gradually declines, the oral hypoglycemic drug treatment is ineffective or contraindicated, exogenous insulin supplementation is a very necessary means. .
I. Commonly used insulin and its classification
< p>According to the molecular structure, insulin can be divided into animal insulin, recombinant human insulin and human insulin analogs. Animal insulin is antigenic and prone to allergic reactions and insulin resistance.
According to the action characteristics, insulin can be divided into mealtime insulin, premixed insulin and basal insulin.
Intermediate-acting human insulin (NPH)Also called neutral protamine zinc insulin. Long-acting human insulin (PZI) is also known as protamine zinc insulin.
Intermediate-acting human insulin and long-acting human insulin have distinct peaks, short duration, and high risk of hypoglycemia, but are inexpensive.
Second, the difference between short-acting and ultra-short-acting insulin
Short-acting insulin(recombinant human insulin) takes effect 20-30 minutes after subcutaneous injection, It must be administered within 30 minutes before meals.
Ultra-short-acting insulin (human insulin analog)10-15 minutes after subcutaneous injection Effective, must be injected immediately before meals. If necessary, it can be administered immediately after a meal.
short-acting insulin (recombinant human insulin)peak time 2~4 hours, duration 5~8 hours,It is easy to cause hypoglycemia.
The difference between commonly used premixed insulins
Premixed human insulin = human insulin (short-acting) + protamine human insulin (long-acting). It must be administered within 30 minutes before meals.
Premixed human insulin analog = human insulin analog (ultra-short-acting) + protamine human insulin analog (long-acting). It should be injected immediately before a meal. If necessary, it can be administered immediately after a meal.
Hypoglycemia risk:
Premixed Human Insulin Analog < Premixed Human Insulin.
Differences between long-acting insulin analogs< /strong>
Insulin glargine and insulin degludec have a long duration of action and only need to be injected subcutaneously once a day. Insulin detemir should be injected once or twice a day according to the patient’s blood sugar control.
Long duration of action of insulin degludec (>42 hours) , and tends to be peak-free, with a lower risk of hypoglycemia and nocturnal hypoglycemia.
V. Differences between routes of administration
short-acting insulin (recombinant human insulin), ultra-short-acting human insulin analogs (insulin aspart, Insulin pro) are colorless and transparent liquids.
Insulin aspart and insulin lispro, which can be injected subcutaneously , intravenously, or continuously subcutaneously through an insulin pump.
<600> (Insulin glargine, insulin detemir, insulin degludec) are colorless and transparent liquids and can only be injected subcutaneously.
Premixed insulin (including premixed human insulin similar to substances) are suspensions and can only be injected subcutaneously .
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