What Is Insulin Injection?

Insulin injection, type 1 and type 1 diabetes. 2. Type II diabetes has severe infections, trauma, major surgery and other severe stress situations, as well as complications of heart, cerebrovascular complications, kidney or retinopathy. 3. Diabetic ketoacidosis, hyperglycemia, non-ketogenic hyperosmolar coma. 4. Plasma insulin level of type 2 diabetes with long course of disease is really low, and those who are not satisfied with the control of reasonable diet, physical activity and oral hypoglycemic drugs, when type II diabetes has contraindications to oral hypoglycemic drugs, such as pregnancy, breastfeeding, etc. 5. Adult or elderly diabetic patients have acute onset and significant weight loss with significant weight loss. 6. Gestational diabetes. 7. Diabetes secondary to severe pancreatic disease. 8. For severe malnutrition, weight loss, intractable pregnancy and vomiting, and early liver cirrhosis, intravenous glucose and a small dose of insulin can be injected at the same time to promote tissue utilization of glucose.

Drug Name: Insulin injection
Drug type: Doping

Hanyu Pinyin: Yi Dao Su Zhu She Ye
Use classification: Hypoglycemic agents

Insulin injection composition

The main ingredient of this product is a sterile aqueous solution of insulin (pig or cattle). Name of excipients: glycerin, phenol, water for injection, adjust pH value with appropriate amount of hydrochloric acid.
Its structural formula:

Molecular formula: C ₂₅₆ H ₃₈₁ N ₆₅ O ₇₆ S ₆
Molecular weight: 5778

Insulin injection properties

This product is a colorless or almost colorless clear liquid.

Insulin injection indication

1. Type 1 diabetes.
2. Type II diabetes has severe infections, trauma, major surgery and other severe stress situations, as well as complications of heart, cerebrovascular complications, kidney or retinopathy.
3. Diabetic ketoacidosis, hyperglycemia, non-ketogenic hyperosmolar coma.
4. Plasma insulin level in type 2 diabetes with long course of disease is really low. Those who are not satisfied with the control of reasonable diet, physical activity and oral hypoglycemic drugs, when type II diabetes has contraindications to oral hypoglycemic drugs, such as pregnancy, breastfeeding, etc.
5. Adult or elderly diabetic patients have acute onset and significant weight loss with significant weight loss.
6. Gestational diabetes.
7. Diabetes secondary to severe pancreatic disease.
8. For severe malnutrition, weight loss, intractable pregnancy and vomiting, and early liver cirrhosis, intravenous glucose and a small dose of insulin can be injected at the same time to promote tissue utilization of glucose.

Insulin injection specifications

10ml: 400 units

Dosage and dosage of insulin injection

1. Subcutaneous injection is usually three times a day, 15 to 30 minutes before meals, and a small injection before bed if necessary. The dose is adjusted gradually according to the condition, blood glucose, and urine glucose from a small dose (2 to 4 units at a time depending on factors such as weight). The total daily insulin requirement for patients with type I diabetes is usually between 0.5 and 1 unit per kilogram of body weight, which is adjusted based on blood glucose monitoring results. The total daily consumption of patients with type 2 diabetes varies greatly. In the absence of acute complications, sensitive people only need 5 to 10 units per day, generally about 20 units. Obesity and poor insulin sensitivity may require obviously increase. In the case of acute complications (infection, trauma, surgery, etc.), patients with type I and type II diabetes should be injected every 4 to 6 hours, and the dose should be adjusted according to the changes in the condition and the blood glucose monitoring results.
2. Intravenous injection is mainly used for the treatment of diabetic ketoacidosis, hyperglycemia and hypertonic coma. Intravenous instillation can be continued for 4 to 6 units per hour for adults, and children can adjust the dose according to blood glucose changes by 0.1 units / kg per hour. It can also be adjusted by intravenous injection of 10 units for the first time and intramuscular injection of 4 to 6 units. In severe cases, 10 units can be injected intravenously, followed by intravenous infusion. When the blood glucose drops below 13.9mmol / L (250mg / ml), the insulin dose and injection frequency will decrease. While using insulin, fluid replacement should also be used to correct electrolyte disorders and acidosis, and pay attention to the body's need for heat. Patients with diabetes who can not eat should inject insulin at the same time as intravenous glucose solution.

Adverse effects of insulin injection

Allergic reactions, redness and swelling at the injection site, pruritus, measles seeking, angioedema.
1. Hypoglycemia response, sweating, palpitations, fatigue, severe cases of disturbance of consciousness, ataxia, tachycardia and even coma.
2. Insulin resistance, the daily dose must be more than 200 units.
3. Fat atrophy and hyperplasia at the injection site.
4. Eye refractive errors.

Insulin injection contraindications

Disabled for patients with insulin allergies.

Precautions for insulin injection

1, hypoglycemia reaction, severe hypoglycemia coma, blood glucose should be closely observed in patients with severe liver and kidney disease.
2. The patient is accompanied by the following conditions, the insulin requirement is reduced: abnormal liver function, hypothyroidism, nausea and vomiting, abnormal renal function, glomerular filtration rate of 10 to 50 ml per minute, and the dose of insulin reduced to 95% ~ 75%; glomerular filtration rate was reduced to less than 10 ml per minute, and insulin dose was reduced to 50%.
3. Patients are accompanied by the following conditions, increased insulin requirements: high fever, hyperthyroidism, acromegaly, diabetic ketoacidosis, severe infection and trauma, major surgery, etc.
4. During the medication, blood glucose, urine routine, liver and kidney function, vision, fundus retinal blood vessels, blood pressure and electrocardiogram should be checked regularly to understand the condition and complications of diabetes.
5, athletes use with caution.

Insulin injection for pregnant and lactating women

Diabetic pregnant women increase their insulin requirements during pregnancy and reduce their requirements after delivery; if the diabetes found in pregnancy is gestational diabetes, the insulin treatment should be terminated after delivery; follow-up of their blood glucose and decide treatment based on the presence or absence of diabetes.

Insulin injection for children

Children are prone to hypoglycemia, and the fluctuation of blood glucose is large. Adjust the dose should be 0.5 to 1 unit, and gradually increase or decrease; adolescents increase the dose appropriately, and then gradually decrease after puberty.

Insulin injection for the elderly

Elderly people are prone to hypoglycemia, so special attention should be paid to the right amount of diet and physical activity.

Insulin injection drug interactions

1, glucocorticosteroids, adrenocorticotropic hormone, glucagon, estrogen, oral contraceptives, adrenaline, phenytoin, thiazide diuretics, thyroxine, etc. can increase blood glucose concentrations to varying degrees, should be used together Adjust the dose of these medicines or insulin.
2, oral hypoglycemic agents and insulin have a synergistic hypoglycemic effect.
3. Anticoagulant drugs, salicylate, sulfa drugs, and antitumor drugs methotrexate can compete with insulin and bind to plasma proteins, thereby increasing the level of free insulin in the blood. Non-steroidal anti-inflammatory analgesics can enhance the hypoglycemic effect of insulin.
4, -blockers such as propranolol can prevent the response of epinephrine to increase blood sugar, interfere with the body's regulation of blood sugar function, and use with insulin can increase the risk of hypoglycemia, and can mask the symptoms of hypoglycemia, prolong the hypoglycemia Blood sugar time. Attention should be paid to the adjustment of insulin dose.
5. Moderate to large amounts of alcohol can enhance the effect of hypoglycemia caused by insulin, which can cause severe and persistent hypoglycemia, which is more likely to occur in the case of fasting or less glycogen storage.
6. Chloroquine, quinidine, quinine, etc. can delay the degradation of insulin and increase the insulin concentration in the blood to strengthen its hypoglycemic effect.
7. Glycemic drugs such as certain calcium channel blockers, clonidine, danazol, diazoxide, growth hormone, heparin, H2 receptor antagonists, cannabis, morphine, nicotine, and sulfopyridone can change sugar metabolism, It can increase blood sugar, so insulin should be added appropriately when combined with the above drugs.
8. Angiotensinase inhibitors, bromocriptine, clofibrate, ketoconazole, lithium, tomidazole, pidoxine, theophylline, etc. can directly or indirectly cause blood sugar reduction in different ways. When insulin is used in combination with the above drugs Should be reduced appropriately.
9. Octreotide can inhibit the secretion of growth hormone, glucagon and insulin, and delay gastric emptying and slow gastrointestinal motility, causing delayed food absorption, thereby reducing postprandial hyperglycemia. When starting octreotide, insulin should Reduce the amount appropriately and adjust it later based on blood sugar.
10. Smoking: It can antagonize the hypoglycemic effect of insulin through the release of catecholamines. Smoking can also reduce the absorption of insulin by the skin. Therefore, when smoking patients who are using insulin therapy suddenly quit smoking, they should observe blood glucose changes and consider whether they need to reduce the amount of insulin appropriately .

Insulin injection overdose

For diabetic patients, if the dosage is too large or not eaten as prescribed, it can cause hypoglycemia or even hypoglycemic coma. When there are aura symptoms, oral glucose, cakes or sugar water should be taken. If the patient is unconscious, it should be taken muscle, subcutaneously or Glucagon is injected intravenously, and after being conscious, sugar is taken orally. Those who do not respond to glucagon must be given an intravenous solution of glucose.

Pharmacology and toxicology of insulin injection

This product is a hypoglycemic drug. The main effect of insulin is to lower blood sugar and affect protein and fat metabolism, including the following aspects.
1. Inhibit liver glycogen breakdown and glycogen heterogeneity, reduce liver output glucose.
2. Promote liver uptake of glucose and liver glycogen synthesis.
3. Promote the uptake of glucose and amino acids by muscle and adipose tissue, and promote the synthesis and storage of protein and fat.
4. Promote liver to produce very low density lipoprotein and activate lipoprotein lipase, promote the decomposition of very low density lipoprotein.
5. Inhibit the decomposition of fats and fats and proteins in muscles, inhibit the production of ketone bodies and promote the utilization of ketone bodies by surrounding tissues.

Pharmacokinetics of insulin injection

Oral is easily destroyed by gastrointestinal digestive enzymes. Subcutaneous administration is rapid absorption, effective from 0.5 to 1 hour after subcutaneous injection, the effect reaches a peak in 2 to 4 hours, and the maintenance time is 5 to 7 hours; the effect of intravenous injection is 10 to 30 minutes, and the peak is 15 to 30 minutes, and the duration is 0.5 ~ 1 hour. Intravenous insulin has a half-life of 5 to 10 minutes in the blood circulation and a half-life of 2 hours after subcutaneous injection. After subcutaneous injection, the absorption is very irregular. The absorption of insulin can be different at different injection sites. Abdominal wall absorption is the fastest, and the lateral upper arm is faster than the anterolateral femur. After insulin is absorbed into the blood circulation, only 5% of it binds to plasma proteins, but it can bind to insulin antibodies, which prolongs the action time of insulin. It is mainly metabolized in the kidneys and liver, and a small amount is excreted by the urine.

Insulin injection storage

Keep tightly closed in a cold place (2-10 ° C). Avoid freezing, this product does not need to be stored in the refrigerator during use. Can be stored at room temperature (up to 25 ° C) for up to four weeks to avoid light and heat.

Insulin injection packaging

10ml controlled antibiotic glass bottles, 2 per box, and 1 disposable sterile insulin syringe.

Expiration Date of Insulin Injection

24 months

Insulin injection standard

"Chinese Pharmacopoeia" 2010 edition two

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