Gensulin

Gensulin is a hypoglycemic medicine, an insulin agent.

[1]

Indications Gensulina

It is used in diabetes mellitus, requiring the introduction of insulin substances.

Release form

The substance is released in the form of an injectable suspension, inside a bottle of glass with a capacity of 10 ml (1 bottle inside the pack). Also sold in cartridges with a volume of 3 ml, 5 pieces inside the box.

Pharmacodynamics

Gensulin is a substance of recombinant human isophane-insulin, which is produced by means of genetic engineering using a non-pathogenic, genetically modified strain of E. Coli.

Insulin is a hormone produced by pancreatic cells. He is a member of the protein, carbohydrate and fat metabolism, helping, for example, to reduce blood sugar levels. With insulin deficiency, a person develops diabetes. Injected insulin has an effect similar to that of a hormone produced by the body.

Pharmacokinetics

The effect of the drug begins within half an hour after the injection. Cmax values are noted after 2-8 hours, and the duration of the effect of the drug reaches 24 hours (depending on the size of the dosage portion). In a healthy person, insulin synthesis with blood protein is up to 5%. It is revealed that insulin penetrates into the cerebrospinal fluid in an amount that is about 25% of the indicators determined inside the blood serum.

The exchange processes of insulin develop inside the kidneys with the liver. Its small volumes are exchanged inside the fatty tissue with the muscles.

Insulin is excreted by the kidneys. Some trace amounts of the substance are excreted in the bile. The half-life of a person’s insulin is approximately 4 minutes. In diseases associated with liver and kidney, delayed insulin elimination may occur. In older people, insulin is excreted at a lower rate, and the period of hypoglycemic effect is prolonged.

Dosing and administration

It is necessary to follow all the recommendations of the doctor. If you have any doubts, you should consult a physician.

Clinical practice has many methods of using insulin. The optimal scheme that will meet all the needs of the patient should be selected by the attending doctor. Based on the blood glucose values, he prescribes the dosage and type of insulin required by the patient.

To change the dosage, mix insulin products, as well as to make other changes in the scheme of insulin therapy can only physician.

The patient needs to monitor the values of sugar inside the urine and blood using standard tests (for example, test strips). If the indicators do not correspond to the normal level, you should report this to the doctor.

Consultation with a physician is required constantly, especially in the first weeks of insulin treatment.

Introduction of Gensulin is made by a hypodermic method. Only in exceptional circumstances can it be administered intramuscularly.

It is necessary to change the places of injections to prevent the appearance of seals on the epidermis. The most suitable for the introduction are the areas of the shoulder, abdomen, front of the thigh and buttocks. When injected into the abdominal area, insulin is absorbed faster than injections in other places. To enter the drug in one area should be a maximum of 1-fold per month. Enter the medication required 15 minutes before a meal.

[3]

Use Gensulina during pregnancy

In pregnant women, it is extremely important to maintain an optimal sugar level, because the development of hyperglycemia can cause abnormalities in the fetus. At the 1st trimester, the need for insulin is reduced, and in this case it is required to reduce its dosage, but at the 2nd and 3rd trimesters this need increases, which is why Gensulin's dosage increase is required (on average, up to + 75% portions used before pregnancy).

Immediately after delivery, the need for insulin drops sharply.

Diabetic lactating women need to change their insulin dosage or diet. The need for insulin at this time is reduced (in comparison with the period before pregnancy), alignment to the initial level occurs after 6-9 months.

Contraindications

Main contraindications:

• the presence of manifestations that indicate the development of hypoglycemia;
• the presence of intolerance to human insulin or other auxiliary components of the drug;
• history of allergies to any insulin drug, medicine, food, dye or preservative;
• change in diet or increase in standard physical activity.

In severe stages of infections, diseases accompanied by severe fever, increased emotional stress, and also in diarrhea, absorption disorders and gastric motility, diseases in the gastrointestinal tract or vomiting, you must constantly monitor the indicators of sugar inside the urine and blood, and in case of violations, consult with a medical specialist. If possible, observe the prescribed dosages of insulin and eat regularly.

When planning a long trip (or changing the time zone), you may need to adjust the size or time of insulin use. Before traveling, where you need to cross at least 2 time zones, you should consult your doctor about the use of insulin. Since it is forbidden to freeze the medicine, it is stored in your carry-on baggage when flying, not in your baggage.

Side effects Gensulina

Such side effects often develop: local signs of allergy, such as puffiness, erythema and itching. Such manifestations often pass after several days or weeks. Sometimes local signs appear not because of insulin (for example, under the action of irritating components contained in the composition of the disinfecting medicine, or in connection with the wrong technique of the injection procedure).

Occasionally, manifestations such as compaction in the injection area occur.

Single common allergic symptoms similar to generalized intolerance to insulin. Among the manifestations - dyspnea and rash on the whole body. In addition, also stridor, acceleration of the pulse, reduction in blood pressure and hyperhidrosis. Sometimes the generalized manifestations of allergies even become life threatening. Occasionally, with a strong reaction to the drug, urgent treatment is required. Desensitization and insulin replacement may be necessary.

[2]

Overdose

When insulin intoxication develops hypoglycemia, which is expressed in the form of a sense of inhibition and lethargy, vomiting, palpitations, hyperhidrosis and headaches.

If hypoglycemia is moderate, you need to drink sweet water or eat a sweet product that contains a lot of carbohydrates. In addition, the patient needs to rest. It is recommended to always carry sweets, sugar cubes or glucose.

In the severe stage of the disorder, seizures can occur, there is a loss of consciousness and sometimes death. To return the victim to consciousness, you need to perform an injection of glucagon (this should be done by a qualified specialist).

After the injection of glucagon, immediately with the restoration of consciousness, the patient should eat sugar or something sweet. In the absence of consciousness after the injection, it is necessary to hospitalize the victim.

It is required that all those who often surround the patient know how to act when they lose consciousness - they need to be laid horizontally, after which they should immediately call medical specialists. It is forbidden to give the victim in this state any food or drinks (due to the high probability of aspiration).

With the development of hypoglycemia with subsequent loss of consciousness or with frequent hypoglycemic conditions, you should consult with the doctor regarding changes in the amount of insulin, as well as the time of drug use, taking into account the physical activity of a person and diet.

The development of hypoglycemia occurs in such cases:

• an injection of too much insulin;
• insufficient amount of consumed food or skipping of its reception;
• non-standard for the patient increase in physical activity.

Interactions with other drugs

Means and drugs that potentiate the properties of insulin: salicylates (aspirin), oral antidiabetic drugs, certain antidepressants (MAOIs), certain substances of an ACE inhibitor (such as enalapril or captopril), non-selective 0-adrenergic blockers (sotalol or propranolol), and ethanol.

Medications that weaken the activity of insulin: thyroid-type hormones, GCS, danazol, growth hormones, p2-sympathomimetics (among them salbutamol with ritodrine and terbutaline), and in addition niacin and diuretic drugs of thiazide character (for example, hydrochlorothiazide).

Changes in the level of need for insulin can produce somatostatin analogs of the substance (such as lanreotide or octreotide).

In some patients who have been treating type II diabetes mellitus and CVS-related diseases for a long time, or those who have had a history of stroke, the combined use of insulin with pioglitazone sometimes develops HF. With the appearance of any manifestations of HF (for example, cyanosis, weight gain, dyspnea, fatigue, swelling in the legs), you should immediately seek medical help.

[4], [5]

Storage conditions

Gensulin is required to be kept in a dark place (refrigerator), closed from the penetration of small children, with temperature values in the range of 2-8 ° C. It is forbidden to freeze the suspension.

The drug in the cartridges after opening remains stable for 28 days (temperature not more than 25 ° C), and the substance in the vials - for 42 days (temperature not higher than 25 ° C). Used cartridges with vials are not allowed to be kept in the refrigerator; the patient can carry them with you.

Shelf life

Gensulin is allowed to apply within the time limit of 24 months from the date of manufacture of the drug substance.

Application for children

There is not enough data on the use of drugs in pediatrics.

Analogs

Analogues of the drug are the means Insuman Bazal GT, Protafan NM Penfill with Protafan NM, and in addition Humulin nph and Protamine-insulin ES.

[6], [7], [8]