Insulin Analogs Vs Human Insulin
There is also another, very important reason, why insulin products aren’t listed in milligrams and that has to do with the existence of Insulin analogs.
Insulin analogs and human insulin technically use the same conversion and are considered ‘equipotent’.
Nevertheless, there are significantdifferences in the pharmacokinetic profiles of each .
- Regular insulin .
- NPH insulin .
Regular human insulin products are considered ‘fast-acting’, with an onset of action around 30 minutes. High concentration regular human insulin , have a slightly faster onset of action and duration of action.
NPH insulin is also known as isophane insulin and is intermediate-acting. It is regular human insulin with added zinc and protamine, which causes a delay in absorption and prolongs the duration of action.
Insulin analogs are altered forms of insulin and are manufactured via genetic engineering. Analogs are created in such a way to alter their pharmacokinetic characteristics from human insulin.
For example, there are several ‘rapid’ acting insulin analogs, and have a faster onset of action than human insulin products. These include:
- Insulin degludec
Conversions Between Human And Analog Insulin
Although all insulin products are considered ‘equipotent’ in regard to the fact that 1 unit of each equals 0.0347 mg, as described above, they have significant differences in their onset of action, time to peak effect, and duration of action.
What Is Sliding Scale Insulin Therapy
One of the most controversial therapies for treating diabetes is sliding scale insulin therapy. In this method, blood sugar is measured by a glucometer, taken before meals and at bedtime. The dose of insulin is then administered according to the sugar level.
Governing organizations strictly prohibit the use of this method in healthcare facilities, however, because it has been proven to be ineffective in regulating blood sugar levels accurately.
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How Long Until My Blood Sugar Get Undrr Control
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How Much Does It Cost To Produce Insulin
A 2018 study estimated that one vial of human insulin costs $2.28-$3.42 to produce, and one vial of analog insulin costs $3.69-$6.16 to produce. The study revealed that a years supply of human insulin could cost $48-$71 per patient, and analog insulin could cost $78-$133 per patient per year.
The study measured the manufacturing cost only. It did not include administrative fees, sales, and research and development for improving medications. However, insulin manufacturers have not provided an adequate explanation for this large discrepancy between production costs and retail costs.
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What Is The Correct Dosage
The correct dosing of insulin is very important:
Giving a patient too little insulin does not adequately lower blood sugar so that they are still left with too much sugar in the blood too much sugar the the blood can cause damage to blood vessels, leading to blindness, kidney failure, severe problems with limbs , stroke and heart disease.
Giving a patient too much insulin can lower blood sugar too much and lead to dangerously low levels of sugar in the blood, which can cause seizures and coma, because the brain depends primarily on glucose in the blood for fuel. Even before a person’s blood sugar level drops low enough to cause seizure or coma, low blood sugar levels can lead to mood swings, impaired mental function, blurred vision, nausea and vomiting, heart palipitations and shakiness.
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How Is It Given
Insulin is given by injection because it cannot be taken orally the stomach will break it down so that is is no longer effective in breaking down blood sugar.
Insulin should always be dosed using special insulin syringes marked with insulin units. Common insulin U-100 syringes can hold 100 units there are also Lo-dose syringes, which are syringes that can hold a total of 30 units or 50 units.
The above picture shows the syringes themselves but they are so small that they can be hard to read, so often we flatten out the measurement on the side of the syringes, so that each syringe label looks something like the pictures below:
|Lo-Dose insulin syringe for measuring up to 50 units Each mark is 1 unit apart.||Insulin syringe for measuring up to 100 units Each mark is 2 units apart.||Insulin syringe for measuring up to 100 units Each mark is 2 units apart. Even numbers are marked on the scale on the rightand odd numbers are marked on the scale on the left.|
Why Am I Paying So Much More Than $130 Per Year For My Insulin
Right now, there is no competitive biosimilar insulin market. Not just in the United States anywhere in the world. This study sites the insulin oligopoly, regulatory challenges and regular incremental developments in insulin as three reasons we havent seen the emergence of a healthy biosimilar market. In order for the low prices suggested here to become a reality, multiple new manufacturing competitors need to enter the ring.
Not only are the big three insulin manufacturers financially opposed to biosimilars entering the market, theyve actively taken legal steps to prevent it. In July 2017, Merck received FDA approval for Lusduna Nexvue, a biosimilar of Lantus. It has not launched in the United States because of an outstanding lawsuit Sanofi, maker of Lantus, sued Merck for patent infringement. Just this month, Merck announced that Lusduna will not come to market because of the cost associated with getting it there.
The answer to why youre paying so much for insulin depends on where you live, what kind of insurance you have, and a slew of other variables. The studys authors remind us: final prices to patients or health systems may include additional mark-ups added during the supply chain. These mark-ups will vary between countries, as they may be subject to local negotiations, regulations, and other factors. In some cases, these additional markups can be very large.
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It Is Divided Into 3 Main Sections:
The modules can be read in any order.
However, if you are newly diagnosed, it is best to start at the beginning in Understanding Diabetes, and work your way through the material.
Below you will find a guide to each module.
As you will see, depending upon your individual therapy, you can choose exercise guidelines and self-management sections that are specific for your diabetes treatment. Additionally, throughout the program, Self-assessment quizzes are available to help you monitor your progress, and how much you are learning.
What Is The Difference Btw Insulin Detemir And Insulin Glargine
Although there is no significant difference between insulin detemir and insulin glargine, some differences still exist. Do you know what that difference is? Really no?? Insulin glargine absorbs more slowly than insulin detemir. It is so because insulin glargine is less soluble under the skin as compared to insulin detemir.
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How Much Does A Bottle Of Insulin Cost With Insurance
It is difficult to say how much a vial of insulin costs when paying through your health plan. Each insurance plan covers insulin products differently.
It is when you actually have health insurance coverage that getting the insulin for a decent price becomes a problem, says Dr. Carnathan. In those cases, the patients are sometimes forced to switch to a different and cheaper type of insulin called NPH or 70/30 among a few others. These insulins have been around for a long time and are affordable. The patient needs a primary care doctor or endocrinologist who is comfortable using these older insulins and adjusting them safely.
Each health plan has varying copays and deductibles, too. For example, for people with a high-deductible plan, the cash price for insulin is paid until you meet the deductible. Some copays can be as high as 50% of the cost of the medication.
It can also sometimes be difficult for people on Medicare to afford insulin. Many patients who are faced with the high cost of insulin find themselves caught in the Medicare donut hole, says Gail Trauco, RN, the principal CEO of The PharmaKon LLC.
Like uninsured customers, patient assistance programs might be of help to Medicare customers. However, these programs require an application, which can take 30 to 60 days for review and approval, and documentation with receipts to confirm your monthly cost-of-living expenses.
Your Childs Correction Factor Will Look Like This:
unit for every point that blood sugar is over
For example, a correction factor of 1:50> 150 means your child will take one unit of fast-acting insulin for every 50 points their blood sugar is over 150 .
To calculate this, take your childs current blood sugar and subtract their target blood sugar. Divide the result by 50, and multiply that result by the number of units.
Here is an example of a correction factor calculation:
If your childs correction factor is 1:50> 150 and their current blood sugar is 233:
- 233 minus 150 equals 83
- 83 divided by 50 equals 1.6
- 1.6 multiplied by 1 equals 1.6
This means your child needs to take 1.6 units of insulin to bring their elevated blood sugar down to their target blood sugar.
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How Do I Store Insulin
|Store in refrigerator. Good until expiration date on insulin pen or cartrige.||Store at room temperature. Throw away 28 days after first use.|
*Source: These are the manufacturers recommendations.
- When storing insulin in the refrigerator, the temperature should be between 36 degrees F and 46 degrees F.
- When storing insulin at room temperature, temperature should be between 36 degrees F and 86 degrees F.
First Some Basic Things To Know About Insulin:
- Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day.
- The other 50-60% of the total daily insulin dose is for carbohydrate coverage and high blood sugar correction. This is called the bolus insulin replacement.
Bolus Carbohydrate coverage
The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio.The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin.
Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 6-30 grams or more of carbohydrate depending on an individuals sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress.
Bolus High blood sugar correction
The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar.
Generally, to correct a high blood sugar, one unit of insulin is needed to drop the blood glucose by 50 mg/dl. This drop in blood sugar can range from 30-100 mg/dl or more, depending on individual insulin sensitivities, and other circumstances.
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How Do I Calculate How Much Insulin To Take
In people who do not have diabetes, their bodies release insulin in response to the foods they eat. This is because many foods contain carbohydrates. Some examples include bread, sweets, fruits, and even vegetables.
Your body breaks carbohydrates down into smaller building blocks, like glucose. You need insulin to use this glucose for energy. If your body cannot make or use insulin effectively, youll need to inject it to process your food for energy.
Calculating how much insulin to take is usually based on two considerations:
- Basal insulin dose. A basal insulin dose is an amount that you give yourself daily regardless of the foods you eat.
- Bolus insulin dose. A bolus insulin dose helps correct or anticipate the carbohydrates you eat throughout the day. You will usually correct this with a bolus dose of rapid-acting insulin.
Anticipating a bolus dose is where insulin administration can get tricky. When you give yourself insulin, you are estimating how many units of insulin it will take to process the carbohydrates you eat.
The University of California, San Francisco states that, as a general rule, 1 unit of insulin will process anywhere from 12 to 15 grams of carbohydrates and lower your blood sugar by about 50 milligrams per deciliter .
Since the human body is so complex, not all people will process insulin the same way. Factors like time of day, stress levels, and physical activity can make these numbers more difficult to predict.
Putting It All Together
Now that you know the how and why behind insulin dosing, lets consider how you may calculate your insulin needs.
Youll usually give yourself an insulin dose around your meals since thats when you take in carbohydrates. You also will typically check your blood sugar to see if youre meeting your premeal target dose.
To calculate your insulin needs:
You may find that if you generally eat about the same amount of carbohydrates each day, you may be able to consistently inject the same amounts of insulin outside of special occasions. It takes time to find out how your body best responds to insulin.
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