Combination of human insulin and delayed insulin (NPH insulin)
Mode of action
Insulin is a hormone that is produced by the cells of the pancreas in healthy people. It is released when the blood sugar level rises, especially after a meal. Insulin then causes glucose to be absorbed in certain body cells, for example those of the muscles and adipose tissue. Furthermore, it inhibits the supply of glucose from the body's own reserves or through new synthesis (production), since in this situation enough sugar is supplied from the outside and the energy production can largely be covered from this. This is why insulin inhibits processes that are stimulated by the body for an alternative energy production in case of a sugar deficiency, for example the breakdown of proteins (e.g. from the muscles) and fat. In situations in which there is enough glucose, insulin also increases the sugar, protein and fat stores (glycogen, protein and lipid synthesis), which in turn can be used to generate energy when the body does not have a glucose supply outside, for example between two meals.
Insulin plays a prominent role in treating patients with Diabetes mellitus. In people with one Type I diabetes insulin is used from the start, in one Type II diabetes only in the course of the disease. Insulin comb® is one of numerous insulin preparations; it contains a combination of Regular insulin and Delay insulin. The normal insulin causes a relative rapid onset of action, the delay insulin has the advantage of more than twice as long Duration of action. This is due to the fact that the insulin molecules are attached to a poorly soluble substance are bound (as NPH that lead to a delayed release of insulin. Pass by until it takes effect about 30 minuteswhy this insulin 15-30 minutes should be injected before a planned meal so that it takes effect in good time. The effect of this combination preparation lasts 14-20 hours on, depending on the proportion of normal and delay insulin. There are preparations with 15, 25 and 50% Proportion of normal insulin and accordingly 85, 75 and 50% Proportion of NPH insulin (Insulin comb 15 ®, Insulin comb 25 ®, Insulin comb 50 ®).
Side effects of Insuman comb®
The desired effect of insulin - the lowering of the glucose level - causes the most common side effect, a Too much lowering of the sugar level (Hypoglycemia). This can show through symptoms such as Racing heart (Tachycardia), Tremble, hunger and sweat. Other possible side effects are Weight gain (by inhibiting the breakdown of sugar, fat and protein reserves), changes in the subcutaneous fat tissue (lipodystrophy) at the puncture site, allergic reaction, Edema due to sodium retention especially at the start of therapy and others.
Low blood sugar (Hypoglycemia) is one absolute contraindication. Insulin should be dosed particularly carefully in patients with insufficiency of kidney or liver.
There are numerous interactions with other drugs. So there is a increased need for insulin with simultaneous therapy with Beta sympathomimetics how Salbutamol (e.g. as part of the therapy of bronchial asthma or the COPD), Corticoids / steroids such as Prednisolone, Thyroid hormones (mostly L-thyroxine), Estrogens (e.g. in the context of contraception with the "pill“), Water tablets (diuretics) and others.
A decreased need for insulin exists when taking at the same time Beta blockers (e.g. at Cardiac arrhythmias, Heart failure or after Heart attack), MAO inhibitors (psychotropic drugs), aspirin (ASS) and others. With insulin therapy there is a risk of alcohol consumption at the same time Hypoglycaemia, as alcohol inhibits the body's own glucose synthesis.
Dosage of Insuman comb®
The dosage is based on individual needs using a Daily schemes. The injection is usually given subcutaneous (s.c.).
Insuman comb 25® is mentioned here as an example. 5 pre-filled syringes cost approximately on a private prescription 54 euros. If you present a prescription, you will have to pay just under 5.50 euros.