In case of insufficient glucose control or a tendency to the appearance of hyper- or hypoglycemia episodes before deciding whether the correction of insulin dose should be sure to verify that the prescribed regimen of insulin administration, to make sure that the insulin is injected into the recommended area, check the correct injection technique and all other factors , which can affect the effect of insulin.
Since the simultaneous administration of a number of drugs (see the section "Interaction with other drugs") can weaken or intensify the hypoglycemic effect of the drug Insuman Rapid GT, no other drugs should be taken with its application without the special permission of the doctor.
Hypoglycaemia
Hypoglycemia occurs if the dose of insulin exceeds the need for it.
The risk of hypoglycemia is high at the beginning of treatment with insulin, when another insulin preparation, patients with low maintenance concentration of glucose in the blood.
As with all insulins, special care should be taken and intensive monitoring of blood glucose in patients for whom hypoglycemic episodes may be of particular clinical importance, such as patients with severe stenosis of the coronary or cerebral arteries (risk of cardiac or cerebral complications of hypoglycemia) is recommended. , as well as in patients with proliferative retinopathy, especially if they did not undergo photocoagulation (laser therapy), since they have the risk of transient amaurosis (full blindness) with the development of hypoglycemia.
There are certain clinical signs and signs that should indicate to the patient or others about developing hypoglycemia. These include: increased sweating, skin moisture, tachycardia, heart rhythm disturbances, increased blood pressure, chest pain, tremor, anxiety, hunger,drowsiness, sleep disturbances, feelings of fear, depression, irritability, unusual behavior, anxiety, paresthesia in the mouth and around the mouth, pallor of the skin, headache, movement coordination disorders, and transient neurological disorders (speech and vision impairment, paralytic symptoms) and unusual sensations. With an increasing decrease: the glucose concentration of the patient may lose self-control and even consciousness. In such cases, coldness and moisture of the skin can be observed, and convulsions may also appear.
Therefore, every patient with diabetes who receives insulin should learn to recognize symptoms that are a sign of developing hypoglycemia. Patients who regularly monitor the concentration of glucose in the blood are less likely to develop hypoglycemia. The patient himself can correct the observed decrease in blood glucose concentration by taking sugar or food with a high carbohydrate content. For this purpose, the patient should always carry 20 g of glucose. In more severe conditions of hypoglycemia, a glucocaine injection is indicated (which can be done by a doctor or average medical personnel).After enough improvement, the patient should eat. If hypoglycemia can not be immediately remedied, then it is urgent to call a doctor. It is necessary to inform the doctor immediately about the development of hypoglycemia, so that he makes a decision about the need to correct the dose of insulin. Failure to comply with a diet, insulin injection, increased insulin requirements due to infectious or other diseases, decreased physical activity may lead to an increase in blood glucose (hyperglycemia), possibly with an increase in the level of ketone bodies in the blood (ketoacidosis). Ketoacidosis can develop within a few hours or days. At the first symptoms of metabolic acidosis (thirst, frequent urination, loss of appetite, fatigue, dry skin, deep and rapid breathing, high concentrations of acetone and glucose in the urine), urgent medical intervention is necessary.
When a doctor changes (for example, during hospitalization for an accident, illness during a vacation), the patient should inform the doctor that he has diabetes mellitus.
Patients should be warned about conditions that may change, be less pronounced, or completely absent symptoms warning of hypoglycemia, for example:
- with a significant improvement in glycemic control;
- with gradual development of hypoglycemia;
- in elderly patients;
- in patients with autonomic neuropathy;
- patients with a long history of diabetes mellitus;
- in patients who are simultaneously receiving treatment with certain medications (see section "Interaction with other drugs").
Such situations can lead to the development of severe hypoglycemia (and possibly with loss of consciousness) earlier than the patient realizes that he develops hypoglycemia.
In case of detection of normal or reduced values of glycosylated hemoglobin, one should think about the possibility of developing recurring, unrecognized (especially nocturnal) episodes of hypoglycemia.
To reduce the risk of hypoglycemia, it is required that the patient accurately follow the prescribed dosing regimen and diet, properly administered insulin injections and be warned about the symptoms of developing hypoglycemia.
Factors that increase predisposition to the development of hypoglycemia require careful monitoring and may require dose adjustment.
These factors include:
- change in the area of insulin administration;
- increased sensitivity to insulin (eg, elimination of stress factors);
- unusual (increased or prolonged physical activity);
- intercurrent pathology (vomiting, diarrhea);
- inadequate intake of food;
- skipping meals;
- alcohol consumption;
- Some uncompensated endocrine diseases (such as hypothyroidism and insufficiency of the anterior lobe of the pituitary gland or insufficiency of the adrenal cortex);
- simultaneous administration of certain drugs (see section "Interaction with other drugs").
Intercurrent diseases
Intercurrent diseases require intensive metabolic control. In many cases, urine tests for the presence of ketone bodies are shown, and often a correction of the insulin dose is necessary. The need for insulin is often increased. Patients with type 1 diabetes must continue to regularly consume at least a small amount of carbohydrates, even if they can take only a small amount of food or if they have vomiting and they should never completely stop the introduction of insulin.
Cross immunological reactions
In a fairly large number of patients with hypersensitivity to animal insulin, the transition to human insulin is difficult due to the cross-immunological reaction of human insulin and insulin of animal origin. With increased sensitivity of the patient to insulin of animal origin, as well as to m-cresol, tolerability of the drug Insuman Rapid HT should be evaluated in the clinic with the help of intradermal tests. If a hypersensitivity to human insulin (an immediate reaction, such as Arthus) is detected during the intradermal test, further treatment should be carried out under clinical control.
Instructions for use and circulation in advance filled with SoloStar® pen
Before the first use, the syringe pen should be held at room temperature for 1-2 hours.
Before use, inspect the cartridge inside the syringe pen. It should be used only if the insulin solution is absolutely transparent, colorless, without visible foreign particles.
Empty SoloStar® pen need not be reused and must be destroyed.
To prevent infection, a pre-filled syringe pen should only be used by one patient and not transferred to another person.
Handling of the SoloStar® syringe handle
Carefully read the usage information before using the SoloStar® pen.
Important information on using the SoloStar® pen
Before each use, it is necessary to carefully connect a new needle to the syringe pen and conduct a safety test.
Only needles that are compatible with SoloStar® should be used.
It is necessary to take special precautions to avoid accidents involving the use of a needle and the possibility of transfer of infection.
Do not use the SoloStar® pen when it is damaged or if you are not sure that it will work properly.
Always have a spare SoloStar® pen in case you lose or damage your copy of the SoloStar® pen.
Storage Instruction
Please read the "Storage conditions" section for the storage rules for the SoloStar® pen.
If the SoloStar® pen is stored in the refrigerator, remove it from there for 1-2 hours before the proposed injection so that the solution will take room temperature. The introduction of chilled insulin is more painful.
The used SoloStar® pen must be destroyed.
Exploitation
The SoloStar® syringe handle must be protected from dust and dirt.
The outer side of the SoloStar® pen can be cleaned by wiping it with a damp cloth.
Do not immerse in liquid, do not rinse and do not lubricate the SoloStar® syringe, as this can damage it.
The syringe handle SoloStar® accurately doses insulin and is safe to work with. It also requires careful handling. Avoid situations in which the SoloStar® pen can be damaged. If you suspect that your copy of the SoloStar® pen can be damaged, use a new syringe pen.
Stage 1. Insulin control
It is necessary to check the label on the SoloStar® syringe pen to ensure that it contains the appropriate insulin. For Insuman Rapid GT, a SoloStar® white syringe pen with a yellow button for injection with a relief ring on it.After removing the cap of the syringe-pen, monitor the appearance of the insulin contained in it: the insulin solution must be absolutely transparent, colorless, without visible foreign particles.
Stage 2. Connecting the needle
Use only needles that are compatible with the SoloStar® syringe handle.
For each subsequent injection, a new sterile needle is always used. After removing the cap, the needle should be carefully installed on the syringe pen.
Stage 3. Performance of the safety test
Before each injection, a safety test must be carried out and make sure that the syringe pen and needle work well and air bubbles are removed.
Measure the dose equal to 2 units.
The outer and inner needle caps must be removed.
With the needle pen up, gently tap the cartridge with the insulin finger so that all air bubbles are directed toward the needle.
Fully press the injection injection button.
If insulin appears at the tip of the needle, it means that the pen and needle work correctly.
If no insulin appears on the tip of the needle, stage 3 can be repeated until insulin appears on the tip of the needle.
Stage 4. Dose selection
The dose can be set to an accuracy of 1 unit from a minimum dose of 1 unit to a maximum dose of 80 units. If it is necessary to enter a dose exceeding 80 units, two or more injections should be given.
The dosage window should indicate "O" after the safety test is completed. After this, the required dose can be set.
Stage 5. Dosing Introduction
The patient should be informed about the technique of injection by a medical professional.
The needle must be inserted under the skin.
The injection button must be pressed completely. It is held in this position for another 10 seconds until the needle is removed. Thus, the introduction of a selected dose of insulin is fully ensured.
Stage 6. Extraction and ejection of a needle
In all cases, the needle after each injection should be removed and discarded. This ensures the prevention of contamination and / or infection, air entering the insulin tank and leakage of insulin.
When removing and discarding the needle, special precautions must be taken. Observe the recommended safety measures for removing and disposing of needles (for example,the technique of putting the cap on with one hand) in order to reduce the risk of accidents involving the use of a needle, and prevention of infection.
After removing the needle, close the SoloStar® syringe with the cap.