Directory → Hormones and their antagonists → Insulins
This page is translated automatically with a help of Google Translate
The groupInsulin is a hormone made by the beta-kletkami pancreas. Insulin molecule consists of two circuits 40b. One contains 21 acid balance (A chain), the second-30 amino acid residues (chain B). The chains are connected by two bridges disulfidnami. Third disulfidnyi bridge formed in a chain of A. The molecular mass insulin molecule is about 5,700.
Insulin is produced in the pancreas humans and animals. The most close to the structure of insulin rights is insulin pigs, who in the chain in the balance of amino acids lysine the balance alanine. In beta-kletkah pancreas produces insulin from predecessor, proinsulin, a non-hormonal activity.
Endogenous insulin is the most important regulator of hydrocarbons, exogenous-specific saharoponijatee resort. It increases tissue uptake of glucose and helps make it the enzyme facilitates entry of glucose into cells. In hypoglycemic, insulin has a number of other effects : increased stocks glycogen in muscles, stimulates synthesis of peptides, reduces fuel cell tissues, etc. The insulin is accompanied by activation or inhibition of certain enzymes : stimulated glikiencintetaza, piruvat-degidrogenaza, gexokinaza, ingibiruyutza lipase (and gidrolizutaya lipids adipose tissue, and lipoprotein-lipaza reduce "flat" serum after taking rich food fats).
The biosynthesis and insulin secreting pancreatic cancers depends on the concentrations of glucose in the blood : while increasing its content secretia increases with the lowering-down.
The effects of insulin led by its interaction with specific receptors, the lokalizutmisa plazmaticescoy membrane cells and education insulinretseptonego complex. Along with insulinovm insulin receptor enters the cell, which affects the fosfaurilirovania cellular proteins and "runs" many Wärmetauscher reaction.
Insulin is the main specific treatment for diabetes.
For medical use insulin used to be mostly from pojeludochnykh glands of cattle, followed by pojeludochnykh glands pigs, Bearing in mind that "pork" insulin is closer to insulino rights. There is a method of chemical synthesis of insulin, but it offers few. Recently, a biotechnology means of obtaining human insulin. Available methods of genetically engineered insulin fully consistent with the look composition insulin rights. The drugs produced in insufficient water may attend impurities (proinsulin, glukagon, somatostatin, proteins, polipeptida, etc.) liable to cause different reactions. Modern technologies provide peeled (monopikove - chromatographically purified allocating "peak" insulin), purified (monokomponentne) and christallizovanne insulin preparations. There is a growing use of crystal is insulin rights. The insulin preparations of animal origin preference monopikovomu insulino obtained from the pancreas of pigs.
Activity insulin determine biological method (by lowering the ability of glucose in the blood of the rabbits), or chemical method (by the electrophoretic paper or by chromatography on paper). During one of the (U), or an international unit (IU), take action 0.04082 mg crystalline insulin.
The major indication for the use of insulin is diabetes mellitus type 1, but under certain conditions (heavy related diseases, pregnancy, Preparations for operational interventions, diabetic coma, etc.), he was appointed and diabetes type 2. Insulin apply not only diabetes but also in some other pathological processes : to a total depletion (as a means anaboliceski), abrasions, tireotoxicose with stomach diseases (atony, gastroptos), chronic hepatitis, Primary forms of cirrhosis, as well as some mental health; sometimes it is used as a component of "polarizing" solutions. used in the treatment of acute coronary insufficiency.
Treatment of diabetes mellitus in a specially designed schemes using insulin preparations with varying duration of action. The product depends on the severity and characteristics of the course of the disease, general condition of the patient and on the speed of onset and duration of action saharosnijatego preparation.
Products produced rapid action is a solution designed for subcutaneous or intramuscular injection. If necessary, they are also introducing users. They provide a quick and relatively short gipoglikemicescoe effect. The effect after subcutaneous injections is 15 to 20 minutes, reaching a peak in 2 hours; the total duration of no more than 6 hours They are used mainly in the hospital during the for the patient doses of insulin, and when a fast (urgentny) effect, with the diabetic coma and precome. Drugs produced a short-acting used as anabolic and appoint, as a rule, in small doses (on the U 4-8 1-2 times per day).
Products produced prolonged action produced in various forms of drugs that have gipoglikemiceski effect of different lengths (from 10 to 36 h). Stretch effect to reduce the number of daily injections. Issued they usually in the form of suspensions imposed only subcutaneously or intramuscularly. In diabetic coma and prekomatozhnykh conditions prolongirovanne drugs do not apply.
All products are produced with a duty to comply with the dietary restriction of caloric intake (from 1700 to 3000 cal).
In determining the dose of insulin by the prandial glycemia during the day, as well as the glukozurii within days. The final selection of doses under the supervision of reducing io, glukozurii, as well as the overall condition of the patient. Too high doses, as well as lack of dietary carbohydrates can cause undesirable gipoglikemicescoe state can develop gipoglikemical coma loss of consciousness, convulsions and cardiac disorders activities.
When the first signs gipoglikemii needed urgent activities : the patient must drink sweet tea or eat a few pieces of sugar. In gipoglikemicescoy coma in suicide impose 40% glucose of 20-40 ml or more, the patient was not going to come out of the coma (usually not more than 100 ml). Remove gipoglikemia can also vnutrimyshecnam or subcutaneous introduction glukagona.
When a skin preparations insulin may lipodistrofii development at the injection.
Modern purified insulin preparations relatively rare cause of allergies, but such cases are not excluded. The severe allergic reaction requires immediate desencibiliziruta therapy and the replacement of the preparation.
Insulin is not suitable for diseases occur with gipoglikemiei, acute liver, pancreas, kidney, stomach ulcer and duodenal ulcer, decompencirovannah heart diseases, and acute coronary insufficiency and some other diseases. Insulinoterapia pregnant carried out under careful supervision.
It should be borne in mind interaction possible while applying insulin with other drugs. Альфа-адреноблокатор�� and beta-adrainostimulatora, tetratziklin, salicilata increase the secretion of endogenous insulin and reinforce the drug tiazidnye dioretiki, beta-adrenoblokatora, alcohol, in contrast, are weakening.
Anti insulin produced in glass bottles, hermetically ukuporennah rubber plugs with aluminium tyres, or special devices.
Currently, the A large number insulinovykh preparations including from pojeludochnykh glands animals and synthesized by means of genetic engineering. The following groups :
1) rapid insulin action (of the usual 30 minutes; maximum of a half hours; the total duration of 4-6 hours);
2) long-term insulin action (beginning at 4-8 hours; peak after 8-18 hours; total duration of 20 to 30 hours);
3) insulin, the average length of the (early in 1.5-2 hours; peak after 3-12h; the total duration of 12 hours);
4) insulin average length of the combinations.