Diabetics have heard of insulin, insulin is hypoglycemic, there are many types of insulin, but the mechanism of lowering blood sugar is the same, different types of insulin their time of action and onset time is different, so this issue is dedicated to this issue.
Insulin in the body is an insulin hexamer formed by 6 insulin molecules and 2 zinc ions, and insulin must be in the form of a monomer to lower blood sugar, so the time it takes for insulin to change from a hexamer to a monomer determines how quickly it acts, that is, the shorter the time from a hexamer to a monomer, the faster it will act, of course, the shorter the time of action, and vice versa is in line with the same logic.
01 Ultra-short-acting insulin
These include insulin lispro (trade name Eupirol) and insulin aspart (trade name Novorid). The two insulins worked the fastest because they replaced an amino acid on the basis of insulin, thereby hindering self-polymerization between insulin monomers. Specifically, the proline on the human insulin B28 position is replaced by lysine to become insulin lispro; the proline on the human insulin B28 position is replaced by aspartic acid and becomes insulin aspart.
In summary, these two insulins exist structurally mainly in the form of a mixture of monomers and bibody, so there is no need for the time to dissociate from hexamer to monomer, so it can be directly effective.
For these two types of insulin, we require that we take it immediately before the meal, that is, prepare the meal and eat it with insulin.
02 Short-acting insulin
Including ordinary insulin in animal insulin, norohelin R and Eumulin R in human insulin.
The basic structure of short-acting insulin is hexamer, subcutaneous injection after dissociation into dimers and monomers can be absorbed, because after injection to slowly dissociate into dimers and monomers, the dissociation time is half an hour, so it is necessary to inject 30 minutes before meals.
03 Moderate-acting insulin (NPH)
Mainly including low sperm protein zinc insulin and insulin zinc suspension, commonly used in the market are low sperm protein recombinant human insulin injection (Ganshulin N), neutral low sperm protein zinc human insulin (Novolin N), sperm protein zinc recombinant human insulin injection (Eumulin N) and so on.
The structure of medium-acting insulin is to gather several hexamers together through protamine, and after injection into the body, several hexamers gathered together are dissociated into one hexamer, and then a single hexamer is dissociated into a monomer, so the time of action needs to be longer, of course, it can prolong the action time of insulin.
Moderate-acting insulin (NPH) is given once a day, usually at night before bedtime.
04 Long-acting insulin
It mainly includes insulin glargine (trade name is Laideshi) and insulin detemir (trade name is Nopin).
Long-acting insulin changes the PH value of insulin through amino acid changes, increasing the time it takes for hexamers to dissociate into monomers. At the same time, the zinc ions contained in insulin glargine further increase the stability of insulin hexamers; detemir binds to albumin in plasma 98% to 99%, which slows down their onset time, and since their onset time is slow, correspondingly, the duration is very long.
05 Premixed insulin
Refers to the mixing of short-acting insulin preparations and medium-acting insulin preparations in different proportions, and has the effect of short-acting insulin and long-acting insulin at the same time.
The advantage is that the number of injections per day is less, and the disadvantage is that this proportion is fixed and cannot be treated precisely for patients.
As can be seen from the above, at present, the most clinically used is the combination of "ultra-short-acting insulin + long-acting insulin", because the ultra-short-acting insulin is to eat after playing, which is more convenient than the short-acting insulin that eats after 30 minutes of injection, and at the same time, the long-acting insulin acts longer than the medium-acting insulin, so the most used at present is the combination of "ultra-short-acting insulin + long-acting insulin".
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