When translated into in patients with type 2 diabetes who are on the basal or basal-bolus insulin therapy regime or regimen prepared mixtures of insulin / self-mixed insulin, should count on the basis of a dose of basal insulin that the patient received prior to his transfer to a new type of insulin, according to the principle “one by one”, and then adjust according to individual patient needs.
Patients with type 1 diabetes
in most patients with type 1 diabetes at the transition from any basal insulin drug bayer proviron uses the principle of “one by one” on the basis of a dose of basal insulin that the patient received prior to the transfer, then the dose is adjusted according to his particular requirements. In patients with type 1 diabetes, which at the time translated into therapy were on insulin basal insulin twice daily administration mode, or in patients with an indicator , must be installed on individual basis. You may need to decrease the dose, followed by individual selection of the dose based on the glycemic indexes.
Flexible dosing regimen
Based on the patient’s needs, allows you to change the time of its introduction (see. Pharmacodynamics section). In this case the interval between injections must be at least 8 hours.
Those patients who forget to enter time insulin dose, it is recommended to introduce a dose as soon as they found it, and then return to his usual time of daily single administration.
Special patient groups
Elderly patients (over 65 years)
drug bayer proviron can be used in elderly patients. You should carefully monitor the concentration of blood glucose and adjust insulin dose individually (see. Pharmacokinetics section).
Patients with impairment of renal function, and hepatic
can be used in patients with renal insufficiency and liver. You should carefully monitor the concentration of blood glucose and adjust insulin dose individually (see. Pharmacokinetics section).
Children and adolescents
Existing pharmacokinetic data presented in subsection pharmacokinetics, however, the efficacy and safety in children and adolescents have not been studied, the dose of the drug recommendations in children have not been developed.
Dosing is intended for subcutaneous administration. The should not be administered intravenously, as it may lead to the development of severe hypoglycemia. The should not be administered intramuscularly, as in this case, the absorption of the drug is changed. The should not be used in insulin pumps.
The is administered subcutaneously in the thigh, the anterior abdominal wall or in the shoulder area. It is necessary to constantly change injection sites within the same anatomic region in order to reduce the risk of lipodystrophy. The cartridge designed for use with disposable injection needles and systems for insulin Novo Nordisk.
Description of individual adverse reactions Violations by the immune system
When applying insulin preparations may develop allergic reactions. Allergic reactions of immediate type on himself insulin preparation or auxiliary components included in it, could potentially threaten the patient’s life.
Using the drug bayer proviron hypersensitivity reactions (including tongue, or lip swelling, diarrhea, nausea, fatigue and pruritus ) and urticaria have been observed rarely.
Hypoglycaemia may develop if the insulin dose is too high in relation to the patient’s need for insulin. Severe hypoglycemia may lead to unconsciousness and / or convulsions, temporary or permanent impairment of brain function or death. Symptoms of hypoglycaemia usually develop suddenly. They include a “cold sweat”, pale skin, fatigue, nervousness or tremor, anxiety, neobshnuyu tiredness or weakness, disorientation, poor concentration, drowsiness, expressed the feeling of hunger, blurred vision, headache, nausea, palpitations.
Lipodystrophy (including lipohypertrophy, lipoatrophy) may occur at the injection site. Compliance with the rules changing the injection site within the same anatomical region helps to reduce the risk of this adverse reaction.
Reactions at the injection site
in patients receiving , observed reactions in the injection site (hematoma, pain, local bleeding, erythema, nodules of the connective tissue, swelling, changes in skin color, itching, irritation and induration at the injection site). Most injection site reactions are minor and of a temporary nature and usually disappear with continued treatment.
Children and adolescents
The pharmacokinetic properties have been studied in children and adolescents under 18 years of age (see. Pharmacokinetics section). Insulin efficacy and safety studies degludek not conducted in children and adolescents.
Special groups of patients
in clinical trials, no differences in the incidence, severity or type of adverse reactions between elderly patients and patients with impaired renal or hepatic function and the general population of patients have been identified.
The particular dose required for insulin overdose are not established, however, hypoglycaemia may develop gradually, if it is too high in comparison with the need of the patient the dose has been introduced (see. Section Cautions).
- An easy hypoglycaemia the patient can remove himself, taking bayer proviron into glucose or sugar products. Therefore, patients with diabetes should always carry sugar-containing products.
- In the case of severe hypoglycemia when the patient is unconscious, he should enter glucagon (0.5 to 1 mg) intramuscularly or subcutaneously (can be administered by trained persons), or intravenous dextrose (glucose) (can only enter health worker). Must also be administered intravenously dextrose if 10-15 minutes after administration of glucagon is not patient regains consciousness. After regaining consciousness of the patient it is recommended to take food rich in carbohydrates, for the prevention of relapse of hypoglycaemia.