Good news for diabetics! Different concentrations of insulin give patients more choices in treatment options

Don’t think that diabetes is a trivial matter. Poor blood sugar control can lead to complications such as stroke, heart disease, and diabetic eye disease! About one in 10 people in Hong Kong has diabetes, and one in eight of them requires daily insulin injections. To control blood sugar, they are most worried about the side effects of hypoglycemia after taking medication. However, in recent years, Europe, the United States and Asia have introduced long-acting insulin of different concentrations. Which patients are suitable for different treatment options? Are they available in Hong Kong? The University of Hong Kong School of Medicine Dr. Li Zhihao, clinical assistant professor of the Department of Internal Medicine and specialist in endocrinology and diabetes, will answer the questions one by one. At present, 90% of patients in Hong Kong have type 2 diabetes. Because of the resistance or insufficient secretion of insulin in the body, glucose cannot enter the cells and remains in the blood, causing blood sugar to rise. Patients need to take medication or even inject insulin to stabilize blood sugar levels. As for type 1 People with diabetes must inject insulin because their bodies cannot produce insulin.

The longer you have diabetes, the higher your chance of taking insulin.

Nowadays, there are various types of oral medicines on the market. Why do some diabetic patients need to inject insulin? Dr. Li explained that as patients suffer from diabetes for longer, the function of their pancreas to secrete insulin will gradually decrease. If they take oral medicines, , if the glycated hemoglobin (HbA1c) is still unable to be controlled to the ideal level, insulin treatment should be started.

Europe, the United States, Mainland China, Taiwan, and Macau have successively introduced long-acting insulin of different concentrations.

In recent years, long-acting insulin of different concentrations has been introduced and widely used in many places in Europe, America and Asia. However, in Hong Kong, certain concentrations of insulin are only available in private hospitals and clinics, and public hospitals have not yet included them in the HA drug formulary. Dr. Li said that there are currently different types of insulin in public hospitals, which can be divided into rapid-acting, short-acting, medium- and long-acting, mixed and long-acting according to the time and duration required to produce effects. Patients may suffer from hypoglycemia after injection. Symptoms such as hunger, rapid heartbeat, cold sweat, dizziness, lack of concentration, blurred vision, nausea, fatigue, headache, etc., especially if they occur in the middle of the night and are not treated immediately, can lead to serious consequences. In the past, some patients were worried about a sharp drop in blood sugar in the middle of the night and simply ate a large amount of snacks before going to bed to raise blood sugar levels. However, Dr. Li believed that this was putting the cart before the horse and making it more difficult to control blood sugar.

People with type 1 diabetes, poor kidney function, and the elderly especially need more different treatment options.

In fact, different concentrations of insulin have different characteristics, and different patients require different treatment options. Dr. Li explained: “Patients with type 1 diabetes and poor renal function especially need more different options, because these patients are more likely to Hypoglycemia occurs. In addition, if an elderly person living alone suffers from hypoglycemia, there may not be anyone at home to help immediately, or patients with dementia may not be aware of their hypoglycemia, which may cause danger at any time. Therefore, more information is needed when choosing an insulin treatment plan for them. consideration.”

Treatment options available to patients with severe insulin resistance

Insulins of different concentrations have different injection volumes when patients take the same dose. For patients who need to take high doses, doctors will consider more when choosing insulin. Dr. Li explained: “Because the concentration of long-acting high-concentration insulin is higher, It is high, so the volume to be injected will be smaller, which is beneficial for patients who need to receive high doses of insulin, such as those with higher insulin resistance or who are heavier.”

Patients who have had a stroke or have poor hand-brain coordination may not be suitable.

However, some patients need to pay attention when injecting different concentrations of insulin. Dr. Li explained that patients must use designated injection pens to inject, which may be difficult for those who have had a stroke, have poor hand-brain coordination, and the elderly. However, he believes that under public-private collaboration, some public hospital patients will be referred to private hospitals for treatment, and they will also undergo follow-up consultation in public hospitals. Therefore, the introduction of different types of insulin can give patients an additional choice.

Dr. Lee Chi-ho, clinical assistant professor of the Department of Internal Medicine at the University of Hong Kong and a specialist in endocrinology and diabetes, said that people with type 1 diabetes, poor kidney function and the elderly are prone to hypoglycemia, so there are more different insulins as their treatment options. , especially important.

Source：https://heart2heart.mingpao.com/糖尿病人喜訊! 不同濃度的胰島素讓病人治療方案有更多的選擇/