INSULINOTERAPIA

Tipul insulinei Denumire Actiune Durata actiunii Observatii

Inceput Maxima uzuala maxima
Insulina umana cu actiune INSUMAN RAPID 30-60 min 30-60 min 3-6 h 6-8 h  100 UI/ml
RAPIDA HUMULIN REGULAR
(regular)
Insulina cu actiune FOARTE APIDRA (GLULIZIN) 10 min 30-90 min 3-4 h 5h
SCURTA HUMALOG (LISPRO) 10 min
(analogi de insulina) NOVORAPID (ASPART) 10 min
FIASP (ASPART) 2 min
LYUMJEV (LISPRO) 2 min
Insuline cu actiune LUNGA LANTUS (GLARGIN) 2-4 h 24 h 24 h 100 UI/ml
(analog) LEVEMIR (DETEMIR) 2-4 h 12 h 12-18 h 100 UI/ml
TRESIBA (DEGLUTEC) 2-4 h 24 h 24 h 100 UI/ml
ABASAGLAR (GLARGIN) 2-4 h 24 h 24 h 100 UI/ml
TOUJEO (GLARGIN) 2-4 h lent 24 h 24 h 300 UI/ml
Insuline PREAMESTECATE HUMULIN M3 30-60 min 2-3 h 10-16 h 14-18 h
(bifazice) INSUMAN COMB 25 ; 30 6-10 h
Insuline PREAMESTECATE HUMALOG MIX 25; 30 10 min 30-90 min 10-16 h 14-18 h
(analogi) NOVO MIX 30 6-10 h
 ANTIDIBETICELE ORALE

Clasa Denumire Doza Durata Mechanism de actiune CI Efecte advrse

comerciala actiunii
BIGUANIDE SIOFOR 500 / 1000 mg 12 h Scade: productia hepatica de Insuf hepatica, Reactii GI,
GLUCOPHAGE XR 500/ 750/ 1000 mg 24 h glucoza, lipoliza, TG, VLDL, LDL, renala, cardiaca. disguezie, acidoza
GLUCOPHAGE 750/ 1000 mg PAI-1, rezistenta la insulina . Transaminaze > lactica
METFOGAMMA 1000 mg Creste: captarea musculara a 3xN. DZ I ,
MEGUAN 500/ 1000 mg glucozei mediate de insulina, cetoacidoza,
METFORMIN ARENA/TEVA 500/ 850/ 1000 mg legarea insulinei de receptori si interventii
activarea tirozin kinazei. chirurgicale
Actiune pe GB si GPP. NU prod (intrerupe cu 48h
*Metformin – elim hipoglicemie, reduce greutatea inainte) , RX cu
renala, corporala. subst. contrast,
antihiperglicemiant, Inhiba abs glucozei in intestin, infectii sistemice,
Nu stim secretia neoglucogeneza, glicogenoliza. soc, alcoholism cr.
insulinei. Nu Cetogen, anorexigen,
influenteaza gr. Kg. fibrinolytic, hipotiroidian.

INHIBITORI AI ALFA- ACARBOZA 50 mg/ 100 mg 4-5 h Scade: glicemia post-prandiala Cetoacidoza Dureri abdominale,
GLUCOZIDAZEI ( GLUCOBAY ) si insulinemia post-prandiala diabetica, ciroza, diaree, flatulenta,
*dupa masa NU produc hipoglicemie inflamatii cresterea
*diminueaza *elim fecala si renala intestinale, sarcina, transaminazelor
degradarea Diabet neinsulinodependent alaptare
polizaharidelor in
monozaharide
absorbabile
SULFONILUREICE GLICLAZID (DIAPREL) 30 / 60 mg 24 h Cresc : insulina circulanta prin DZ I, interventii Hipoglicemii
GLIMEPIRID (AMARYL) 1/2/3/4/6 mg 12 h stimularea secretiei de nsulina, chirurgicale, frecvente, creste G
GLIBOMET 2.5 + 400 mg glicoliza, contractilitatea cetoacidoza, IMA, kg, greata, dureri
(glibenclamid + miocardului varsta > 60 ani, IR, epigastrice, vome,
metformin) Scad : gluconeogeneza, IH, precoma si eruptii cutanate
GLURENORM 30 mg oxidarea AG. coma diabetica, prurit, cefalee,
(GLIQUIDONA) Effect hipotiroidian disfunctii tiroidiene ameteli,
severe. fotosensibilitate,
*inainte de masa trombopenie,
leucopenie.
Agonisti ai RECEPT EXENATIDA 2 mg 1 sapt Scad: glicemia bazala, glicemia DZ I, Cetoacidoza Greata, rar vome,
GLP1 (BYDUREON) post-prandiala, HbA1C, diabetica, srcina, pacreatita acuta
(inj) LIRAGLUTID 0.6/1.2/1.8/2.4/3 mg 24 h greutatea kg, Tas, Tad, LDL, TG alaptare. Boli TGI
(VICTOZA) 1.5 mg 1 sapt Cresc: HDL severe
DULAGLUTID Nu produc hipoglicemii in
(TRULICITY) 0.25/0.5/1 mg 1 sapt monoterapie
SEMAGLUTID
(OZEMPIC)
Agonisti ai RECEPT SEMAGLUTID 3/7/14 mg 24 h Scad: glicemia bazala, glicemia DZ I, Cetoacidoza Greata, rar vome,
GLP1 (RYBELSUS) post-prandiala, HbA1C, diabetica, srcina, pacreatita acuta
(oral) greutatea kg, Tas, Tad, LDL, TG alaptare. Boli TGI
Cresc: HDL severe
Nu produc hipoglicemii in
monoterapie
INHIBITORII DPP4 SITAGLIPTINA 50/100 mg 12-24 h Scad: glicemia bazala, glicemia DZ I, cetoacidoza Tulburari digestive,
(oral) (JANUVIA) post-prandiala, HbA1C diabetica, sarcina, cefalee,
SAXAGLIPTINA 2.5/50mg Neutru pe greutatea kg alaptare, BCR rinofaringite,
(ONGLYZA) Sigurata cardiovasculara reactii de
VILDAGLIPTINA 50 mg hipersensibilitate
(AGARTHA)
(DALMEVIN)

INHIBITORI DE DAPAGLIFLOZIN 10 mg 24 h Scade: glicemia bazala, glicemia DZI . cetoacidoza, Depletie volemica,
SGLT2 NA- GLUC (FORXIGA) post-prandiala, HbA1C, TA, varsta <18 ani, tulburari TGI
(oral) EMPAGLIFLOZIN 10/20 mg reabsorbtia renala a glucozei, sarcina, alaptare, (constipattie,
(JARDIANCE) greutate kg varsta > 70 ani, RFG xerostomie),
Creste: protectia CV, excretia < 25 tulburari renale
urinara a glucozei ml/min/1.73m2 (disurie, poliurie,
Actioneaza independent de vulvo-vaginita.
insulina Balanita, ITU),
Creste creatinine,
accentuarea
dislipidemiei