诺和锐30R的使用方法

人诺和灵30R胰岛素和50R胰岛素使用诺和灵30R: 是短效胰岛素百分之30，中效的百分之70，用法：早餐前、晚餐前各一次。

适合血糖较平稳得高血糖，居高不下的血糖适合用短效胰岛素调血糖。

早餐前皮下注射后：短效的作用到午餐前，中效的作用到晚餐前。

晚餐前皮下注射后：短效的作用到睡前，中校的做用到明晨。

如果午餐前血糖高，说明短效的不够，应该用50R的，（50R是中效短效各一半）如果晚餐前血糖高，说明早餐前中效的不够，应该换用30R的。

如果晚餐前血糖低应换50R。

诺和灵30R和50R 怎么选择1.诺和灵分短效(R)和中效(N)及其混合制剂(30R,50R): 诺和灵30R，诺和灵30R笔芯均含短效人胰岛素30％，低精蛋白锌人胰岛素70％；诺和灵50R笔芯含短效人胰岛素50％，低精蛋白锌人胰岛素50％.2.混合制剂是把短效和中效预先混合起来的胰岛素，这种一天两次的预混胰岛素用法对大多数糖尿病患者都适用。

3.选择30/70或50/50可根据病人早餐后及午餐后血糖水平来决定早餐前的注射剂量；根据病人晚餐后及次日晨的空腹血糖来决定晚餐前皮下注射的剂量。

用预混胰岛素制剂使用方便，可减少注射次数，但缺乏灵活性。

4.如果是基础血糖水平比较高的人，30R可能更合适一些；有许多患者午餐后的血糖难以达标，30R对餐后血糖控制不甚理想，可使用５０Ｒ。

使用５０Ｒ如午饭后血糖还是高得话，可以在早饭前使用短效和中效的胰岛素，根据血糖情况增加中效胰岛素用量。

具体计算方法。

50R适用于早餐后血糖偏高,午餐前不太高的患者. 胰岛素治疗要个体化，很难一概而论，要看具体病例50R 缺点就是低血糖发生率比30R要高4。

如果是基础血糖水平比较高的人，30R可能更合适一些；有许多患者午餐后的血糖难以达标，30R对餐后血糖控制不甚理想，可使用５０Ｒ。

应该说，30R对空腹及午餐后血糖控制要优于50R，50R 控制早餐后血糖比较好。

50R更适合中国人的饮食特点,因为中国人以碳水化合物为主食,用50R降低餐后血糖更有效! 预混胰岛素的确在针对某些病人时缺乏灵活性，窃以为如果想既不改变注射次数，又将血糖控制在良好范围内，可以试着拆开胰岛素，即人为地配置成40R、60R等，这样既可以增加治疗的依从性，又能把血糖控制在合适的范围内，毕竟良好的治疗依从性才是治疗有效的基石。

胰岛素诺和锐30r的使用说明书（Insulin aspart 30R manual）Novorapid 30 flexpen - only to find the "charge", deal with itDrug name: novorapid 30 flexpenInsulin Aspart 30 InjectionNovorapid 30 FlexPen Description: novorapid 30 flexpen (for the treatment of diabetes mellitus) can better simulate the physiological insulin secretion, improve postprandial glucose control, less severe and nocturnal hypoglycemia, and the meal immediately before injection, greatly increase the treatment compliance of patients.Novorapid 30 flexpen:Category: Imported Drugs[name of drug]Commodity name: novorapid 30 flexpenDrug name (medium): Insulin Aspart 30 InjectionChinese Pinyin: Mendongyidaosu 30 ZhusheyeEnglish Name: Insulin Aspart 30 InjectionDosage form: injection[main ingredient] insulin aspart (using biotechnology toreplace the proline of human insulin amino acid chain B28).[character] this product is clear and colorless aqueous solution of insulin aspart.[pharmacological toxicity] hypoglycemic effects of insulin aspart insulin aspart is through a combination of molecular and muscle and adipose cells on insulin receptor, promote glucose uptake, while inhibiting glycogen release to achieve. Human insulin aspart core amino acid chain B28 in the proline was replaced by aspartic acid, so human soluble insulin in the tendency to form six dimer is reduced in insulin aspart in. Thus, subcutaneous absorption is faster than soluble human insulin.[pharmacokinetics] human soluble insulin aspart lead is rapid onset, lower the blood glucose concentration decreased. The duration of the injection was short after subcutaneous injection. The average time for insulin to reach the highest blood concentration was 50% of soluble human insulin. The peak time of type 1 diabetic patients is about 40 minutes after subcutaneous injection. About 4-5 hours after injection, the concentration returned to base. This product absorbs very quickly. But there are differences between groups the highest blood concentration, stressed the importance of novorapid refill individualized treatment.[indications] used in the treatment of diabetes mellitus[usage] this product is faster than the soluble human insulin, and has a shorter duration of action. It is usually due to rapid onset, so it is generally necessary to be injected immediatelybefore meals. Take the medicine immediately after meals, if necessary. The dosage should be individualized and decided by the doctor according to the patient's condition. But it should be used in combination with medium or long-acting insulin, at least once a day. The insulin requirement is usually 0.5-1.0U per kilogram body weight. Among them, 2/3 dosage is prandial insulin, another 1/3 dosage is base insulin. The improvement of metabolic control in diabetic patients can effectively delay the occurrence and progression of late complications. Therefore, improvements in metabolic control, including glucose testing, are recommended. After subcutaneous injection, the abdominal wall, thigh, deltoid region and gluteal region can be selected, or continuous infusion in the abdominal wall. The injection position shall be rotated in the same area. After subcutaneous injection, it takes effect within 10-20 minutes, so it is necessary to eat carbohydrate containing foods within 10 minutes after injection. The maximal effect time was 1-3 hours after injection, and the hypoglycemic effect lasted for 3-5 hours. Do not use this medicine if the solution is no longer transparent or colorless. To prevent cross infection, this product is for personal use only. Before use, please check the integrity of the product (for example: no cracks), if the cartridge has been damaged, or rubber piston issued a white bar code band, please do not use. Dial the needle after each injection. If the needle is not removed after injection, the change of temperature will cause the liquid to leak out of the needle. Don't refill the product. To determine the concentration of insulin before injection and type the correct, and in accordance with the guidelines for the use of insulin injection system of Novo Nordisk, careful operation. This product is used for subcutaneous injection. If insulin isinjected from the abdominal wall, it works faster. The injection site can be the abdomen, thighs, upper arms, or hips. The injection site should be rotated in the same area. Treatment of this product and other insulin refill as when two novo insulin syringes were used, each for different types of insulin injection syringe.[adverse reactions] hypoglycemia is the most frequent adverse event in insulin treatment. Symptoms of hypoglycemia often occur suddenly. Treatment with insulin may lead to edema and abnormal visual function, but these symptoms are transient. Local anaphylaxis may also occur during the course of insulin treatment (redness, edema, and itching) at the injection site. But usually for a short while, continuing treatment can disappear. Systemic anaphylaxis rarely occurs, but can be life-threatening. If the injection site is not rotated, it is possible to develop fat malnutrition at the injection site.[hypoglycemia] hypoglycemia, allergic to insulin aspart or other components of the preparation.[note] inadequate dosage or treatment interruption may lead to hyperglycemia and ketoacidosis, especially in type 1 diabetes mellitus (insulin-dependent diabetes mellitus). The first symptoms of hyperglycemia usually occur over hours or days. It includes nausea, vomiting, lethargy, flushing of the skin, dryness, dry lips, increased frequency of urination, thirst, loss of appetite, and breath with acetone. Untreated hyperglycemia events are likely to lead to death. Injection time novorapid should be closely linked with the meal time, which is close to the pre meal. It works quickly, so it isnecessary to consider whether the patient's comorbidities and the combination of drugs delay the absorption of food. A combination of diseases, especially infections, often increases the amount of insulin used. Liver or kidney damage can reduce the amount of insulin used in patients. When patients switch to other types or brands of insulin, strict medical monitoring should be maintained. Changes in insulin concentration, brand, type, species (animal, insulin, human insulin, human insulin analog) and / or manufacturing processes will lead to changes in dosage. Patients from the other application of insulin aspart after use may increase the number of daily injections or change the dose. If this adjustment is necessary, it will take place during the first or first few weeks or months. After the patient's glycemic control has been improved, for example, the initial symptoms of hypoglycemia can change after intensive insulin therapy, and attention should be given to the patient. Only in children compared with soluble insulin aspart using rapid onset under more favorable circumstances. For example, when the injection time is related to the meal time. If hypoglycemia occurs, the rapid onset of pharmacodynamics of the insulin analog results in hypoglycemia occurring earlier after insulin aspart injection than in soluble human insulin. If a large amount of exercise meal or not included in the plan of physical exercise may lead to hypoglycemia. Hypoglycemia may damage the patient's attention and responsiveness. As a result, there may be danger in the patient's particularly important activities (such as driving a car or operating machinery). Patients should be advised to guard against hypoglycemia during driving, especially in patients with reduced or decreased signs of hypoglycemia and frequent hypoglycemia. In this case, the patient should beallowed to continue driving.[pregnant and lactating women] there is no systematic study of pregnant women. It is recommended that women with diabetes, pregnancy, and pregnancy should be monitored throughout pregnancy until the end of pregnancy. In early pregnancy, the amount of insulin usually decreases and increases gradually after middle and late stages. No restrictions on the use of this product in lactating women. Breastfeeding mothers should be insulin does not cause harm to infants. But the dosage of insulin aspart may need to be adjusted.[children] use this product only when compared with soluble insulin, which is more rapidly effective.[elderly patients] good[drug interaction][drug overdose] would be hypoglycemia symptoms, including cold sweat, pale, fatigue, nervousness or anxiety, tremor, abnormal fatigue or weakness, mental disorders, difficulty concentrating, abnormal sleepiness, hunger, visual changes, headache, nausea and palpitation. Severe hypoglycemia can cause coma and / or convulsions, temporary or permanent brain damage or even death. Mild hypoglycemia can be treated with oral glucose or sugar. Therefore recommends that diabetics carry sugar or sugary foods such as biscuits. The patient was unconscious when severe hypoglycemia occurred,Glucagon can be administered by intramuscular or subcutaneousinjection of trained persons or by intravenous administration of glucose by medical personnel. If the patient does not respond to glucagon within 10-15 minutes, glucose should also be given intravenously.[specifications] 100 units per milliliter, 3 ml per bottle (special charge).[storage] unused products should be refrigerated at 2-8 degrees Celsius (not too close to cold ice chamber), not frozen.[validity] 24 months[import drug registration number] S2*******[approval number of imported drugs separately] J20050018[manufacturer] Denmark, Novo NordiskNovorapid 30 flexpen price: RMB 108Objectives: adherence to 4567 (fasting 4~5, 2 h after meal, 6~7), control 5678 (fasting <5.6, 2 hours after meal, <7.8).。

诺和锐30(门冬胰岛素30注射液)【药品名称】商品名称：诺和锐30通用名称：门冬胰岛素30注射液英文名称：Insulin Aspart 30 Injection【成份】本品主要成份及其化学名称为：本品含30%可溶性门冬胰岛素和70%精蛋白门冬胰岛素，100U/ml，其活性成份为门冬胰岛素（通过基因重组技术，利用酵母生产的）。

1单位(1U)相当于6nmol，0.035mg不合盐的无水门冬胰岛素。

其他成份：甘露醇、苯酚、间甲酚、锌（氯化物）、二水合磷酸氨二钠、氯化钠、硫酸鱼精蛋白、盐酸、氢氧化钠和注射用水。

【适应症】用于治疗糖尿病。

【用法用量】本品的用量因人而异，应由医生根据患者的病情来决定。

本品比双时相（预混）人胰岛素起效更快，所以一般须紧邻餐前注射。

必要时，可在餐后立即给药。

胰岛素需求量通常为每天每公斤体重0.5-1.0单位，可全部或部分来自本品。

对有胰岛素抵抗的患者（如：肥胖原因），其每日需要量可能更高：对仍有残余内源性胰岛素分泌的患者，其每日需要量可更少。

本品经皮下注射，部位可选择大腿或腹壁。

如方便，也可选择臀部或三角肌区域。

注射点应在同一注射区域内轮换。

像所有胰岛素一样，剂量、注射部位、血流、温度及运动量均会影响其作用时间。

关于不【不良反应】患者使用本品时发生的不良反应主要与剂量相关，且与胰岛素药理学作用有关。

与其他胰岛素制剂相同，低血糖是本品治疗中最常见的不良反应。

如果胰岛素使用剂量远高于需要量，就可能发生低血糖。

严重的低血糖可能导致意识丧失和/或惊厥以及暂时性或永久性脑损伤甚至死亡。

临床试验和上市后的经验表明，低血糖发生的频率随患者的人群和用法用量的不同而变化，因此无法呈现低血糖发生的确切频率。

在临床试验期间，本品与人胰岛素相比，低血糖的总体发生率没有差异。

总结临床试验中不良反应发生的频率，经过总体判断认为和本品有关的不良反应如下【禁忌】以下患者禁用：·低血糖发作时。

·对门冬胰岛素或本品中任何其他成份过敏者。

门冬胰岛素30 的三种用法双时相门冬胰岛素30（简称门冬胰岛素30）是由30％的速效门冬胰岛素和70 ％的精蛋白门冬胰岛素组成的一种新型胰岛素。

它兼有短效胰岛素起效迅速和中效胰岛素作用时间较长的特点。

门冬胰岛素30 一般在注射10〜20分钟后即可起效，此药血药浓度的高峰可持续1〜3 个小时，总药效可持续3〜5个小时，可以有效地控制糖尿病患者空腹及餐后的血糖水平，而且引发低血糖的几率极小。

因此，糖尿病患者可在进餐前10分钟或进餐时注射门冬胰岛素30（不必像使用预混人胰岛素30R那样在餐前30分钟注射），甚至可在餐后注射，故使用起来极为方便。

另外，门冬胰岛素30 还具有维持人体内糖化血红蛋白水平的作用。

正因为门冬胰岛素30 具有以上优点，因此临床上已经开始广泛使用此药。

面就介绍三种门冬胰岛素30 的用法：、直接使用门冬胰岛素30 疗法注射3 次门冬胰岛素30疗法。

1 1 日注射2 次门冬胰岛素30 疗法。

一般来说，使用口服降糖药治疗三个月以上、血糖仍未达标的糖尿病患者，即可直接使用门冬胰岛素30 进行治疗，其用法是：在每天早餐前和晚餐前10 分钟各注射1 次门冬胰岛素30 ，每次注射12 个此方法可分为1 日注射2 次门冬胰岛素30 疗法和1 日单位，同时可根据白天的空腹血糖水平调节早餐前的用药量，根据晚上的空腹血糖水平调节晚餐前的用药量。

另外，糖尿病患者若因某些原因无法使用1 日注射2 次门冬胰岛素30 的疗法，可改用1 天注射1 次门冬胰岛素30 的疗法。

此疗法的给药时间应选择在晚餐前（因为中国人常在晚餐时吃得很多，此时给药有利于控制其晚餐后和夜间的血糖水平）或血糖控制得不好的时间段（如上午血糖高就在早餐前注射），用药量应由医生决定。

2 1 日注射3 次门冬胰岛素30 疗法。

此疗法适合以下糖尿病患者使用：①使用1日注射2次门冬胰岛素30疗法16 周以上，其血糖仍未达标者。

②使用1 日注射2 次门冬胰岛素30 疗法后其空腹血糖水平正常，但其糖化血红蛋白仍高于7%者。

诺和锐30临床应用一、诺和锐30临床应用概述1.1 产品介绍诺和锐30是一种新型药物，主要用于治疗疾病，具有较好的疗效和安全性。

1.2 适应症诺和锐30适用于以下病情：- 疾病A- 疾病B- 疾病C1.3 禁忌症诺和锐30禁用于以下情况：- 对本品过敏者- 孕妇及哺乳期妇女- 有严重肝功能损害者二、用法与用量指导2.1 给药途径诺和锐30通过口服给药，并随餐服用。

2.2 用量指导根据患者的具体情况，诺和锐30的用量会有所调整，一般建议的用量为：- 成人：每日X mg，分X次服用。

- 儿童：根据体重进行剂量调整。

三、不良反应及注意事项3.1 不良反应使用诺和锐30可能出现以下不良反应：- 头痛- 恶心- 腹泻- 肝功能异常等3.2 注意事项- 患者在使用诺和锐30期间应定期检查肝功能指标。

- 若出现严重不良反应或过敏反应，应立即停药并就医。

- 本药物需储存在阴凉干燥处，避免阳光直射。

四、药物相互作用4.1 诺和锐30与其他药物的相互作用- 与药物A可能会导致效应增强/减弱。

- 与药物B同时使用可能会增加不良反应的风险。

4.2 药物相互作用的管理在使用诺和锐30时，应注意以下几点：- 在使用其他药物之前，请通知医生或药师。

- 与其他药物同时使用时，注意可能的相互作用。

五、临床试验研究5.1 临床试验设计诺和锐30的临床试验采用随机、双盲、安慰剂对照的方式设计，共纳入名患者。

5.2 临床试验结果诺和锐30在临床试验中显示出显著的疗效，治疗组与安慰剂组相比，指标有显著性差异。

六、附件附件1：诺和锐30产品说明书附件2：诺和锐30临床试验报告七、法律名词及注释- 法律名词A：解释A- 法律名词B：解释B。

诺和锐(R)30临床使用河南专家建议河南省诺和锐(R)30专家建议组【摘要】@@ 我国最新的流行病学调查结果显示,在20岁以上的成年人中,糖尿病患病率为9.7%[1].其中,2型糖尿病(T2DM)占90%以上[2-3],而且仅有1/4的糖尿病患者糖化血红蛋白(HbA1c)达标(<6.5%)[4].2010版的<中国2型糖尿病防治指南>指出,HbA1c不达标的患者应尽早起始胰岛素治疗.预混胰岛素市场占有率超过70%[5].相比于预混人胰岛素,预混胰岛素类似物在有效控制血糖的同时还可降低重度低血糖的风险.【期刊名称】《郑州大学学报（医学版）》【年(卷),期】2012(047)001【总页数】3页(P138-140)【关键词】2型糖尿病;预混胰岛素类似物;应用;河南省【作者】河南省诺和锐(R)30专家建议组【作者单位】【正文语种】中文我国最新的流行病学调查结果显示，在20岁以上的成年人中，糖尿病患病率为9.7%［1］。

其中，2型糖尿病(T2DM)占90%以上［2-3］，而且仅有1/4的糖尿病患者糖化血红蛋白(HbA1c)达标(＜6.5%)［4］。

2010 版的《中国 2 型糖尿病防治指南》指出，HbA1c不达标的患者应尽早起始胰岛素治疗。

预混胰岛素市场占有率超过70%［5］。

相比于预混人胰岛素，预混胰岛素类似物在有效控制血糖的同时还可降低重度低血糖的风险。

诺和锐®30(门冬胰岛素注射液)为预混胰岛素类似物，含30%可溶性门冬胰岛素和70%精蛋白门冬胰岛素。

河南省的专科医生在预混胰岛素类似物的使用方面积累了丰富的经验，为此，河南省内分泌暨糖尿病学会组织多位专家经过多次研讨，编写了诺和锐®30的临床使用专家建议，旨在让诺和锐®30的临床使用更加规范，以便使更多的糖尿病患者获益。

1 诺和锐®30应用之前的注意事项①阅读诺和锐®30说明书，使用时不应违背该药品说明书的要求。