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Profissional Documentos
Cultura Documentos
Diadaptasi dari PERKENI 2015. Konsensus Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia.
American Diabetes Association. 2007. Insulin Myths and Facts
LEVEMIR®
Insulin Detemir
• Levemir® is a soluble, basal insulin analogue with a prolonged duration of
effect (up to 24 hours).
Significant improvement
(p<0.001)
*p<0.001
Soewondo P, et al. Clinical experience with insulin detemir: Results from the Indonesian cohort of the international A1chieve study.
Diabetes Research and Clinical Practice 2013; 100(S1): S47–S53
NovoRapid®
Insulin Aspart
• NovoRapid® is a rapid-acting insulin analogue.
• Storage
• Before opening: Store in a refrigerator (2°C – 8°C). Keep away from the
cooling element.
• During use or when carried as a spare: Do not refrigerate. Store below
30°C. Use within 4 weeks.
• Do not freeze.
• Keep the pen cap on NovoRapid® FlexPen® in order to protect from
light.
• NovoRapid® must be protected from excessive heat and light.
Fix the FPG first using basal insulin (dose optimisation) Fix the FPG first using basal insulin (dose optimisation)
Goal: FPG 70-130 mg/dl (3.9-7.2 mmol/l) Goal: FPG 70-130 mg/dl (3.9-7.2 mmol/l)
Consider adding bolus insulin when : Consider adding bolus insulin when :
A1C>7% and FPG at goal or basal insulin dose > 0.5 U/kg A1C>7% and FPG at goal or basal insulin dose > 0.5 U/kg
Id A1C>7% after 3 months despite titrating bolus dose, Id A1C>7% after 3 months despite titrating bolus dose, or
or bolus dose s are more than 30 U per meal : bolus dose is more than 30 U per meal :
Resume titration of basal insulin and/or consider performing Add 2nd bolus of 4U at 2nd largest meal and titrate as before.
a 7 point profile Repeat for 3rd bolus dose at final meal of the day
Pfutzner A, Forst T. Intensification with prandial insulin. Int J Clin Pract 2009; 63 (Suppl. 164): 11–14
NovoMix® 30
Biphasic Insulin Aspart 30
• NovoMix®30 dosing is individual and determined in accordance with the
needs of the patient.
• Storage
• NovoMix® 30 FlexPen® that is being used or carried as a spare is not to
be kept in the refrigerator. It can be kept at room temperature (below
30°C) for up to 4 weeks.
• Keep the pen cap on FlexPen® in order to protect from light.
BIAsp, biphasic insulin aspart; BID, twice daily; OD, once daily; TZDs, thiazolidinediones
Unnikrishnan et al. Int J Clin Pract 2009;63:1571–7
Teknik Injeksi
Insulin
Materi presentasi
• Pengenalan FlexPen®
• Jarum NovoTwist®
• Teknik Injeksi Insulin
Bagian Flexpen® device
Flexpen® Device
1 pen : 3 ml ~ 300 U
Warna yang kontras, mudah dibedakan
Tactile pada push button
1 klik = 1 Unit
Pen sekali pakai, praktis untuk pasien
Dosis yang lebih akurat dibanding pen
insulin lainnya1
• Pengenalan FlexPen®
• Jarum NovoTwist®
• Teknik Injeksi Insulin
Pasien berhak mendapat jarum yang baik pada saat
inisiasi insulin
NovoTwist®
Didesain untuk kemudahan
22
NovoTwist® portfolio
Panjang Diameter
5 mm 32G (0.32 mm)
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Kelebihan NovoTwist® – Just Twist
Nyeri yang minimal – Jarum yang tipis seperti NovoTwist® meminimalkan rasa
nyeri saat penyuntikan
References:
2. Arendt-Nielsen L et al. Pain following controlled cutaneous insertion of needles with different diameters. Somatosensory and Motor Research 2006; 23 (1-2); 37-43.
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Jarum Insulin Sekali Pakai
dan telunjuk.
5 mm
Tahan selama
5-10 detik
setelah
menyuntik dan
Kulit dicubit Kulit dicubit
sebelum
mencabut jarum
• Pengenalan FlexPen®
• Jarum NovoTwist®
• Teknik Injeksi Insulin
Area Penyuntikan dan Rotasinya
Keterangan
&
Teknik Injeksi dengan Flexpen®
Teknik Injeksi dengan Flexpen®
Teknik Injeksi dengan Flexpen®