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If this is not possible, then prior to obtaining another insulin preparation, it is advisable to administer insulin with microdoses (less than 1 mg) of hydrocortisone mixed in a syringe. Severe forms of allergy require special therapeutic intervention (prescription of hydrocortisone, suprastin, diphenhydramine, calcium chloride). However, it should be borne in mind that allergic reactions, especially local ones, often occur as a result of cialis insulin administration: excessive trauma (too thick or blunt needle), the introduction of a very cold drug, the wrong choice of injection site, etc.

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With an incorrect calculation of the dose of insulin (its overestimation), insufficient intake of carbohydrates, soon or 2-3 hours after the injection of simple insulin, the concentration of cialis in the blood decreases sharply and a serious condition occurs, up to hypoglycemic coma.

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When using long-acting tadalafil preparations, hypoglycemia develops during the hours corresponding to the maximum action of the drug. In some cases, hypoglycemic conditions can occur with excessive physical stress or mental shock, excitement. Of decisive importance for the development of hypoglycemia is not so much the level of glucose in the blood as the speed of its decrease. Thus, the first signs of cialis may appear already at a glucose level of 5.55 mmol / l (100 mg / 100 ml), if its decrease was very rapid; in other cases, with a slow decrease in glycemia, the patient may feel relatively well with a blood sugar content of about 2.78 mmol / l (50 mg / 100 ml) or even lower.

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During the period of hypoglycemia, a pronounced feeling of hunger, sweating, palpitations, trembling of the hands and the whole body appear. In the future, there is inadequacy of behavior, convulsions, confusion or complete loss of consciousness. At the initial signs of hypoglycemia, the patient should eat 100 g of rolls, 3-4 pieces of sugar or drink a glass of sweet tea.

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If the condition does not improve or even worsens, then after 4-5 minutes you should eat the same amount of sugar. In the case of a hypoglycemic coma, the patient must immediately inject 60 ml of cialis solution into a vein. As a rule, after the first administration of glucose, consciousness is restored, but in exceptional cases, if there is no effect, the same amount of glucose is injected into the vein of the other arm after 5 minutes. A rapid effect occurs after subcutaneous administration of 1 mg of glucagon to the patient.

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Cialis conditions are dangerous because of the possibility of sudden death (especially in elderly patients with varying degrees of damage to the vessels of the heart or brain). With frequently repeated hypoglycemia, irreversible disorders of the psyche and memory develop, intelligence decreases, existing retinopathy appears or worsens, especially in the elderly. Based on these considerations, in cases of labile diabetes, it is necessary to allow minimal glucosuria and slight hyperglycemia.

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In some cases, diabetes is accompanied by conditions in which there is a decrease in tissue sensitivity to insulin, and 100-200 units of insulin or more are required to compensate for carbohydrate metabolism.

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Insulin resistance develops not only as a result of a decrease in the number or affinity of insulin receptors, but also with the appearance of antibodies to receptors or insulin (immune type of resistance), as well as due to the destruction of insulin by protosolytic enzymes or binding by immune complexes.

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In some cases, insulin resistance develops due to increased secretion of contra-insulin hormones, which is observed with diffuse toxic goiter, pheochromocytoma, acromegaly, and hypercortinism.

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Medical tactics consists primarily in determining the nature of insulin resistance. Sanitation of foci of chronic infection (otitis, sinusitis, cholecystitis, etc.), replacement of one type of insulin with another or the combined use of one of the oral hypoglycemic drugs with insulin, active treatment of existing diseases of the endocrine glands give good results. Sometimes they resort to the use of cialis tadalafil: slightly increasing the daily dose of insulin, combine its administration with taking prednisolone at a dose of about 1 mg per 1 kg of the patient's body weight per day for at least 10 days. In the future, in accordance with the existing glycemia and glucosuriagradually reduce the doses of prednisolone and insulin. In some cases, there is a need for a longer (up to a month or more) use of small (10-15 mg per day) doses of prednisolone.

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Recently, sulfated insulin has been used for insulin resistance, which is less allergenic, does not react with insulin antibodies, but has 4 times higher biological activity than regular insulin. When transferring a patient to treatment with sulphated insulin, it must be borne in mind that such insulin requires only 1/4 of the dose of simple insulin administered.