Insulin
Brand names Humalog, Human Actrapid, Human Insulatard, Human Mixtard, Human Monotard, Human Ultratard, Human Velosulin, Humulin, Hypurin, Lentard MC, Pork Insulatard, Pork Mixtard, Pork Velosulin, Rapitard MC, Semitard MC
GENERAL INFORMATION
Insulin is a hormone manufactured by the pancreas and vital to the body’s ability to use sugar. It is given by injection to supplement or replace natural insulin in the treatment of diabetes mellitus. It is the only effective treatment in juvenile (insulin-dependent) diabetes and may also be prescribed in adult (maturity-onset) diabetes. It should be used with a carefully controlled diet. Illness, vomiting, or alterations in diet or in exercise levels may require dosage adjustment.
Insulin is available in a wide variety of preparations, which can be short-, medium-, or long-acting. Combinations of these types are often given. People receiving insulin should carry a warning card or tag.
INFORMATION FOR USERS
Follow instructions on the label. Call your doctor if symptoms worsen.
How taken
Injection, infusion pump.
Frequency and timing of doses
1-4 x daily. Short-acting insulin is usually given 15-30 minutes before meals. However, the exact time of these injections and the times of administration for longer-acting preparations will be tailored to your individual needs; follow the instructions you are given.
Dosage range
The dose (and type) of insulin is determined according to the needs of the individual.
Onset of effect
30-60 minutes (short-acting); 1-2 hours (medium- and long-acting).
Duration of action
6-8 hours (short-acting); 18-26 hours (medium-acting); 28-36 hours (long-acting).
Diet advice
A low-carbohydrate diet is necessary. Follow your doctor’s advice.
Storage
Refrigerate, but do not freeze. Follow the instructions on the container.
Missed dose
Discuss with your doctor. Appropriate action depends on dose and type of insulin.
Stopping the drug
Do not stop taking the drug without consulting your doctor; stopping the drug may lead to confusion and coma.
OVERDOSE ACTION
Seek immediate medical advice in all cases. You may notice symptoms of low blood sugar, such as faintness, hunger, sweating, trembling, confusion, or headache. If these occur, eat or drink something sugary. Take emergency action if fits or loss of consciousness occur.
See Drug poisoning emergency guide.
POSSIBLE ADVERSE EFFECTS
Symptoms such as dizziness, sweating, weakness, and confusion indicate low blood
sugar. Serious allergic reactions (rash, swelling, and shortness of breath) are rare.
INTERACTIONS
General note 1
Many drugs, including some antibiotics, monoamine oxidase inhibitors (MAOIs), and oral antidiabetic drugs, increase the risk of low blood sugar.
Corticosteroids and diuretics may oppose the effect of insulin.
General note 2
Check with your doctor or pharmacist before taking any medicines; some contain sugar and may upset control of diabetes.
Beta blockers may affect insulin needs and mask signs of low blood sugar.
QUICK REFERENCE
Drug group Drug for diabetes
Overdose danger rating High
Dependence rating Low
Prescription needed No
Available as generic No
SPECIAL PRECAUTIONS
Be sure to tell your doctor if:
You have had a previous allergic reaction to insulin.
You are taking other medications, or your other drug treatment is changed.
Pregnancy
No evidence of risk to the developing baby from insulin, but poor control of diabetes increases the risk of birth defects. Careful monitoring is required.
Breast-feeding
No evidence of risk. Adjustment in dose may be necessary while breast-feeding.
Infants and children
Reduced dose necessary.
Over 60
No special problems.
Driving and hazardous work
Usually no problem, but strenuous exercise alters your insulin and sugar requirements. Avoid these activities if you have warning signs of low blood sugar.
Alcohol
Avoid. Alcoholic drinks upset diabetic control.
Surgery and general anaesthetics
Insulin requirements may increase during surgery, and blood glucose levels will need to be monitored during and after an operation. Notify your doctor or dentist that you are diabetic before any surgery.
PROLONGED USE
No problems expected.
Monitoring
Regular monitoring of levels of sugar in the urine and/or blood is required.
