Generic Name : INSULIN
Pronunciation : (in' su lin)
Trade Name(s) : Actraphane HM Penfill, Actrapid, Actrapid HM, Actrapid MC, Human actrapid, Human insulatard, Human mixtard, Human monotard, Human prodica, Human rapidica, Human rapimix, Humanzinulin, Huminsulin, Huminsulin-N, Huminsulin-R, Iletin - N, Iletin - R, Insulatard, Insulatard HM, Insulin, Insulin Isophane, insulin Protamine Zinc, Insulin Zinc (lente),Insuman rapid, Lentard, Mixtard, Mixtard HM Penfill, Prodica, Rapidica, Rapimix, Zinulin
Why it is prescribed: Insulin is a hormone produced in the pancreas. Insulin is necessary to move sugar from the blood into other body tissues where it is needed for energy. Insulin also helps the body to metabolize carbohydrates, fats, and proteins from the diet. In a person with diabetes, the pancreas does not produce enough insulin for the body's needs, so additional insulin is required. It must be injected because stomach acid would destroy it if taken orally. Insulin controls - but does not cure - diabetes. It must be taken regularly. People with diabetes can gradually develop serious nerve, blood vessel, kidney, and eye problems, especially if the diabetes is not controlled properly.
When it is to be taken: Your doctor will determine how often and at what time of day to inject yor insulin, as well as what type of insulin will best control the level of sugar in your blood. The different types of insulin vary as to how quickly they start to work and how long they go on reducing the amount of blood sugar. For example, rapid-acting insulin, such as regular insulin and Semilente, start to work in 30 to 60 minutes and go on working for 5 to 16 hours; long-acting insulin, such as Ultralente, start to work in four to eight hours and continue working for 36 hours.
How it should be taken:
1. Insulin is usually given by subcutaneous (beneath the skin) injection. The amount of insulin you need depends on diet, other diseases, exercise, and drugs and may change with time.
2. All insulin bottles are marked with large black letters to indicate what type of insulin they contain. For example, regular = R and Ultralente = U. You must know both the type of insulin you use and how many units to take with each injection. There are two different strengths of insulin: U-100 and U-500. Your doctor will determine which strength you should use.
3. U-100 syringes must be used with U-100 insulin, and different syringes must be used with U-500 insulin. Be sure that you get the right kind and the same brand each time. Plastic syringes are disposable; use a new one each time. Used needles will hurt more and may cause an infection.
4. Do not use the insulin if it has changed color or if the expiration date on the bottle has passed. Regular insulin should be a clear, colorless solution. Discard the bottle if the solution is cloudy or thickened. Other forms of insulin should be cloudy in appearance. Roll the bottle between the palms of your hands and invert it several times to mix it. Do not shake the bottle vigorously. Do not use it if the insulin has clumped, if lumps or particles are stuck to the sides of the bottle, or if the insulin remains clear after you roll and invert the bottle.
5. Ask your doctor to show you how to prepare your insulin dose. Wipe the rubber cap with an alcohol pad or cotton dipped in rubbing alcohol. It is easier to withdraw insulin if you first inject air into the bottle. Pull the syringe plunger back to draw up the same number of units of air as insulin that you will be taking. Insert the needle through the rubber cap and inject the air into the bottle. Invert the bottle and syringe, pull back on the plunger to draw insulin into the syringe, and measure the correct number of units of insulin. Be sure that there are no bubbles in the syringe.
6. If you have trouble seeing the small markings on the syringe, have someone help you. Also let your doctor know about this problem. They can provide syringes that are easier to read, special tools to help you fill the syringe, or pre-filled syringes. If you take two types of insulin at the same time - regular and NPH, for example - do not change the order of mixing. Whenever you mix regular insulin with another type of insulin, draw up the regular insulin first.
7. You will be shown how to inject insulin correctly. You can inject it into your abdomen, buttocks, thighs, and arms. Clean the skin at the injection site with an alcohol pad or rubbing alcohol. Pinch a fold of skin with your fingers at least 3 inches apart and insert the needle at a 45 to 90 degree angle.
8. Before injecting the insulin, pull back on the syringe plunger and check that no blood appears in the syringe. If blood appears, remove the needle and reinsert it in a different place. Inject the insulin, withdraw the needle, and press lightly on the skin.
9. Use a different site for each injection - about 1 inch away from the previous injection but in the same general area e.g., thigh. Use all available sites in the same general area before switching to a different area e.g., arm. Do not use the same injection site more often than once every month or two.
10. You may need a prescription for syringes, depending on the state you live in. It is a good idea to carry extra syringes at all times.
Special Instruction :
1. Because diabetics are susceptible to infections, maintain good personal hygiene, particularly dental and foot care. Bathe daily; keep all cuts, scratches and open sores clean. Visit an op
2. Visit an ophthalmologist at least once a year.
3. To monitor the effectiveness of insulin, measure the amount of sugar in your blood or urine. For these measurements, you will need special paper tapes, tablets, or plastic strips that change colour depending on how much sugar is present.
4. You also can use a special device called glucometer to measure the amount of sugar in your blood. Your doctor also may ask you to test your urine for ketones, substances present when diabetes is not under control.
5. Follow your doctor's instructions for testing your urine and blood and for recording the results accurately.
6. If your blood sugar is high or if sugar or ketones are present in your urine, contact your doctor.
7. Do not change your insulin dose without consulting your doctor.
8. Tell your doctor if you smoke or if you change your smoking habits while taking insulin. Your dose may need to be adjusted.
9. Special Dietary Instructions should be followed : To control diabetes, you must follow a strict diet in addition to taking insulin regularly. Your insulin dose is based in part on your intake of calories from food. Follow your doctor's instructions concerning diet, body weight, and exercise.
10. Alcoholic beverages may cause hypoglycemia i.e., low blood sugar. Alcoholic beverages also contain calories; these calories should be taken into consideration when planning your diet.
11. When you first start taking insulin, ask your doctor what to do if you forget to take a dose at the correct time. Write down these instructions so that you can refer to them later.
Side Effects :
1. Low blood sugar i.e., hypoglycemia as a result of taking too much insulin or exercising strenuously: headache, nausea, sweating, hunger, paleness, numb mouth, tingling fingers, tremors, blurred or double vision, chills, muscle weakness, fatigue, irritability, mental confusion, uncontrolled yawning, shallow breathing, palpitations, fast heartbeat. These reactions are most common in the late afternoon or during the night when insulin is working hardest. Drink fruit juice or eat lump sugar or something containing sugar. You may wish to carry glucose with you in case you have this reaction. Glucose comes in chewable tablets and gel and is available without a prescription.
2. High blood sugar i.e., hyperglycemia as a result of not taking enough insulin: frequent urination, thirst, headache, weakness, nausea, and dizziness. Often it is difficult to tell if your blood sugar is too high or too low. If possible, test your blood sugar with a glucometer. Otherwise, call your doctor. If you feel faint, instruct someone to take you to your doctor or a hospital right away.
Other Precautions :
1. Tell your doctor if you ever had an allergic reaction to beef or pork insulin, if you are pregnant, and if you have any medical problem such as thyroid, liver, or kidney disease or an infection.
2. Before you take insulin, tell your doctor what prescription and nonprescription drugs you are taking.
3. Other medications can affect the action of insulin and can cause inaccurate results in urine tests for sugar or ketones.
4. Do not take nonprescription medications, particularly cold and allergy medications, and medications that contain alcohol or sugar without consulting your doctor.
5. Wear or carry identification indicating that you have diabetes. Write down your doctor's name, telephone number, and the type and dose of insulin you are taking on the identification card.
6. Do not allow anyone else to take this medication.
Storage Conditions :
1. Store insulin in the refrigerator.
2. Never allow insulin to freeze; do not use insulin that has been frozen. 3. Never heat insulin to warm it.