Indications
Regular (soluble) Human Insulin is a short acting insulin used to control high blood sugar in people with type 1 diabetes and in people with type 2 diabetes who need insulin. It is also used in hospital for diabetic emergencies such as diabetic ketoacidosis, during surgery and serious illness, and to treat high potassium levels. It is often supplied premixed with Isophane Insulin (for example 30/70 mixtures).
How It Works
Insulin is the natural hormone that lets the body’s cells take up sugar (glucose) from the blood and use it for energy. It also stops the liver releasing too much glucose. Regular Human Insulin is identical to the insulin made by the human pancreas. When injected under the skin it starts working in about 30 minutes, has its peak effect at 2 to 4 hours, and lasts about 6 to 8 hours, so it covers the rise in sugar after meals.
Dosage and Administration
The dose is set individually by your doctor and depends on your blood sugar, diet, activity and other medicines, so use it exactly as prescribed. It is usually injected under the skin of the abdomen, thigh, buttock or upper arm about 30 minutes before a meal. Change the injection spot each time within the same area to prevent lumps. Premixed insulin should be gently rolled to mix before use; clear Regular Insulin does not need mixing. Intravenous use is only given by a doctor or nurse in hospital. Never share insulin pens or needles.
Interactions
- Other diabetes medicines, alcohol, ACE inhibitors, some antidepressants and salicylates can increase the sugar lowering effect.
- Steroids, thyroid hormones, some diuretics, oral contraceptives and some antipsychotics can raise blood sugar and increase insulin needs.
- Beta blockers may hide the warning signs of low blood sugar.
- Pioglitazone with insulin can increase the risk of heart failure.
Contraindications
- Low blood sugar (hypoglycaemia) at the time of injection.
- Allergy to human insulin or any ingredient.
Side Effects
The most common side effect is low blood sugar, with sweating, shaking, hunger, fast heartbeat, headache, confusion or irritability. Redness, swelling or itching at the injection site can occur, and repeated injection in the same spot can cause lumps under the skin. Weight gain and temporary blurred vision or swelling of the ankles may occur when starting treatment. Low potassium can occur, mainly with intravenous use.
If you have signs of low blood sugar, take glucose, sugar or a sugary drink straight away, then a snack. Get urgent medical help if the person is confused, unable to swallow, has a fit or loses consciousness (do not give anything by mouth; a glucagon injection or hospital treatment is needed), or if there is a serious allergic reaction.
Pregnancy and Lactation
Human insulin is the standard treatment for diabetes in pregnancy and is safe for the baby. Insulin needs usually change during pregnancy and after delivery, so blood sugar must be checked closely. It is safe during breastfeeding; doses may need adjusting.
Precautions and Warnings
- Check blood sugar regularly, especially when changing dose, diet or activity, or when ill.
- Always carry a source of glucose and a diabetes identification card.
- Do not drive if your blood sugar is low; check before driving.
- Never change insulin type, brand or strength without medical advice.
- Check the label every time to avoid mix ups between insulins.
Overdose
Too much insulin causes low blood sugar, which can be severe and lead to fits, unconsciousness and brain damage. Treat mild cases with glucose or sugar by mouth; severe cases need emergency medical help with glucagon or intravenous glucose.
Therapeutic Class
Antidiabetic; short acting human insulin.
Storage
Store unopened insulin in a refrigerator at 2 to 8°C; do not freeze. The vial or pen in use can be kept below 25 to 30°C, away from heat and light, for the period stated on the pack (usually 4 to 6 weeks). Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.