| Insulin is a hormone secreted by the beta cells of the islets of Langerhans located in the pancreas. Insulin preparations are classified as rapid-acting (insulin glulisine, insulin lispro), short-acting (insulin regular human), intermediate -acting (insulin human isophane), or long-acting (insulin insulin glargine). Insulin is used as replacement therapy in the treatment of type 2 diabetes mellitus when the beta cells are not producing any insulin. It is also used in the treatment of diabetic keto-acidosis and hyperos-molar hyperglycemic states. Insulin may also be used as short term treatment in patients with type 2 diabetes who need to undergo major surgery, experience severe trauma, infections, serious renal and hepatic dys-function and those who are pregnant, or in women who develop gestational diabetes. Two major types of insulin are listed as CATEGORY A in the Formulary. These are the short acting, or regular insulin and the intermediate insulin. These are available as the recombinant DNA insulin. Human analogs, insulin glargine and glulisine are available as CATEGORY B for use in patients with type 1 diabetes. Cautions/Side Effects: When prescribing insu-lin,doctors should clearly state the type and dosage of the insulin required. Patients should be given the correct syringes/needles and shown the volume to draw up. Note! Local irritation and lipoatrophy at injection site can be reduced by the routine rotation of the injection site. Additionally, it is recommended that injection sites be rotated within one anatomic region rather than selecting another region to decrease day to day variability in insulin absorp-tion. Patients should inject insulin that is at room temperature to avoid painful injections. Overdose causes hypo-glycaemia. Dose: The dose should be individualized to suit the patient’s condition. It is crucial to check exactly how the patient is measuring the insulin! |
