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Can You Give Lantus And Regular Insulin At The Same Time

Insulin Glargine (rx)

Insulin Glargine (rx)

Dosage Forms & Strengths injectable solution 100 units/mL (Lantus; 10mL vial) 100 units/mL (Lantus SoloSTAR; Basaglar KwikPen; 3 mL disposable prefilled pens) 300 units/mL (Toujeo; 1.5 mL SolosStar disposable prefilled pen) Note: Recent studies have suggested that glargine-300 extends blood glucose control well beyond 24 hr Type 1 or 2 Diabetes Mellitus Lantus and Toujeo are recombinant human insulin analogs indicated to improve glycemic control in adults with type 1 or 2 diabetes mellitus Dosing Considerations Indicated for once-daily SC administration; exhibits relatively constant glucose-lowering profile over 24 hr May be administered at any time during the day; should be administered SC once daily at the same time every day Dose must be individualized based on clinical response; blood glucose monitoring is essential in all patients receiving insulin therapy Patients adjusting the amount or timing of dosage should do so only under medical supervision with appropriate glucose monitoring In patients with type 1 diabetes, insulin glargine must be used in regimens with short-acting insulin Should not be administered IV or via an insulin pump; IV administration of the usual SC dose could result in severe hypoglycemia As with all insulins, injection sites should be rotated within the same region (abdomen, thigh, or deltoid) from one injection to the next to reduce the risk of lipodystrophy; no clinically relevant difference in insulin glargine absorption after abdominal, deltoid, or thigh SC administration As with all insulins, the rate of absorption and, consequently, the onset and duration of action may be affected by exercise and other variables (eg, stress, intercurrent illness, changes in coadministered drugs, meal patterns) Type 1 diabetes mellitus: Starting dose sho Continue reading >>

Lantus Side Effects

Lantus Side Effects

Generic Name: insulin glargine (IN su lin GLAR gine) Brand Names: Basaglar KwikPen, Lantus, Lantus Solostar Pen, Toujeo SoloStar What is Lantus? Lantus (insulin glargine) is a man-made form of a hormone that is produced in the body. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Insulin glargine is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours. Lantus is used to improve blood sugar control in adults and children with diabetes mellitus. Lantus is used to treat type 1 or type 2 diabetes in adults, and type 1 diabetes children who are at least 6 years old. Some brands of insulin glargine are for use only in adults. Carefully follow all instructions for the brand of insulin glargine you are using. Important information You should not use Lantus if you are having an episode of hypoglycemia (low blood sugar), or if you are in a state of diabetic ketoacidosis. Never share a Lantus injection pen or cartridge with another person. Sharing injection pens or cartridges can allow disease such as hepatitis or HIV to pass from one person to another. Lantus is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels. Before taking this medicine You should not use Lantus if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar). Lantus is not approved for use by anyone younger than 6 years old, and should not be used to treat type 2 diabetes in a child of any age. To make sure Lantus is safe for you, tell your docto Continue reading >>

How To Mix Insulin Clear To Cloudy

How To Mix Insulin Clear To Cloudy

Learn how to mix insulin clear to cloudy. Drawing up and mixing insulin is a skill that nurses will utilize on the job. Insulin is administered to patients who have diabetes. These type of patients depend on insulin so their body can use glucose. Therefore, nurses must be familiar with how to mix insulin. The goal of this article is to teach you how to mix insulin. Below are a video demonstration and step-by-step instructions on how to do this. How to Mix Insulin Purpose of mixing insulin: To prevent having to give the patient two separate injections (hence better for the patient). Most commonly ordered insulin that are mixed: NPH (intermediate-acting) and Regular insulin (short-acting). Important Points to Keep in Mind: Never mix Insulin Glargine “Lantus” with any other type of insulin. Administer the dose within 5 to 10 minutes after drawing up because the regular insulin binds to the NPH and this decreases its action. Check the patient’s blood sugar and for signs and symptoms of hypoglycemia to ensure they aren’t hypoglycemic …if patient is hypoglycemic hold the dose and notify md for further orders. Key Concept for Mixing Insulin: Draw up CLEAR TO CLOUDY Remember the mnemonic: RN (Regular to Nph) Why? It prevents contaminating the vial of clear insulin with the cloudy insulin because if contaminated it can affect the action of the insulin. Why does this matter because they will be mixed in the syringe? You have 5 to 10 minutes to give the insulin mixed in the syringe before the action of the insulins are affected Demonstration on Drawing Up Clear to Cloudy Insulin Steps on How to Mix Insulin 1. Check the doctor’s order and that you have the correct medication: Doctor’s order says: “10 units of Humulin R and 12 units of Humulin N subcutaneous before b Continue reading >>

Insulin Basics | Diabetesnet.com

Insulin Basics | Diabetesnet.com

Thu, 11/18/2010 - 15:14 -- Richard Morris Store insulin you are not using in a refrigerator. It is a protein dissolved in water, sort of like a soup stock, so keep it cold to prevent it from spoiling. Keep it between 36º and 46º F. If it gets colder it will freeze. If the insulin freezes, when it thaws it will separate and clump and will no longer be usable. If it gets warmer it will be ok for awhile but will eventually spoil. If it starts to spoil, bacteria growing in it breaks down the insulin. It won't hurt you to use this. However, its not as effective so your blood sugar will be higher than you expect even though you took the right amount of insulin at the right time. It is ok to keep a bottle of insulin you are using at room temperature for up to 28 days (room temperature is 59º to 86º F). The preservative in insulin keeps it from spoiling this long. Insulin at room temperature injected into the skin is more comfortable for many people. Also, it may be easier to get rid of air bubbles in the syringe when it is at room temperature. If you live in a hot climate and your room temperature is above 80º, keep your insulin in the refrigerator. Insulin in a pen can only be kept at room temperature for 2 weeks before it begins to spoil. Check with your pharmacist, the package insert or the manufacturer's websites. Insulin used past 28 days at room temperature or past the expiration date on the box may still be good. However, using it may cause control problems and is not recommended. Lantus, Humalog and Novolog seem to spoil faster than Regular and NPH. If you can't afford to buy insulin and insurance does not cover it, you may be able to get it free. Check the website www.helpingpatients.org or call 202-835-3400. The doctor who prescribes your insulin can help you g Continue reading >>

Insulin: How To Give A Mixed Dose

Insulin: How To Give A Mixed Dose

Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful because the needles are short and thin and the insulin shots are placed into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection. In some cases, the doctor prescribes a mixed dose of insulin. This means taking more than one type of insulin at the same time. A mixed dose allows you to have the benefits of both short-acting insulin along with a longer acting insulin — without having to give 2 separate shots. Usually, one of the insulins will be cloudy and the other clear. Some insulins cannot be mixed in the same syringe. For instance, never mix Lantus or Levemir with any other solution. Be sure to check with your doctor, pharmacist, or diabetes educator before mixing. These instructions explain how to mix two different types of insulin into one shot. If you are giving or getting just one type of insulin, refer to the patient education sheet Insulin: How to Give a Shot. What You Will Need Bottles of insulin Alcohol swab, or cotton ball moistened with alcohol Syringe with needle (You will need a prescription to buy syringes from a pharmacy. Check with your pharmacist to be sure the syringe size you are using is correct for your total dose of insulin.) Hard plastic or metal container with a screw-on or tightly-secured lid Parts of a Syringe and Needle You will use a syringe and needle to give the shot. The parts are labeled below. Wash the work area (where you will set the insulin and syringe) well with soap and water. Wash your hands. Check the drug labels to be sure they are what your doctor prescribed. Check the expiration date o Continue reading >>

Page 1 Of 14 Nda 21-081 Draft Package Insert (sponsor Revision #5) Date Of Submission: April 20, 2000

Page 1 Of 14 Nda 21-081 Draft Package Insert (sponsor Revision #5) Date Of Submission: April 20, 2000

Draft1 Prescribing Information as of April 20002 LANTUS®3 (insulin glargine [rDNA origin] injection)4 LANTUS® must not be diluted or mixed with any other insulin or solution.5 DESCRIPTION6 LANTUS® (insulin glargine [rDNA origin] injection) is a sterile solution of insulin glargine for use7 as an injection. Insulin glargine is a recombinant human insulin analog that is a long-acting (up to 24-8 hour duration of action), parenteral blood-glucose-lowering agent (see CLINICAL9 PHARMACOLOGY). LANTUS is produced by recombinant DNA technology utilizing a non-10 pathogenic laboratory strain of Escherichia coli (K12) as the production organism. Insulin glargine11 differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine12 and two arginines are added to the C-terminus of the B-chain. Chemically, it is 21A-Gly-30Ba-L-13 Arg-30Bb-L-Arg-human insulin and has the empirical formula C267H404N72O78S6 and a molecular14 weight of 6063. It has the following structural formula:15 Ile Val Glu Gln Cys Cys Thr Ser Ile Cys Ser Leu Tyr Gln Leu Glu Asn Tyr Tyr 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Cys Gly Leu 19 20 21 Leu Val Cys GlySer LeuAlaGluVal Glu HisGlyCysLeu Arg HisGlnAsnValPhe Phe Phe GlyTyrArg Lys Pro ThrThrArg B - chain 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 2223242526272829303132 S S S S S S Gly A - chain 16 LANTUS consists of insulin glargine dissolved in a clear aqueous fluid. Each milliliter of LANTUS17 (insulin glargine injection) contains 100 IU (3.6378 mg) insulin glargine, 30 mcg zinc, 2.7 mg m-18 cresol, 20 mg glycerol 85%, and water for injection. The pH is adjusted by addition of aqueous19 solutions of hydrochloric acid and sodium hydroxide. LANTUS has a pH of approximately 4.20 Page 2 of 14 NDA 21-081 Continue reading >>

Lantus (insulin Glargine) Side Effects

Lantus (insulin Glargine) Side Effects

What Is Lantus (Insulin Glargine)? Lantus is the brand name of insulin glargine, a long-acting insulin used to treat adults and children with type 1 diabetes mellitus and adults with type 2 diabetes mellitus to control high blood sugar. Lantus replaces the insulin that your body no longer produces. Insulin is a natural substance that allows your body to convert dietary sugar into energy and helps store energy for later use. In type 2 diabetes mellitus, your body does not produce enough insulin, or the insulin produced is not used properly, causing a rise in blood sugar. Like other types of insulin, Lantus is used to normalize blood sugar levels. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual dysfunction. Proper control of diabetes has also been shown to reduce your risk of a heart attack or stroke. Lantus is meant to be used alongside a proper diet and exercise program recommended by your doctor. Lantus is manufactured by Sanofi-Aventis. It was approved for use by the Food and Drug Administration (FDA) in 2000 as the first long-acting human insulin administered once a day with a 24-hour sugar-lowering effect. Lantus Warnings You will be taught how to properly inject this medication since that is the only way to use it. Do not inject cold insulin because this can be painful. Always wash your hands before measuring and injecting insulin. Lantus is always clear and colorless; look for cloudy solution or clumps in the container before injecting it. Do not use Lantus to treat diabetic ketoacidosis. A short-acting insulin is used to treat this condition. It is recommended that you take a diabetes education program to learn more about diabetes and how to manage it. Other medical problems may affect the use of this Continue reading >>

Injecting Lantusâ® With A Vial And Syringe

Injecting Lantusâ® With A Vial And Syringe

BEFORE YOU GET STARTED: • Wash your hands. • Make sure the insulin is clear and colorless. Do not use it if it is cloudy or if you see particles; throw it away. • Do not mix or dilute Lantus® with any other insulin or solution. It will not work as intended, and you may lose blood sugar control. • Do not share needles, insulin pens, or syringes with others. Do NOT reuse needles. Always use a new syringe. • Relax. STEP 1: PREPARE THE DOSE • Remove the cap—If you are using a new vial, remove the protective cap. Do not remove the stopper. • Sterilize the top—Wipe the top of the vial with an alcohol swab. • Inject air into the vial—Draw air into the syringe that is equal to your insulin dose. • Put the needle through the rubber top of the vial and push the plunger to inject the air into the vial. • Draw up the dose—Leave the syringe in the vial and turn both upside down. Hold the syringe and vial firmly in one hand. Make sure the tip of the needle is in the insulin. With your free hand, pull the plunger to withdraw the correct dose into the syringe. STEP 2: REMOVE AIR BUBBLES • Check for bubbles—Before you take the needle out of the vial, check the syringe for air bubbles. • Tap to release—If bubbles are in the medicine, hold the syringe straight up and tap the side of the syringe until the bubbles float to the top. • Eject the air—Push the bubbles out with the plunger and draw insulin back in until you have the correct dose. • Remove the needle—Remove the needle from the vial. Do not let the needle touch anything. You’re now ready to inject. Please see additional Important Safety Information for Lantus® on the next page. Pl Continue reading >>

How To Use Long-acting Insulin: Types, Frequency, Peak Times, And Duration

How To Use Long-acting Insulin: Types, Frequency, Peak Times, And Duration

Long-acting insulin can help to stabilize blood sugar levels throughout the day, with only one or two shots. Fast-acting insulin replaces the surge of insulin that a healthy pancreas would release at mealtime. In contrast, long-acting insulin mimics the low-level flow of insulin normally released between meals and overnight. In this way, long-acting insulin works to establish a healthy baseline blood sugar level for the body to work around. Contents of this article: Using long-acting insulin Long-acting insulin cannot be delivered in pill form because it would be broken down in the stomach. Instead, it must be injected into the fatty tissue under the skin. From here, it can be gradually released into the bloodstream. Delivery methods According to the National Institute of Diabetes and Digestive and Kidney Diseases, there are a few ways to deliver long-acting insulin. These include: Needle and syringe: a dose of insulin is drawn from a vial into a syringe. Different types of insulin must not be mixed in the same syringe. Pen: this can be loaded with a cartridge containing a premeasured dose, or prefilled with insulin and discarded after use. Injection port: a short tube is inserted into the tissue beneath the skin. Insulin can be delivered using either a syringe or a pen. This only requires the skin to be punctured when the tube needs to be replaced. Injection sites Long-acting insulin can be injected into the abdomen, upper arms, or thighs. Abdomen injections deliver insulin into the blood most quickly. The process takes a little more time from the upper arms, and it is even slower from the thighs. It is important to stay consistent with the general injection area, but the exact injection site should be rotated frequently. Repeat injections at the same spot on the skin Continue reading >>

Lantus & Humalog - Diabetes - Diabetes Forums

Lantus & Humalog - Diabetes - Diabetes Forums

Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Can I take my Lantus at the same time as my humalog? Which one should i take first? I try to take my Lantus everyday at the same time but i work shift work. How should i do my injections? Yes you can take them at the same time, but not in the same syringe or the same exact injection site. You would usually take the Humalog a little before (or same time) as eating carbs/meals, and/or to correct a high bg. Lantus is usually taken either in the morning or at bedtime (and sometimes split into 2 doses per day). I think I scanned another post about you taking Lantus already, but just getting the Humalog, correct? Do you have a ratio for how much Humalog to take for a certain amount of carbs? (example 1 unit for 15 carbs). And a ratio for how much Humalog to take to lower a high bg? (example 1 unit lowers bg 50 points). I have just taken my first dose of novolog (what is the difference between humolog and novolog by the way?) I was @ 120 mg/dl before I ate Cereal and Milk(usually makes me about 225 post prandial) and some pringles. 30 min after first bite I was at 170 mg/dl, 1hr after first bite I was 90 mg/dl , 67 mg/dl 1hr 40 min after first bite... bout to eat something so i dont get too low Most people say they are the same. But I found Novolog to be quicker and stronger than Humalog. It looks like you are finding the same thing. Well I just ate some meatloaf, mash potatoes, mixed vegies, cucumber and a cup of ice cream... no rapid insulin. I will see where that gets me. How long does the rapid stuff stay in the body, when does it peak? Generally speaking, most of it is finished in three hours, Continue reading >>

Insulin Actions Times And Peak Times

Insulin Actions Times And Peak Times

A good way to improve your glucose levels is to track the peaks and drops in your glucose , so you can figure out why they happened and how to correct them. Once you identify glucose patterns (they ARE there!), you also want to understand when each of your insulins is active and when they typically stop lowering your glucose. This helps you adjust your doses or food intake to stop unwanted ups and downs in your readings. The table below shows the start, peak, and end times for various insulins with some explanations and typical uses for each. When Does My Insulin Peak and How Long Does It Last? designed to peak, covers meals and lowers high BGs Humalog , Novolog and Apidra insulins currently give the best coverage for meals and help keep the glucose lower afterward. Their glucose lowering activity starts to work about 20 minutes after they are taken, with a gradual rise in activity over the next 1.75 to 2.25 hours. Their activity gradually falls over the next 3 hours with about 5 to 6 hours of activity being common with these insulins.Although insulin action times are often quoted as 3-5 hours, the actual duration of insulin action is typically 5 hours or more. See our article Duration of Insulin Action for more information on this important topic. In general, "rapid" insulins are still too slow for many common meals where the glucose peaks within an hour and digestion is complete within 2-3 hours. The best kept secret on stopping post meal spiking is to eake the injection or bolus earlier before the meal and to eat slower low glycemic carbs. Regular insulin still carries its original name of "fast insulin" but its slower action often works better for people who take Symlin or for those who have gastroparesis (delayed digestion). It is also a great choice for those who Continue reading >>

Types Of Insulin And How They Work

Types Of Insulin And How They Work

Insulin is a hormone the body makes to control the level of glucose (sugar) in the blood. It lowers blood sugar by allowing glucose to leave the bloodstream and enter body cells. Without enough insulin, the level of glucose in the bloodstream can become too high. Everyone needs insulin to use food properly. People without diabetes make enough of their own insulin to keep their blood sugar at healthy levels all the time. People with type 1 diabetes no longer make insulin of their own. Instead, they need to take shots of one or more types of insulin to keep their blood sugars close to normal. Between 75 and 90 percent of people with type 2 diabetes need to take insulin shots to help them get the best control of their blood sugar levels. Deciding How Much Insulin to Take The amount of insulin a person needs depends on: Body weight Percentage of body fat Activity level Diet Other medicines Emotions and stress General health Type of insulin When you first start taking insulin shots, your doctor might ask you to change the amount you take or the time you take it several times. You and your doctor will base these changes on the results of your blood sugar tests. You'll need to make adjustments until you find the dose and schedule that work best for you. Each person's need for insulin is different: Some people can control their blood sugar with one shot of insulin a day. Most people need more than three shots every day. Many people need more than one type of insulin. If you take several insulin shots a day or use more than one type of insulin, it doesn't mean your diabetes isn't in good control. Your blood sugar, not the amount or type of insulin you take, is the best way to judge how well you are doing. If you take three shots a day and your blood sugar is near normal, that's Continue reading >>

Insulin Basics: The Reasons Behind The Recommendations

Insulin Basics: The Reasons Behind The Recommendations

INSULIN BASICS: THE REASONS BEHIND THE RECOMMENDATIONS This column focuses on providing information to help people make their diabetes care fit their needs and their lives. This month's column contains general information about insulin. I have received quite a few questions lately about why people are supposed to do particular things when drawing insulin and giving injections. So here are answers to those questions, organized into three general topics: storing, drawing, and injecting insulin. This is definitely not everything there is to know; these are just the questions I have been asked most often. Q: Why am I supposed to store insulin in a refrigerator? A: Insulin is a protein dissolved in water. (You can think of it as something like a soup broth.) Like any other protein, it can spoil. Keeping it cold helps to keep it from spoiling. Q: What will happen if the insulin starts to spoil? A: Bacteria growing in it will break down the protein. The insulin will not poison you or make you sick. It just won't work very well. If this happens to you, your blood sugar would be higher than you expect, even though you have given your injection in the right amount at the right time. A: Insulin you are not using should be kept between 36 degrees and 46 degrees Fahrenheit. If it gets colder than that it can freeze. If it gets warmer than that, it will be good for a while, but eventually it will start to break down. Q: I have been told it's OK to keep a bottle of insulin I'm using at room temperature. Is this really OK? If so, why? A: Yes, the standard recommendation from all the insulin manufacturers is that a vial of insulin you are using can be kept at room temperature for up to 28 days. Room temperature is defined as between 59 degrees and 86 degrees Fahrenheit. This works beca Continue reading >>

Early Pharmacokinetic And Pharmacodynamic Effects Of Mixing Lispro With Glargine Insulin

Early Pharmacokinetic And Pharmacodynamic Effects Of Mixing Lispro With Glargine Insulin

Go to: Clinicians who treat children with type 1 diabetes often try to minimize the number of daily injections to reduce treatment burden and improve compliance. Despite the manufacturer's cautions against mixing glargine with rapid-acting insulin analogs, clinical studies have failed to demonstrate deleterious effects of mixing on glucose excursions or A1C levels. However, no formal glucose clamp studies have been performed to determine whether mixing with glargine has an adverse effect on the early pharmacodynamic action of rapid-acting insulin in humans. To examine this question, euglycemic glucose clamps were performed twice, in random order, in 11 youth with type 1 diabetes (age 15.1 ± 3 years, A1C 7.6 ± 0.6%) with 0.2 units/kg lispro and 0.4 units/kg glargine, given either as separate or as a single mixed injection. Mixing the two insulins shifted the time action curve to the right, with significantly lower glucose infusion rate (GIR) values after the mixed injections between 60 and 190 min and significantly higher values between 270 and 300 min, lowered the GIRmax (separate 7.1 ± 1 vs. mix 3.9 ± 1, P = 0.03), and markedly delayed the time to reach GIRmax (separate 116 ± 8 min vs. mix 209 ± 15 min, P = 0.004). The GIR area under the curve was significantly lower after the mixed injections. Mixing had similar effects on plasma insulin pharmacokinetics. These data demonstrate that mixing lispro with glargine markedly flattens the early pharmacodynamic peak of lispro and causes a shift to the right in the GIR curve changes that might lead to difficulties in controlling meal-related glucose excursions. Pharmacokinetic profiles. Insulin concentration, measured by ELISA with a reported cross-reactivity of 44% for insulin glargine, for separate and mixed injections Continue reading >>

1. Indications And Usage

1. Indications And Usage

Generic Name: insulin glargine Dosage Form: injection, solution Lantus is indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Limitations of Use Lantus is not recommended for the treatment of diabetic ketoacidosis. 2. DOSAGE AND ADMINISTRATION Important Administration Instructions Administer Lantus subcutaneously once daily at any time of day but at the same time every day. Prior to initiation of Lantus, train patients on proper use and injection technique. Patient should follow the Instructions for Use to correctly administer Lantus. Administer Lantus subcutaneously into the abdominal area, thigh, or deltoid, and rotate injection sites within the same region from one injection to the next to reduce the risk of lipodystrophy [see Adverse Reactions (6.1)]. Visually inspect Lantus vials and SoloStar prefilled pens for particulate matter and discoloration prior to administration. Only use if the solution is clear and colorless with no visible particles. Refrigerate unused (unopened) Lantus vials and SoloStar® prefilled pens. Do not administer intravenously or via an insulin pump. Do not dilute or mix Lantus with any other insulin or solution. General Dosing Instructions Individualize and adjust the dosage of Lantus based on the individual's metabolic needs, blood glucose monitoring results and glycemic control goal. Dosage adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), during acute illness, or changes in renal or hepatic function. Dosage adjustments should only be made under medical supervision with appropriate glucose monitoring [see Warnings and Precautions (5.2)]. Initiation of Lantu Continue reading >>

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