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Intermediate And Long-acting Insulins: A Review Of Nph Insulin, Insulin Glargine And Insulin Detemir

Intermediate And Long-acting Insulins: A Review Of Nph Insulin, Insulin Glargine And Insulin Detemir

Objective: To review intermediate- and long-acting insulins with specific emphasis on the newer insulin analogs. Methods: A MEDLINE search, in English, was conducted with a cut-off of June 30, 2006, using the terms ‘NPH insulin’, ‘insulin analogs’, ‘insulin glargine’, ‘insulin detemir’ and ‘long-acting insulins’. All clinical trials from within the search period were included. Results: The insulin analogs, insulin glargine and insulin detemir, were introduced in an attempt to improve glycemic control among patients with diabetes, without increasing the risk of hypoglycemia. This review indicates that both insulin analogs demonstrate better glycemic control than NPH insulin, based on measurements of HbA1c, fasting glucose and intra-subject variability in blood glucose. This was accomplished with similar or reduced risk of hypoglycemia. Also, insulin detemir appears to be associated with less body weight increase than NPH insulin or insulin glargine. Conclusion: The newer long-acting insulin analogs, insulin detemir and glargine, appear to provide better glycemic control than NPH insulin without increasing the risk of hypoglycemia. Continue reading >>

Insulin For Type 1 And Type 2 Diabetes

Insulin For Type 1 And Type 2 Diabetes

The different types of insulin are categorized according to how fast they start to work (onset) and how long they continue to work (duration). The types now available include rapid-, short-, intermediate-, and long-acting insulin. Injectable insulin is packaged in small glass vials (bottles) and cartridges that hold more than one dose and are sealed with rubber lids. The cartridges are used in pen-shaped devices called insulin pens. Insulin usually is given as an injection into the tissues under the skin (subcutaneous). It can also be given through an insulin pump , an insulin pen , or jet injector, a device that sprays the medicine into the skin. Some insulins can be given through a vein (only in a hospital). Research is ongoing to develop not only new forms of insulin but also insulin that can be taken in other ways, such as by mouth. Insulin lets sugar (glucose) in the blood enter cells, where it is used for energy. Without insulin, the blood sugar level rises above what is safe for the body. If the cells don't get sugar to use for energy, they try to use other nutrients in the body. When this happens, acids can build up. Too much acid production (ketoacidosis) can be serious or even life-threatening. Your body uses insulin in different ways. Sometimes you need insulin to work quickly to reduce blood sugar. Your body also needs insulin on a regular basis to keep your blood sugar in a target range. Rapid-acting and short-acting insulins reduce blood sugar levels quickly and then wear off. When you use intermediate- or long-acting insulin with rapid- or short-acting insulins, the longer acting insulin starts taking effect when the shorter acting insulin begins to wear off. For example, the long-acting insulin glargine (Lantus) starts to work within 1 to 2 hours after Continue reading >>

Insulin Nph/regular (by Injection)

Insulin Nph/regular (by Injection)

Home > Drugs A Z > Insulin NPH/Regular (By injection) Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article. Type 1 Diabetes in Adults: Diagnosis and Management Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability. Diabetes (Type 1 and Type 2) in Children and Young People: Diagnosis and Management Diabetes is a long-term condition that can have a major impact on the life of a child or young person, as well as their family or carers. In addition to insulin therapy, diabetes management should include education, support and access to psychological services, as detailed here and in this guideline. Preparations should also be made for the transition from paediatric to adult services, which have a somewhat different model of care and evidence base. Insulin therapy is essential for everyone who has type 1 diabetes and some people who have type 2 diabetes. Various types of insulin are available. They differ in terms of how quickly and how long they are effective, as well as in their chemical structure.Some types of insulin work quickly (short-acting insulin or rapid-acting insulin), while others only start to work after a certain amount of time, and then work over Continue reading >>

Humulin N Vs. Novolin N: A Side-by-side Comparison

Humulin N Vs. Novolin N: A Side-by-side Comparison

Diabetes is a disease that causes high blood sugar levels. Not treating your high blood sugar levels can damage your heart and blood vessels. It can also lead to stroke, kidney failure, and blindness. Humulin N and Novolin N are both injectable drugs that treat diabetes by lowering your blood sugar levels. Humulin N and Novolin N are two brands of the same kind of insulin. Insulin lowers your blood sugar levels by sending messages to your muscle and fat cells to use sugar from your blood. It also tells your liver to stop making sugar. We’ll help you compare and contrast these drugs to help you decide if one is a better choice for you. Humulin N and Novolin N are both brand names for the same drug, called insulin NPH. Insulin NPH is an intermediate-acting insulin. Intermediate-acting insulin lasts longer in your body than natural insulin does. Both drugs come in a vial as a solution that you inject with a syringe. Humulin N also comes as a solution you inject with a device called a KwikPen. You do not need a prescription to buy Novolin N or Humulin N from the pharmacy. However, you do need to talk to your doctor before you start using it. Only your doctor knows whether this insulin is right for you and how much you need to use. The table below compares more drug features of Humulin N and Novolin N. Humulin N Novolin N What drug is it? Insulin NPH Insulin NPH Why is it used? To control blood sugar in people with diabetes To control blood sugar in people with diabetes Do I need a prescription to buy this drug? No* No* Is a generic version available? No No What forms does it come in? Injectable solution, available in a vial that you use with a syringe Injectable solution, available in a cartridge that you use in a device called a KwikPen Injectable solution, available in Continue reading >>

Insulin Preparations With Prolonged Effect

Insulin Preparations With Prolonged Effect

Invited ArticlesOpen AccessOpen Access license Insulin Preparations with Prolonged Effect The discovery of insulin and its clinical application early in the last century dramatically improved the prospects of people with diabetes. However, the limitations of those initial, unmodified insulin preparations were quickly recognized; most notably, their relatively short action meant that multiple daily subcutaneous injections were required. This stimulated a concerted effort to modify the properties of insulin in order to extend the duration of its blood glucose-lowering effect, minimize dosing frequency, and decrease the burden of treatment. The first successful attempts to prolong insulin's action were achieved by modifying its formulation with additives such as protamine and zinc, culminating in the production of intermediate-acting neutral protamine Hagedorn (NPH) insulin in the 1940s and the lente family of insulins in the 1950s. However, NPH and lente insulins were still associated with several limitations, including considerable variability of effect and a pronounced peak in their timeaction profile. In the 1980s, the focus of research moved toward the modification of insulin itself with the aim of producing a long-acting insulin that would better satisfy basal insulin requirements over the entire day. Once-daily insulin glargine was the first long-acting insulin analog in clinical practice, followed by once- or twice-daily insulin detemir and, more recently, insulin degludec, which is now being evaluated for administration at less frequent intervals. These analogs demonstrate several benefits over intermediate-acting insulins, including a lower risk of both overall hypoglycemia and nocturnal hypoglycemia and reduced day-to-day glucose variability, making it more fea Continue reading >>

Association Redetection Of Regular Insulin And Nph Insulin Using Statistical Features

Association Redetection Of Regular Insulin And Nph Insulin Using Statistical Features

Abstract: Diabetes Mellitus (DM), commonly referred as diabetes is a disorder that most of the people suffer from and which also leads to death many of the times. Type 1, Type 2 and Gestational diabetes are the types of diabetes. The present study is of patients suffering from Type 1 DM. In Type 1 diabetes a patient has to take external insulin to maintain the blood glucose level (BGL). Insulin is a hormone produced in the pancreas which maintains the BGL of a person. BGL is responsible for a person's daily activity. Within a specified target range the blood glucose level has to be maintained. Thus the blood glucose monitoring helps one to link between blood glucose, food, exercise and insulin. The readings of the blood glucose level determine the best management strategy for diabetes. The complications occurring in diabetes reduces by maintaining good blood glucose control. Four to five types of insulin are available in which our focus is on Regular insulin and NPH insulin. Regular insulin is a short acting insulin and NPH insulin is an intermediate acting insulin. The association detection of first fifteen patients by doing statistical study has already been done in which no association was found. This study has been done on the next fifteen patients dataset, to verify same result are obtained or result differs from it. A not-for-profit organization, IEEE is the world's largest technical professional organization dedicated to advancing technology for the benefit of humanity. © Copyright 2018 IEEE - All rights reserved. Use of this web site signifies your agreement to the terms and conditions. Continue reading >>

Why Walmart Insulins Aren’t The Answer To High Insulin Prices

Why Walmart Insulins Aren’t The Answer To High Insulin Prices

A diabetes advocate contrasts the performance of generic insulins versus the more popular brands. Commentary Some people don’t understand why people with diabetes get upset at the price of insulin. They see insulin for sale at a relatively reasonable price in Walmart and don’t see the problem. What they don’t know is that these Walmart insulins just don’t perform nearly as well as the more expensive insulins, and that gap in performance can have a very negative effect on the health of people with diabetes. There are three insulins available at Walmart for the price of $25 – NPH, Regular, and 70/30 (a mix of the two). NPH was first approved by the FDA in 1950, Regular was approved in 1982, 70/30 in 1989. That means NPH has been around for 66 years, Regular for 33 years, 70/30 for 27 years. Take a moment and think about what healthcare was like in 1950. Now, I’m sure someone is saying, “Well, they must still work if they are still being sold.” And they do, but they don’t work in the same way. These insulins are not interchangeable. If a person with Type 1 diabetes were to switch from a Humalog/Lantus insulin regimen to Regular and NPH, it would drastically alter their lifestyle, making blood sugar control more irregular and raising A1C scores. The biggest issue is that whereas Lantus is steady, NPH peaks. A person using NPH must keep a very set dietary schedule, making sure to eat meals and snacks at certain times to correspond with peak times of an insulin dose. The strict schedule is difficult for everyone, but especially for children. They are unable to alter their daily schedules and must always be sure to eat at specific times. Even if they’re not hungry, they must eat to avoid low blood sugar. And if they are hungry, they often cannot have more t Continue reading >>

Insulin Nph (vials): Indications, Side Effects, Warnings - Drugs.com

Insulin Nph (vials): Indications, Side Effects, Warnings - Drugs.com

It is used to lower blood sugar in patients with high blood sugar (diabetes). What do I need to tell my doctor BEFORE I take Insulin NPH? If you have an allergy to insulin or any other part of insulin NPH (vials). If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives ; itching; shortness of breath; wheezing ; cough; swelling of face, lips, tongue, or throat; or any other signs. This is not a list of all drugs or health problems that interact with insulin NPH (vials). Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins ) and health problems. You must check to make sure that it is safe for you to take insulin NPH (vials) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. What are some things I need to know or do while I take Insulin NPH? Tell all of your health care providers that you take insulin NPH (vials). This includes your doctors, nurses, pharmacists, and dentists. Allergic reactions have happened with insulin NPH (vials). Rarely, some reactions can be very bad or life-threatening. Talk with the doctor. Low blood sugar may happen with insulin NPH (vials). Very low blood sugar can lead to seizures , passing out, long lasting brain damage, and sometimes death. Talk with the doctor. Low blood potassium may happen with insulin NPH (vials). If not treated, this can lead to a heartbeat that is not normal, very bad breathing problems, and sometimes death. Talk with the doctor. Avoid driving and doing other tasks or actions that call for you to be alert until you see how insulin NPH (vials) affects you. Some diabetes drugs like p Continue reading >>

Insulin Nph Isophane U-100 Human Subcutaneous : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - Webmd

Insulin Nph Isophane U-100 Human Subcutaneous : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - Webmd

Insulin isophane is used with a proper diet and exercise program to control high blood sugar in people with diabetes . Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke . This man-made insulin product is the same as human insulin . It replaces the insulin that your body would normally make. It is an intermediate-acting insulin (isophane). It starts to work more slowly but lasts longer than regular insulin. Insulin isophane works by helping blood sugar ( glucose ) get into cells so your body can use it for energy. Insulin isophane is often used in combination with a shorter-acting insulin. It may also be used alone or with other oral diabetes drugs (such as metformin ). How to use Insulin NPH Human Recomb Suspension Read the Patient Information Leaflet provided by your pharmacist before you start using insulin isophane and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist. Learn all preparation and usage instructions from your health care professional and the product package. Before using, gently roll the vial or cartridge, turning it upside down and right side up 10 times to mix the medication . Do not shake the container. Check this product visually for particles or discoloration. If either is present, do not use the insulin . Insulin isophane should look evenly cloudy/milky after mixing. Do not use if you see clumps of white material, a "frosty" appearance, or particles stuck to the sides of the vial or cartridge. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin Continue reading >>

Nph Insulin

Nph Insulin

NPH insulin, also known as isophane insulin, is an intermediate–acting insulin given to help control blood sugar levels in people with diabetes.[3] It is used by injection under the skin once to twice a day.[1] Onset of effects is typically in 90 minutes and they last for 24 hours.[3] Versions are available that come premixed with a short–acting insulin, such as regular insulin.[2] The common side effect is low blood sugar.[3] Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions.[3] Use during pregnancy is relatively safe for the baby.[3] NPH insulin is made by mixing regular insulin and protamine in exact proportions with zinc and phenol such that a neutral-pH is maintained and crystals form.[1] There are human and pig insulin based versions.[1] Protamine insulin was first created in 1936 and NPH insulin in 1946.[1] It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system.[4] The wholesale cost in the developing world is about 2.23 to 10.35 USD per 1,000 iu of NPH insulin.[5] In the United Kingdom 1,000 iu of NPH insulin costs the NHS 7.48 pounds while in the United States this amount costs about 134.00 USD.[2][6] Chemistry[edit] NPH insulin is cloudy and has an onset of 1–4 hours. Its peak is 6–10 hours and its duration is about 10–16 hours. History[edit] Hans Christian Hagedorn (1888–1971) and August Krogh (1874–1949) obtained the rights for insulin from Banting and Best in Toronto, Canada. In 1923 they formed Nordisk Insulin laboratorium, and in 1926 with August Kongsted he obtained a Danish Royal Charter as a non-profit foundation. In 1936, Hagedorn and B. Norman Jensen discovered that the effects of injecte Continue reading >>

Insulin Nph And Reg Human Insulin 100 Unit/ml (70-30)subcutaneous Susp

Insulin Nph And Reg Human Insulin 100 Unit/ml (70-30)subcutaneous Susp

Combination isophane/regular insulin is used with a proper diet and exercise program to control high blood sugar in people with diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke.This man-made insulin product is the same as human insulin. It replaces the insulin that your body would normally make. It is a mixture of 70% intermediate-acting insulin (isophane) and 30% short-acting insulin (regular). It starts to work as quickly as regular insulin but lasts longer. This insulin product works by helping blood sugar (glucose) get into cells so your body can use it for energy. This product may be used alone or with other oral diabetes drugs (such as metformin). Read the Patient Information Leaflet provided by your pharmacist before you start using combination isophane/regular insulin and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist.Learn all preparation and usage instructions from your health care professional and the product package.Before using, gently roll the vial or cartridge, turning it upside down and back 10 times to mix the medication. Do not shake the container. Check this product visually for particles or discoloration. If either is present, do not use the insulin. Combination isophane/regular insulin should look evenly cloudy/milky after mixing. Do not use if you see clumps of white material, a "frosty" appearance, or particles stuck to the sides of the vial or cartridge.Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin and to avoid developing pro Continue reading >>

Humulin N (nph, Human Insulin Isophane (rdna Origin)) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Humulin N (nph, Human Insulin Isophane (rdna Origin)) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Intermediate-acting Human Insulins and Analogs Intermediate-acting insulin with a longer onset and duration of activity when compared to regular insulin; hormone secreted by pancreatic beta-cells of the islets of Langerhans essential for the metabolism and homeostasis of carbohydrate, fat, and protein; usually requires >= 2 injections/day when used as a basal insulin. Humulin N/Novolin N Subcutaneous Inj Susp: 1mL, 100U For the treatment of type 1 diabetes mellitus or for type 2 diabetes mellitus inadequately managed by diet, exercise, and oral hypoglycemics. NOTE: A consensus algorithm issued by the ADA and the European Association for the Study of Diabetes lists basal or intermediate-acting insulin as a second line or third line agent in patients with type 2 diabetes not controlled on oral drugs; metformin is the initial recommended therapy in all type 2 diabetics without contraindications. Once insulin is added, therapy can be intensified (e.g., addition of prandial insulin) to achieve optimal glycemic control. In patients who are receiving a sulfonylurea, the sulfonylurea should be discontinued when insulin therapy is initiated. The total daily dose is given as 1 to 2 injections per day, given 30 to 60 minutes before a meal or bedtime. Some patients may initially be given a single daily dose 30 to 60 minutes before breakfast, but 24-hour blood glucose control may not be possible with this regimen. Thus, a second injection given 30 to 60 minutes before dinner or bedtime may be required. When oral agents are used concomitantly in type 2 DM, a low initial dose of NPH insulin (e.g., 10 units) is often given in the evening. When used for intensive insulin therapy, NPH insulin is frequently mixed with a quick-acting insulin and given twice daily, although some patients w Continue reading >>

Insulin Nph (otc)

Insulin Nph (otc)

Type 2 Diabetes Mellitus Suggested guidelines for beginning dose: 0.2 unit/kg/day Dosing Considerations Dosage of human insulin, which is always expressed in USP units, must be based on the results of blood and urine glucose tests and must be carefully individualized to optimal effect Dose adjustments should be based on regular blood glucose testing Adjust to achieve appropriate glucose control Blood sugar patterns (>3 days) Look for consistent pattern in blood sugars for >3 days For the same time each day: Compare blood glucose level For each time of day: Calculate blood glucose range Calculate median blood glucose Consider eating and activity patterns during day Blood glucose adjustments Adjust only 1 insulin dose at a time Correct hypoglycemia first Correct highest blood sugars next If all blood sugars are high (within 2.75 mmol/L [50 mg/dL]): Correct morning fasting blood glucose first Change insulin doses in small increments: Type 1 diabetes (1-2 unit change); type 2 diabetes (2-3 unit change) Many sliding scales exist to determine exact insulin dose based on frequent blood glucose monitoring Commonly written for q4hr blood glucose test Sliding scale coverage usually begins after blood glucose >11 mmol/L (200 mg/dL) If coverage is needed q4hr x 24 hr, then base insulin dose is adjusted first; sliding scale doses may be adjusted upwards as well Continue reading >>

Intermediate Acting Insulin

Intermediate Acting Insulin

Tweet Intermediate acting insulins are often taken in conjunction with a short acting insulin. Intermediate acting insulins start to act within the first hour of injecting, followed by a period of peak activity lasting up to 7 hours. After this, the activity starts to tail off. Are intermediate acting insulins known by any other names? Intermediate acting insulins may also be referred to as ‘isophane’or ‘NPH’ (Neutral Protamine Hagedorn) insulins. Those who inject intermediate acting insulins should be aware of the risk of hypoglycemia, and particularly the risk of night time hypoglycemia. Hypurin isophane Hypurin is based around the active ingredient isophane insulin, and is an intermediate-acting insulin. It usually starts working approximately two hours after injection and will work for between 18 and 24 hours. This helps to regulate blood sugars throughout the day. Commonly used in conjunction with short-acting insulin, isophane insulin such as Hypurin is administered before meals to control blood glucose levels after eating. Hypurin isophane is available in bovine (beef insulin) and porcine (pork insulin) forms. Hypurin porcine 30/70 insulin is also available. This is a premixed insulin made up of 30% short acting (neutral) insulin and 70% intermediate acting (isophane) insulin. Humulin I Humulin I is a human isophane insulin made by Eli Lilly & Co. It can be taken with shiort acting insulin before a meal, or without short acting insulin before bed. Humulin I has a peak activity between 1 and 8 hours after injecting with a duration of activity lasting as much as up to 22 hours. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produc Continue reading >>

Type 2 Diabetes And Insulin

Type 2 Diabetes And Insulin

Getting Started When most people find out they have Type 2 diabetes, they are first instructed to make changes in their diet and lifestyle. These changes, which are likely to include routine exercise, more nutritious food choices, and often a lower calorie intake, are crucial to managing diabetes and may successfully lower blood glucose levels to an acceptable level. If they do not, a drug such as glyburide, glipizide, or metformin is often prescribed. But lifestyle changes and oral drugs for Type 2 diabetes are unlikely to be permanent solutions. This is because over time, the pancreas tends to produce less and less insulin until eventually it cannot meet the body’s needs. Ultimately, insulin (injected or infused) is the most effective treatment for Type 2 diabetes. There are many barriers to starting insulin therapy: Often they are psychological; sometimes they are physical or financial. But if insulin is begun early enough and is used appropriately, people who use it have a marked decrease in complications related to diabetes such as retinopathy (a diabetic eye disease), nephropathy (diabetic kidney disease), and neuropathy (nerve damage). The need for insulin should not be viewed as a personal failure, but rather as a largely inevitable part of the treatment of Type 2 diabetes. This article offers some practical guidance on starting insulin for people with Type 2 diabetes. When to start insulin Insulin is usually started when oral medicines (usually no more than two) and lifestyle changes (which should be maintained for life even if oral pills or insulin are later prescribed) have failed to lower a person’s HbA1c level to less than 7%. (HbA1c stands for glycosylated hemoglobin and is a measure of blood glucose control.) However, a recent consensus statement from Continue reading >>

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