diabetestalk.net

What Kind Of Insulin Is Nph

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 >>

Selecting An Insulin For Treating Diabetes Mellitus In Dogs And Cats

Selecting An Insulin For Treating Diabetes Mellitus In Dogs And Cats

Richard W. Nelson, DVM, Dipl ACVIM University of California Davis, California From: The 30th Annual Royal Canin/Ohio State University Symposium for the treatment of small animal diseases: Endocrinology, October 2006, Veterinarians often ask which insulin is the best for treating diabetes mellitus in dogs and cats. Unfortunately, this question is difficult to answer. All insulin types currently on the market have the potential to work well in some diabetic dogs and cats but not in others. Recommendations regarding the insulin of choice for treating diabetic dogs and cats are based on personal experiences and vary between clinicians. Some clinicians prefer NPH insulin while others prefer lente insulin for treating diabetic dogs. Some clinicians prefer PZI, some NPH, some lente, and some insulin glargine for treating diabetic cats. Which insulin is ultimately effective in a diabetic is unpredictable. The clinician’s role is to identify which type of insulin works best in the diabetic dog or cat currently being treated. Success with insulin therapy requires knowledge of currently available insulin preparations - their intended use, potency, trends regarding duration of effect, and potential impact of species of insulin origin on diabetic control. Overview of Insulin Types. Commercial insulin is categorized by promptness, duration, intensity of action, and origin. Short-acting prandial insulins include regular crystalline (Humulin R®, Eli Lilly, Indianapolis, IN), insulin lispro (Humulog®, Eli Lilly) and insulin aspart (Novolog®, Novo Nordisk, Princeton, NJ). Regular crystalline insulin is a recombinant human insulin while insulin lispro and insulin aspart are insulin analogs. Recombinant DNA technology has been used to alter the amino acid sequence of the insulin molec Continue reading >>

What Is Nph Insulin, Its Side Effects, Onset Peak Time And Duration?

What Is Nph Insulin, Its Side Effects, Onset Peak Time And Duration?

Insulin is a type of hormone which is produced by the pancreas to help our body to properly use the glucose we derive from food we eat. People with diabetes cannot naturally produce enough amounts of insulin or use it properly. This leads to a build up of glucose in the body rather than moving into the cells. High levels of blood sugar can lead to health problems for people with diabetes. However, insulin can be injected under the skin to help people with diabetes reduce the level of blood sugar in their body. NPH insulin is the medication used by patients with diabetes to help manage blood glucose. This type of insulin works by enabling blood glucose to get into the cells so that it can be used for energy by the body. Taken note that insulin NPH is not a cure for diabetes, but helps to control blood sugar levels. What is NPH insulin? NPH is an acronym for Neutral Protamine Hagedorn. NPH insulin also referred to as isophane insulin, is a type of insulin that is given to patients with diabetes to help control their blood sugar levels. It is taken as an injection and the metabolic effects can be felt within 1 or 2 hours after injection. However, its strongest effect is felt between 6 to 10 hours after injection. Insulin Isophane peak Insulin NPH is considered to be an intermediate acting insulin, which takes 1 to 3 hours before the injection effects are felt. Isophane insulin peaks between 5 and 8 hours after injection but the effects start to cease after 18 to 24 hours. Dosage The insulin NPH dosage that your doctor recommends depends on the ability of your pancreas to produce insulin and how well it is used by your body. Your doctor will recommend the right dose, depending on the results obtained after monitoring the values of your blood sugar levels. Other factors like Continue reading >>

Nph Insulin: Mixing Is Critical For Best Results

Nph Insulin: Mixing Is Critical For Best Results

With commentary by study author Geremia Brunetto Bolli, MD, professor of endocrinology, Perugia University School of Medicine, Perugia, Italy Patients on insulin known as NPH (Humulin N, Novolin N) are often reminded that they need to re-suspend it before use by shaking it or rolling it in the palm of their hand. However, doctors know that patients often hurry and don't take the time to mix up this kind of insulin before using it. Now, a new study suggests how crucial that step is. Italian researchers compared the effects of mixing or not mixing NPH insulin on the insulin concentrations in the blood. "It is well known that NPH insulin needs resuspension prior to its use," says Geremia Brunetto Bolli, MD, professor of endocrinology at the Perugia University School of Medicine in Perugia, Italy, who led the study. "However, the different glucose lowering effect of re-suspended versus non-resuspended NPH was not known," he says. In his study, he found that non resuspended NPH insulin ''may result in an approximately twofold difference" in the effect on insulin levels in the blood. His study was published online Sept. 10 in Diabetes Care. So it is important that NPH is properly resuspended prior to its use, says Dr. Bolli. Other insulins that don't require mixing have often replaced NPH. Ideally "people with type 1 diabetes should not use NPH," he says, but be switched to newer types. "However, NPH is still used a lot in type 2 diabetes, either as NPH or mixed with rapid insulin," he says. Two common reasons people are still using NPH: “Limited health insurance coverage, or lack of insurance,” says EndocrineWeb Advisory Board Member Amy Hess Fischl, MS, RD, LDN, BC-ADM, CDE, an advanced practice dietitian at the University of Chicago Kovler Diabetes Center. She adds tha Continue reading >>

Types Of Insulin

Types Of Insulin

Insulin analogs are now replacing human insulin in the US. Insulins are categorized by differences in onset, peak, duration, concentration, and route of delivery. Human Insulin and Insulin Analogs are available for insulin replacement therapy. Insulins also are classified by the timing of their action in your body – specifically, how quickly they start to act, when they have a maximal effect and how long they act.Insulin analogs have been developed because human insulins have limitations when injected under the skin. In high concentrations, such as in a vial or cartridge, human (and also animal insulin) clumps together. This clumping causes slow and unpredictable absorption from the subcutaneous tissue and a dose-dependent duration of action (i.e. the larger dose, the longer the effect or duration). In contrast, insulin analogs have a more predictable duration of action. The rapid acting insulin analogs work more quickly, and the long acting insulin analogs last longer and have a more even, “peakless” effect. Background Insulin has been available since 1925. It was initially extracted from beef and pork pancreases. In the early 1980’s, technology became available to produce human insulin synthetically. Synthetic human insulin has replaced beef and pork insulin in the US. And now, insulin analogs are replacing human insulin. Characteristics of Insulin Insulins are categorized by differences in: Onset (how quickly they act) Peak (how long it takes to achieve maximum impact) Duration (how long they last before they wear off) Concentration (Insulins sold in the U.S. have a concentration of 100 units per ml or U100. In other countries, additional concentrations are available. Note: If you purchase insulin abroad, be sure it is U100.) Route of delivery (whether they a Continue reading >>

Basal Insulins (intermediate And Long-acting)

Basal Insulins (intermediate And Long-acting)

Who? Intermediate- and long-acting (basal) insulins are recommended for patients with type 1, type 2, or gestational diabetes. They may also be used in other types of diabetes (i.e. steroid-induced). Persons with type 1 diabetes generally use intermediate-acting insulin or long-acting insulin in conjunction with regular or rapid acting insulin. Persons with type 2 diabetes may use intermediate or long-acting insulins in conjunction with regular or rapid acting insulins or with oral medications. What? Injections given under the skin. Not suitable for insulin pumps. These medications can be injected with a traditional syringe and needle, or with a disposable pen that has been prefilled with insulin. Most patients tend to prefer pens though while convenient, they can be more expensive. The most common type of intermediate-acting insulin is: NPH (marketed as Humulin N and the Humulin N Pen) NPH (marketed as Novolin N and the Novolin N FlexPen) Long-acting insulins are marketed as different brands. The common ones are: Glargine (marketed as Lantus and the Solo Star Pen) Detemir (marketed as Levemir and the FlexPen) Degludec (marketed as Tresiba and the FlexTouch Pen) Where? These medicines are injected into the tissue under the skin and are slowly released into the body. These insulins allow glucose from the bloodstream to enter the cells in the body so that glucose can be used as energy. They also reduce glucose release into the bloodstream. When? NPH is usually injected twice a day. It begins working 1-3 hours after injection, and is most effective between 4-10 hours of injection. It generally keeps working for 10-16 hours. Detemir can be used once or twice a day. It begins working a few hours after injection and generally keeps working for anywhere from 20-24 hours. Glarg Continue reading >>

Insulin (and Other Injected Drugs)

Insulin (and Other Injected Drugs)

Diabetes is a disease affecting the body's production of insulin (type 1) or both the body's use and its production of insulin (type 2). Injectable insulin is a lifesaver for people who can no longer produce it on their own Continue reading >>

Insulin Types

Insulin Types

What Are the Different Insulin Types? Insulin Types are hormones normally made in the pancreas that stimulates the flow of sugar – glucose – from the blood into the cells of the body. Glucose provides the cells with the energy they need to function. There are two main groups of insulins used in the treatment of diabetes: human insulins and analog insulins, made by recombinant DNA technology. The concentration of most insulins available in the United States is 100 units per milliliter. A milliliter is equal to a cubic centimeter. All insulin syringes are graduated to match this insulin concentration. There are four categories of insulins depending on how quickly they start to work in the body after injection: Very rapid acting insulin, Regular, or Rapid acting insulins, Intermediate acting insulins, Long acting insulin. In addition, some insulins are marketed mixed together in different proportions to provide both rapid and long acting effects. Certain insulins can also be mixed together in the same syringe immediately prior to injection. Rapid Acting Insulins A very rapid acting form of insulin called Lispro insulin is marketed under the trade name of Humalog. A second form of very rapid acting insulin is called Aspart and is marketed under the trade name Novolog. Humalog and Novolog are clear liquids that begin to work 10 minutes after injection and peak at 1 hour after injection, lasting for 3-4 hours in the body. However, most patients also need a longer-acting insulin to maintain good control of their blood sugar. Humalog and Novolog can be mixed with NPH insulin and are used as “bolus” insulins to be given 15 minutes before a meal. Note: Check blood sugar level before giving Humalog or Novalog. Your doctor or diabetes educator will instruct you in determini Continue reading >>

Types Of Insulin

Types Of Insulin

For people who need to take external or supplemental insulin (insulin your body did not produce but that was instead made by a pharmaceutical company), there are several different types and kinds of insulin. The insulin you take will depend on your personal needs. Different types of insulin work differently in different people. The University of California, San Francisco explains that insulin “was initially extracted from beef and pork pancreases. In the early 1980’s, technology became available to produce human insulin synthetically. Synthetic human insulin has replaced beef and pork insulin in the US. And now, insulin analogs are replacing human insulin.” Here’s a chart of how the types of insulin work to replicate the normal pancreatic delivery of insulin and how they are typically used. Type of Insulin Brand (Generic) Onset Peak Duration Rapid-Acting Apidra (glulisine), Humalog (lispro), Novolog (aspart) 15 minutes 1 or 2 hours 2 to 4 hours Regular- or Short-Acting Humulin R, Novolin R (human recombinant) 30 minutes 2 to 3 hours 3 to 6 hours Intermediate-Acting Humulin N, Novolin N (insulin isophane)) 2 to 4 hours 4 to 12 hours 12 to 18 hours Long-Acting or Basal Insulin Lantus (glargine), Levemir (detemir), Basaglar (glargine) 2 to 4 hours lower peak 24 hours Ultra Long-Acting Toujeo (glargine), Tresiba (degludec) 6 hours small peak 36 hours Inhaled Insulin Afrezza (insulin human) 15 minutes 30 minutes 3 hours Rapid-acting insulin analogs (Insulin Aspart, insulin Lyspro, Insulin Glulisine): Usually taken as a bolus before a meal to cover the blood glucose elevation from eating or to correct for high blood glucose. This type of insulin is often used with longer-acting insulin, which is used to cover the body’s metabolic need for insulin. Short-acting synth 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 >>

Types Of Insulin

Types Of Insulin

Topic Overview Insulin is used to treat people who have diabetes. Each type of insulin acts over a specific amount of time. The amount of time can be affected by exercise, diet, illness, some medicines, stress, the dose, how you take it, or where you inject it. Insulin strength is usually U-100 (or 100 units of insulin in one millilitre of fluid). Short-acting (regular) insulin is also available in U-500. This is five times more concentrated than U-100 regular insulin. Long-acting insulin (glargine) is also available in U-300. This is three times more concentrated than U-100 long-acting insulin. Be sure to check the concentration of your insulin so you take the right amount. Insulin is made by different companies. Make sure you use the same type of insulin consistently. Types of insulinfootnote 1 Type Examples Appearance When it starts to work (onset) The time of greatest effect (peak) How long it lasts (duration) Rapid-acting Apidra (insulin glulisine) Clear 10-15 minutes 1-1.5 hours 3-5 hours Humalog (insulin lispro) Clear 10-15 minutes 1-2 hours 3.5-4.75 hours NovoRapid (insulin aspart) Clear 10-15 minutes 1-1.5 hours 3-5 hours Short-acting Humulin R, Novolin ge Toronto (insulin regular) Clear 30 minutes 2-3 hours 6.5 hours Intermediate-acting Humulin N, Novolin ge NPH(insulin NPH) Cloudy 1-3 hours 5-8 hours Up to 18 hours Long-acting Lantus (insulin glargine) Clear 1.5 hours Does not apply Up to 24 hours Levemir (insulin detemir) Clear 1.5 hours Does not apply 16 to 24 hours Toujeo (insulin glargine U-300) Clear Up to 6 hours Does not apply Up to 30 hours Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal. Rapid-acting insulin acts most like insulin that is produced by 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 >>

Diabetes, Insulin

Diabetes, Insulin

How does insulin work? 1. decreases blood glucose by; transporting glucose into cells & inhibit conversion of glycogen and amino acids to glucose 2. facilitates passage of glucose into cells for energy 3. Suppresses excess production of sugar in the liver and muscles, and the breakdown of fat for energy 4. Can't be given PO as GI secretions destroy insulin structure 5. Adverse effect = hypoglycemia Regular insulin / short acting humulin R Novolin R onset 30-60 min peak 2-4 h duration 6-8 h both can be given all 3 ways can be mixed with NPH, draw up regular first explain how to draw up a mixed insulin Continue reading >>

Short-acting Insulins

Short-acting Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Onset: 30 minutes Peak: 2.5 - 5 hours Duration: 4 - 12 hours Solution: Clear Comments: Best if administered 30 minutes before a meal. Mixing NPH: If Regular insulin is mixed with NPH human insulin, the Regular insulin should be drawn into the syringe first. Aspart - Novolog ®: Compatible - but NO support clinically for such a mixture. Draw up Novolog first before drawing up Regular Insulin. Lispro - Humalog ®: Compatible - but NO support clinically for such a mixture. Draw up Humalog first before drawing up Regular Insulin. Mixtures should not be administered intravenously. When mixing insulin in a syringe, draw up the quickest acting insulin first (e.g. draw up Humalog or Novolog before drawing up Regular Insulin, or draw up Regular insulin before Novolin N (NPH) or Lente insulin. CLINICAL PHARMACOLOGY Insulin is a polypeptide hormone that controls the storage and metabolism of carbohydrates, proteins, and fats. This activity occurs primarily in the liver, in muscle, and in adipose tissues after binding of the insulin molecules to receptor sites on cellular plasma membranes. Insulin promotes uptake of carbohydrates, proteins, and fats in most tissues. Also, insulin influences carbohydrate, protein, and fat metabolism by stimulating protein and free fatty acid synthesis, and by inhibiting release of free fatty acid from adipose cells. Insulin increases active glucose transport through muscle and adipose cellular membranes, and promotes conversion of intracellular glucose and free fatty acid to the appropriate storage forms (glycogen and triglyceride, respectively). Although the liver does not require active glucose transport, insulin increases hepatic gl Continue reading >>

Types Of Insulin For Diabetes Treatment

Types Of Insulin For Diabetes Treatment

Many forms of insulin treat diabetes. They're grouped by how fast they start to work and how long their effects last. The types of insulin include: Rapid-acting Short-acting Intermediate-acting Long-acting Pre-mixed What Type of Insulin Is Best for My Diabetes? Your doctor will work with you to prescribe the type of insulin that's best for you and your diabetes. Making that choice will depend on many things, including: How you respond to insulin. (How long it takes the body to absorb it and how long it remains active varies from person to person.) Lifestyle choices. The type of food you eat, how much alcohol you drink, or how much exercise you get will all affect how your body uses insulin. Your willingness to give yourself multiple injections per day Your age Your goals for managing your blood sugar Afrezza, a rapid-acting inhaled insulin, is FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in your blood in about 15-20 minutes and it clears your body in 2-3 hours. It must be used along with long-acting insulin in people with type 1 diabetes. The chart below lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood sugar), peak (the time period when it best lowers blood sugar) and duration (how long insulin continues to work). These three things may vary. The final column offers some insight into the "coverage" provided by the different insulin types in relation to mealtime. Type of Insulin & Brand Names Onset Peak Duration Role in Blood Sugar Management Rapid-Acting Lispro (Humalog) 15-30 min. 30-90 min 3-5 hours Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with Continue reading >>

More in insulin