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Which Type Of Insulin Should Never Be Mixed?

Humalog Mix

Humalog Mix

Generic Name: insulin lispro and insulin lispro protamine (IN soo lin LISS pro and IN soo lin LISS pro PRO ta meen) Brand Names: HumaLOG Mix 50/50, HumaLOG Mix 50/50 KwikPen, HumaLOG Mix 75/25, HumaLOG Mix 75/25 KwikPen What is Humalog Mix? Humalog Mix contains a mixture of insulin lispro and insulin lispro protamine. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Insulin lispro is a fast-acting insulin. Insulin lispro protamine is an intermediate-acting insulin. This combination insulin starts to work within 10 to 20 minutes after injection, peaks in 2 hours, and keeps working for up to 24 hours. Humalog Mix is used to improve blood sugar control in adults with diabetes mellitus. This medicine may be used for type 1 or type 2 diabetes. Humalog Mix may also be used for purposes not listed in this medication guide. Important information Use Humalog Mix within 15 minutes before eating a meal. Never share a Humalog Mix injection pen, cartridge, or syringe with another person, even if the needle has been changed. Sharing injection pens or cartridges can allow disease such as hepatitis or HIV to pass from one person to another. You should not use Humalog Mix is injected under the skin. if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar). Before taking this medicine You should not use Humalog Mix if you are allergic to insulin lispro, or if you are having an episode of hypoglycemia (low blood sugar). Humalog Mix is not approved for use by anyone younger than 18 years old. To make sure Humalog Mix is safe for you, tell your doctor if you have: liver or kidney disease; or low levels of potassium in your blood (hypokalemia). Tell your doctor if you also take pioglitazone or rosiglitazone (sometime Continue reading >>

Getting Started With Insulin

Getting Started With Insulin

If you have been talking about getting started on insulin with your doctor, or if taking insulin is new to you, you may have questions or concerns. The following guide will help you understand the types of insulin, options for taking insulin, how and where to inject insulin, and insulin care and storage. Insulin pens Your pen comes with an instruction book. Please review it to understand how your pen works, how to load the cartridge and how to prepare your pen for an insulin injection. Mixing insulin Insulin that is cloudy (NPH, premixed) needs to be mixed before using. The pen should be rolled ten times, tipped ten times and checked for a milky-white consistency. Check insulin flow (prime) Attach pen needle. Dial up two units and, with pen tip facing upwards, push the dosing button. If no stream of insulin appears, repeat with another two units. Giving your injection After you have checked the insulin flow, dial up the dose of insulin to be taken. Insert pen tip into skin at a 90º angle. Push the dosing button until you see ‘0’. Count 10 seconds before removing the needle from your skin to ensure you receive the full dose. With longer needles (≥ 8mm), you may need to gently lift the skin before injection. Insulin injection sites Site Pros Cons Abdomen (tummy) Stay 2 inches (5 cm) away from your belly button Easy to reach; insulin absorbs fast and consistently None Buttock and thigh Slower absorption rate than from abdomen and arm sites Slower absorption; absorption can be affected by exercise Outer arm After abdomen, arm provides the next fastest absorption rate Harder to reach for self-injections NOTE: It is really important to change (rotate) where you give yourself insulin to prevent fatty lumps from forming since these can affect how your body absorbs insuli 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 >>

Diabetes: Giving Yourself An Insulin Shot

Diabetes: Giving Yourself An Insulin Shot

Introduction If you have type 1 diabetes—or if you have type 2 diabetes and oral medicines are not controlling your blood sugar—you have to take insulin. If you have gestational diabetes, you may need to take insulin if diet and exercise have not been able to keep your blood sugar levels within your target range. With little or no insulin, sugar (glucose) in the blood cannot enter your cells to be used for energy. As a result, the sugar in your blood rises above a safe level. When your blood sugar rises past about 180 mg/dL, your kidneys begin to release sugar, which can make you dehydrated. If you are dehydrated, your kidneys make less urine, which means your body can't get rid of extra sugar. This is when blood sugar levels rise. If you can drink enough fluid to prevent getting dehydrated, you'll be able to release excess sugar in your urine. Taking insulin can prevent the symptoms of high blood sugar and emergencies such as diabetic ketoacidosis (in type 1 diabetes) and hyperosmolar coma (in type 2 diabetes). Insulin also can help prevent serious and permanent complications from long-term high blood sugar. Most people use insulin in an injection, or shot. It is given into the fatty tissue just under the skin. It also can be given through an insulin pump, an insulin pen, or a device that sprays the medicine into the skin (jet injector). And now skin patches are available with insulin in them, which can be worn for days. Experts are studying other ways of giving insulin, such as in an implantable pump. But this information is about insulin in syringes. After you get past the initial anxiety, giving yourself a shot will become a routine part of your day. It's quite easy to learn the basics of drawing the insulin up into a syringe and injecting it. Although never ple Continue reading >>

About Fast-acting Mealtime Insulin

About Fast-acting Mealtime Insulin

What is mealtime insulin? Mealtime insulins are fast-acting insulins that are taken immediately before or after meals. As you eat, your blood sugar naturally goes up, or “spikes.” Humalog® (a fast-acting insulin) works to manage those blood sugar spikes and may help keep your sugar levels in balance. Humalog should be taken within 15 minutes before eating or right after eating a meal. People who take Humalog will usually continue to take longer-acting insulin to help manage blood sugar levels at night and between meals. Taking mealtime insulin in addition to longer-acting insulin may help to control blood sugar levels throughout the day. Low blood sugar (hypoglycemia) is the most common side effect of Humalog that may be severe and cause unconsciousness (passing out), seizures, and death. Test your blood sugar levels as your doctor instructs. Talk to your doctor about low blood sugar symptoms and treatment. The orange area shows how blood sugar levels typically rise after meals. The pattern of insulin action may vary in different individuals or within the same individual. Comparing types of insulin Take a look at our overview below to find out about the different types of insulin. You’ll notice that there are differences in when the types of insulin reach your bloodstream, when they “peak” in your body, and how long they can last (length of time the insulin keeps lowering your blood sugar). Fast-acting insulin (also called rapid-acting) is absorbed quickly and starts working in about 15 minutes to lower blood sugar after meals. Humalog fast-acting insulin should be taken 15 minutes before eating or right after eating a meal. Depending on the type of diabetes you have, you may need to take Humalog with a longer-acting insulin or oral anti-diabetes medication. Continue reading >>

Insulins

Insulins

Insulin is a hormone made naturally in the body by the pancreas. This hormone controls the level of sugar (glucose) in the blood. People who have type 1 diabetes need to have regular insulin injections. In type 1 diabetes, the body stops making insulin and the blood sugar level goes very high. Some people who have type 2 diabetes may also need to have insulin injections to help control blood sugar levels. Insulin is usually injected under the skin between 2-4 times a day. There are different types of insulin available which are classified according to how quickly and for how long they work. Your doctor or diabetes nurse will discuss the various preparations and devices available and help you choose a regimen that is right for you. Treatment with insulin is usually lifelong. What is insulin and how does it work? What does insulin do? Play VideoPlayMute0:00/0:00Loaded: 0%Progress: 0%Stream TypeLIVE0:00Playback Rate1xChapters Chapters Descriptions descriptions off, selected Subtitles undefined settings, opens undefined settings dialog captions and subtitles off, selected Audio TrackFullscreen This is a modal window. Beginning of dialog window. Escape will cancel and close the window. TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal Dialog End of dialog window. Insulin is a hormone that is 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 >>

What You Should Know About Symlin

What You Should Know About Symlin

SYMLIN® (pramlintide acetate) injection is available only as the SymlinPen Pen-Injector. The SymlinPen comes in two dose forms: 60 micrograms and 120 micrograms. The amount of SYMLIN you use will depend on whether you have type 1 diabetes or type 2 diabetes. Your healthcare provider will prescribe the SymlinPen that is right for you. SYMLIN initiation, required SYMLIN dose escalation and insulin dose adjustments must be guided by your healthcare provider's instructions and may require more frequent blood sugar monitoring. Additional things to consider when using SYMLIN > Using SYMLIN and insulin with type 1 diabetes When starting SYMLIN, you will need to reduce your dose of mealtime insulin. Your healthcare provider will tell you how to reduce your dose of mealtime insulin the right way. You must check your blood sugar as often as your healthcare provider tells you to, which may include before and after every meal and at bedtime. The usual starting dose of SYMLIN for people who have type 1 diabetes is 15 micrograms (mcg) injected under your skin. Inject SYMLIN under your skin (subcutaneously) just before a major meal. A major meal must have at least 250 calories or 30 grams of carbohydrate. If you have not had any nausea for 3 days or more after your dose of SYMLIN is changed, your healthcare provider may tell you to slowly increase your dose of SYMLIN. Do not increase your dose of SYMLIN unless your healthcare provider tells you to. Tell your healthcare provider right away if you have nausea or low blood sugar after your dose of SYMLIN is changed. Your healthcare provider will tell you what to do. Your healthcare provider may make changes to your insulin dose to better control your blood sugar. Your healthcare provider should tell you what the right dose of insulin is Continue reading >>

Insulin – Pharmacology, Therapeutic Regimens And Principles Of Intensive Insulin Therapy

Insulin – Pharmacology, Therapeutic Regimens And Principles Of Intensive Insulin Therapy

Go to: Since the introduction of insulin analogs in 1996, insulin therapy options for type 1 and type 2 diabetics have expanded. Insulin therapies are now able to more closely mimic physiologic insulin secretion and thus achieve better glycemic control in patients with diabetes. This chapter reviews the pharmacology of available insulins, types of insulin regimens and principles of dosage selection and adjustment, and provides an overview of insulin pump therapy. For complete coverage of this and related aspects of Endocrinology, please visit our FREE web-book, www.endotext.org. Go to: PHARMACOLOGY In 1922, Canadian researchers were the first to demonstrate a physiologic response to injected animal insulin in a patient with type 1 diabetes. In 1955, insulin was the first protein to be fully sequenced. The insulin molecule consists of 51 amino acids arranged in two chains, an A chain (21 amino acids) and B chain (30 amino acids) that are linked by two disulfide bonds (1) (Figure 1). Proinsulin is the insulin precursor that is transported to the Golgi apparatus of the beta cell where it is processed and packaged into granules. Proinsulin, a single-chain 86 amino acid peptide, is cleaved into insulin and C-peptide (a connecting peptide); both are secreted in equimolar portions from the beta cell upon stimulation from glucose and other insulin secretagogues. While C-peptide has no known physiologic function, it can be measured to provide an estimate of endogenous insulin secretion. Go to: SOURCES OF INSULIN With the availability of human insulin by recombinant DNA technology in the 1980s, use of animal insulin declined dramatically. Beef insulin, beef-pork and pork insulin are no longer commercially available in the United States. The United States FDA may allow for persona Continue reading >>

Insulin (medication)

Insulin (medication)

"Insulin therapy" redirects here. For the psychiatric treatment, see Insulin shock therapy. Insulin is used as a medication to treat high blood sugar.[3] This includes in diabetes mellitus type 1, diabetes mellitus type 2, gestational diabetes, and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states.[3] It is also used along with glucose to treat high blood potassium levels.[4] Typically it is given by injection under the skin, but some forms may also be used by injection into a vein or muscle.[3] 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] Insulin can be made from the pancreas of pigs or cows.[5] Human versions can be made either by modifying pig versions or recombinant technology.[5] It comes in three main types short–acting (such as regular insulin), intermediate–acting (such as NPH insulin), and longer-acting (such as insulin glargine).[5] Insulin was first used as a medication in Canada by Charles Best and Frederick Banting in 1922.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] The wholesale cost in the developing world is about US$2.39 to $10.61 per 1,000 iu of regular insulin and $2.23 to $10.35 per 1,000 iu of NPH insulin.[8][9] In the United Kingdom 1,000 iu of regular or NPH insulin costs the NHS 7.48 pounds, while this amount of insulin glargine costs 30.68 pounds.[5] Medical uses[edit] Giving insulin with an insulin pen. Insulin is used to treat a number of diseases including diabetes and its acute complications such as diabetic ketoacid Continue reading >>

Humalog 50-50

Humalog 50-50

HUMALOG® Mix50/50™ 50% Insulin Lispro Protamine Suspension and 50% Insulin Lispro Injection (Rdna Origin) 100 Units Per Ml (U-100) DESCRIPTION Humalog® Mix50/50™ [50% insulin lispro protamine suspension and 50% insulin lispro injection, (rDNA origin)] is a mixture of insulin lispro solution, a rapid-acting blood glucose-lowering agent and insulin lispro protamine suspension, an intermediate-acting blood glucose-lowering agent. Chemically, insulin lispro is Lys(B28), Pro(B29) human insulin analog, created when the amino acids at positions 28 and 29 on the insulin B-chain are reversed. Insulin lispro is synthesized in a special non-pathogenic laboratory strain of Escherichia coli bacteria that has been genetically altered to produce insulin lispro. Insulin lispro protamine suspension (NPL component) is a suspension of crystals produced from combining insulin lispro and protamine sulfate under appropriate conditions for crystal formation. Insulin lispro has the following primary structure: Insulin lispro has the empirical formula C257H383N65O77S6 and a molecular weight of 5808, both identical to that of human insulin. Humalog Mix50/50 vials and Pens contain a sterile suspension of insulin lispro protamine suspension mixed with soluble insulin lispro for use as an injection. Each milliliter of Humalog Mix50/50 injection contains insulin lispro 100 units, 0.19 mg protamine sulfate, 16 mg glycerin, 3.78 mg dibasic sodium phosphate, 2.20 mg Metacresol, zinc oxide content adjusted to provide 0.0305 mg zinc ion, 0.89 mg phenol, and Water for Injection. Humalog Mix50/50 has a pH of 7.0 to 7.8. Hydrochloric acid 10% and/or sodium hydroxide 10% may have been added to adjust pH. Continue reading >>

Other Delivery Systems

Other Delivery Systems

The 10-mL vial NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart injectable suspension) 100 U/mL is also available in 10-mL vials. Syringes are sold separately and may need a prescription from your doctor. If you have questions about how to use the vial and syringe, see the Instructions For Use below or ask your health care provider. NovoLog® Mix 70/30 10-mL vial (100 Units/mL, U-100) Instructions For Use Read the following Patient Instructions for Use carefully before you start using your NovoLog® Mix 70/30 10-mL vial. Before starting, gather all of the supplies that you will need to use for preparing and giving your insulin injection. Never reuse syringes and needles. How should I use the NovoLog® Mix 70/30 vial? Check to make sure that you have the correct type of insulin. This is especially important if you use different types of insulin. Look at the vial and the insulin. The insulin should be white and cloudy after mixing. The tamper-resistant cap should be on the vial before the first use. If the cap has already been removed before your first use of the vial, or the insulin looks clear or contains particles, do not use it and return it to your pharmacy. Wash your hands with soap and water. Clean your injection site with an alcohol swab and let the injection site dry before you inject. Talk with your health care provider about how to rotate injection sites and how to give an injection. If you are using a new vial, pull off the tamper-resistant cap. Wipe the rubber stopper with an alcohol swab. Roll the vial gently 10 times in your hands to mix it. This should be done with the vial in a horizontal (flat) position between your palms. Do not shake the vial. Shaking right before the dose is drawn into the syringe may cause bubbles or foam. This can ca 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 >>

Health Library

Health Library

Insulin Detemir Solution for injection INSULIN DETEMIR (IN su lin DE te mir) is a human-made form of insulin. This drug lowers the amount of sugar in your blood. It is a long-acting insulin that is usually given once or twice a day. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions. What should I tell my health care provider before I take this medicine? They need to know if you have any of these conditions: episodes of hypoglycemia kidney disease liver disease an unusual or allergic reaction to insulin, metacresol, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feeding How should I use this medicine? This medicine is for injection under the skin. Take this medicine at the same time(s) each day. Use exactly as directed. This insulin should never be mixed in the same syringe with other insulins before injection. Do not vigorously shake insulin before use. You will be taught how to adjust doses for activities and illness. Do not use more insulin than prescribed. Do not use more or less often than prescribed. Always check the appearance of your insulin before using it. This medicine should be clear and colorless like water. Do not use if it is cloudy, thickened, colored, or has solid particles in it. It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or healthcare provider to get one. Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 years for selected conditions, precautions do apply. Overdosage: If you think you have taken too much of this medicine contact Continue reading >>

New Insulin Therapies For Patients With Diabetes

New Insulin Therapies For Patients With Diabetes

As rapid-acting insulin analogs were developed, the risk for error grew. The newest insulin is an inhaled formulation. With the new therapies now available, it's even more important to read every label, every time. The latest long-acting insulin analog, detemir (Levemir), also delivers a basal dose and is generally given once a day. However, detemir doesn't last as long as glargine, so patients may need a nighttime dose of the drug. That second dose may impact the next basal dose, as well as any doses of rapid-acting insulin used for post-prandial spikes in blood sugar, creating a potential risk for hypoglycemia. New forms of delivery. Eventually, newer ways of administering insulin may help cut down on mistakes. The latest form of insulin is Exubera, an inhaled, rapid-acting formulation. It's an alternative for Type 1 and Type 2 diabetes patients who fear needles. There's also an oral insulin tablet being developed, which could mean the end of injections for many patients. Perfecting tight blood sugar control In the last two years, the benefits of tight blood sugar control have led to the development of several insulin-enhancing agents. Subcutaneous injection. Exenatide (Byetta) is the first of a new class of medications called incretin mimetics, designed for use in Type 2 diabetes. Incretins are gut hormones that promote insulin secretion during a meal, suppress glucagon release, and delay gastric emptying, which effectively reduces post-prandial blood sugars. Exenatide is usually given subcutaneously as an adjunct to oral antihyperglycemics. To prevent severe hypoglycemia, exenatide should be administered before breakfast or dinner only. Keep in mind, too, that if the patient takes an oral antihyperglycemic requiring rapid absorption, the delay in gastric emptying wi Continue reading >>

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