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Why Can't Lantus Be Mixed With Other Insulins

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 >>

Lantus

Lantus

How does this medication work? What will it do for me? Insulin is a naturally occurring hormone made by the pancreas that helps our body use or store the glucose (sugar) it gets from food. For people with diabetes, either the pancreas does not make enough insulin to meet the body's requirements, or the body cannot properly use the insulin that is made. As a result, glucose cannot be used or stored properly and accumulates in the bloodstream. Insulin injected under the skin helps to lower blood glucose levels. There are many different types of insulin and they are absorbed at different rates and work for varying periods of time. Insulin glargine is an extended, long-acting insulin. It takes about 90 minutes to begin working after injection, and it stops working after about 24 hours. After injection, insulin glargine is released slowly and constantly into the bloodstream. This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it. What form(s) does this medication come in? Vial Each mL of sterile solution contains 100 u Continue reading >>

Nclex Study Pharmacology Insulin

Nclex Study Pharmacology Insulin

Sort Can intermediate acting insulin be mixed with regular or rapid acting insulin? Isophane suspension: NPH Humulin N Novolin N YES What is the technique for mixing intermediate insulin with rapid or regular insulin? Isophane suspension: NPH Humulin N Novolin N CLEAR TO CLOUDY Draw up clear (regular or rapid acting) then draw up cloudy (NPH) 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 >>

F A C T S H E E T F O R P A T I E N T S A N D F A M I L I E Sf A C T S H E E T F O R P A T I E N T S A N D F A M I L I E S

F A C T S H E E T F O R P A T I E N T S A N D F A M I L I E Sf A C T S H E E T F O R P A T I E N T S A N D F A M I L I E S

Why can’t I just take a pill? So far, pill forms of insulin haven’t worked. Since insulin is a protein, stomach acids tend to digest it just like they do the protein in foods. This destroys the insulin before it has a chance to work. Right now the most common ways to take insulin are by injection with a needle and syringe or with a disposable insulin pen. This handout provides instructions for using these devices. (It doesn’t explain how to use an insulin pump, which is another way of taking insulin.) Diabetes Medications: insulin Insulin is used to treat diabetes. It’s taken by injection (shot) or with an insulin pump. As with other diabetes medications, it works best when you’re following the rest of your treatment plan. This means checking your blood glucose regularly, following your meal plan, and exercising every day. What does insulin do? In general, insulin works just like the insulin made in a normal pancreas: it helps move glucose (sugar) out of your bloodstream and into your body’s cells. There are many types of insulin. Some work right away and don’t last very long. Others act more slowly, over a longer period of time. Your doctor will explain which type you use and how to take it properly. Page 2 has a table that lists types of insulin and how they work in your body. Why is insulin important for my health? • If you have type 1 diabetes, you already know you need insulin to live every day. Without insulin, your body can’t get fuel from food. • If you have type 2 diabetes or gestational diabetes, your doctor has determined that your body needs extra help processing glucose. Adding insulin to your treatment plan will do this. Like your other diabetes medications, it helps control your blood glu 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 >>

Diabetes And Insulin

Diabetes And Insulin

On this page: Diabetes mellitus (diabetes) is a chronic and potentially life-threatening condition where the body loses its ability to produce insulin, or begins to produce or use insulin less efficiently, resulting in blood glucose levels that are too high (hyperglycaemia). Blood glucose levels above the normal range , over time, can damage your eyes, kidneys and nerves, and can also cause heart disease and stroke. An estimated 280 Australians develop diabetes every day. Diabetes is Australia's fastest-growing chronic disease. The main types of diabetes are type 1, type 2, and gestational diabetes. Type 1 diabetes Type 1 diabetes develops when the cells of the pancreas stop producing insulin. Without insulin, glucose cannot enter the cells of the muscles for energy. Instead the glucose rises in the blood causing a person to become extremely unwell. Type 1 diabetes is life threatening if insulin is not replaced, and people need to inject insulin for the rest of their lives. Type 1 diabetes often occurs in children and people under 30 years of age, but it can occur at any age. This condition is not caused by lifestyle factors. Its exact cause is not known but research shows that something in the environment such as the rubella virus can trigger it in a person that has a genetic risk. The body’s immune system attacks and destroys the beta cells of the pancreas after the person gets a virus because it sees the cells as foreign. Most people diagnosed with type 1 diabetes do not have family members with this condition. For more information about symptoms, visit the Diabetes type 1 fact sheet. Type 2 diabetes Type 2 diabetes develops when the pancreas does not make enough insulin and the insulin that is made does not work as well as it should (also known as insulin resistan Continue reading >>

Prefilling Insulin Syringes

Prefilling Insulin Syringes

I just saw the following question: Can syringes be prefilled for future use of insulin for the next few days? I was told once that syringes cannot be prefilled, but I cannot find information in the literature to support this. My reply: I’ll assume that you are not interested in using insulin pens, which contain insulin that was prefilled by the manufacturer. For some insulin products, pre-filling insulin syringes for use in the next few days has been a standard practice in some settings. However, at least one insulin (Lantus, AKA insulin glargine) becomes cloudy by day 3 and hence the manufacturer "does not recommend preï¬lling syringes with Lantus and storing for any period longer than needed for application." (See How Long Should Insulin Be Used Once a Vial is Started?). Prefilling syringes with insulin has been commonly done in some settings, such as when a home health nurse or aide is visiting a blind person with diabetes every-few-days. There’s a long discussion from Medicare online that spells out that "An adequately trained home health aide could make intermittent visits, usually on a weekly basis, to the home for the purpose of filling that supply of insulin ordered by the physician." Several thoughts to minimize the possibility of problems: Set an upper limit on the number of days worth of insulin that you pre-fill. There’s no science behind the number that I’m aware of, but I’d suggest a week or less. One website has several tables listing storage conditions for insulin for various insulin products; the table titled "Maximum Storage Conditions for Syringes Pre-drawn or Vials Premixed" indicates some products are stable up to 30 days if refrigerated, and others discourage pre-drawing. Store the preloaded syringes in the refrigerator, both to preserv Continue reading >>

What Is Lantus? (insulin Glargine)

What Is Lantus? (insulin Glargine)

What is Lantus? 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 mellitusto 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 (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. LANTUS (insulin glargine injection) is a sterile solution of insulin glargine for subcutaneous use. Insulin glarg Continue reading >>

Diabetes: Giving Yourself An Insulin Shot

Diabetes: Giving Yourself An Insulin Shot

Introduction Insulin is used for people who have type 1 diabetes. It's also used if you have type 2 diabetes and other medicines are not controlling your blood sugar. If you have gestational diabetes, you may need to take insulin if diet and exercise have not helped to keep your blood sugar levels within your target range. With little or no insulin, sugar (glucose) in the blood can't enter your cells to be used for energy. This causes the sugar in your blood to rise to a level that's not safe. When your blood sugar rises past about 180 mg/dL, your kidneys start to release sugar into the urine. This can make you dehydrated. If that happens, your kidneys make less urine, which means your body can't get rid of extra sugar. This is when blood sugar levels rise. Taking insulin can prevent symptoms of high blood sugar. It can also help to prevent emergencies such as diabetic ketoacidosis (in type 1 diabetes) and hyperosmolar coma (in type 2 diabetes). Insulin can help lower blood sugar too. This can prevent serious and permanent health problems from long-term high blood sugar. Remember these key tips for giving insulin shots: Make sure you have the right dose of insulin, especially if you are giving two types of insulin in the same syringe. Practice how to give your shot. Store the insulin properly so that each dose will work the way it should. How to prepare and give an insulin injection Your health professional or certified diabetes educator (CDE) will help you learn to prepare and give your insulin dose. Here are some simple steps that can help. To get ready to give an insulin shot, follow these steps. Wash your hands with soap and running water. Dry them well. Gather your supplies. Most people keep their supplies in a bag or kit so they can take them wherever they go. Che Continue reading >>

Combination Insulins

Combination Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Novolin® 70/30 - Humulin® 70/30 Novolog® Mix 70/30 Humalog® Mix 75/25 SOLIQUA™ 100/33 (insulin glargine and lixisenatide injection) XULTOPHY® 100/3.6 (insulin degludec and liraglutide injection) --® Onset: 30-60 min Peak: 2-12 hours Duration: 18 - 24 hours Solution: Cloudy Comments: Mixture of 70% NPH, Human Insulin Isophane Suspension and 30% Regular, Human Insulin Injection. Recommended interval between dosing and meal initiation: 30 minutes. Mixing You should not attempt to change the ratio of this product by adding additional NPH or Regular insulin to the vial. If the physician has prescribed insulin mixed in a proportion other than 70% NPH and 30% Regular, you should use the separate insulin formulations (e.g. NPH and Regular insulin ) in the amounts recommended by the physician. All Unopened Novolin 70/30: • Keep all unopened Novolin 70/30 in the refrigerator between 36° to 46°F (2° to 8°C). • Do not freeze. Do not use Novolin 70/30 if it has been frozen. • If refrigeration is not possible, the unopened vial may be kept at room temperature for up to 6 weeks (42 days), as long as it is kept at or below 77°F (25°C). • Keep unopened Novolin 70/30 in the carton to protect from light. Novolin 70/30 in use: Vials • Keep at room temperature below 77°F (25°C) for up to 6 weeks (42 days). • Keep vials away from direct heat or light. • Throw away an opened vial after 6 weeks (42 days) of use, even if there is insulin left in the vial. • Unopened vials can be used until the expiration date on the Novolin 70/30 label, if the medicine has been stored in a refrigerator. Note: double mouse click to return to the top of the page Onset Continue reading >>

Relion Insulin: Everything You Need To Know

Relion Insulin: Everything You Need To Know

For my patients who have no insurance, ReliOn products at Walmart are a lifesaver. In North Carolina, we never funded Medicaid expansion. Some people could receive Obamacare through the federal marketplace, but others were left in the gap where it was too costly for them. The tax penalty was less, so they took the penalty instead of buying coverage. For those with Type 1 and Type 2 Diabetes in the no insurance gap, for those in the “Medicare donut hole,” and for those in disaster situations, ReliOn insulin is available at a very affordable cost. If you want insulin at a cheaper cost, it is important to be aware of some of the differences between ReliOn insulin and name brand insulins. Renee’s story Renee had Type 1 Diabetes, and couldn’t afford her insurance coverage here in North Carolina. After running her insurance cost numbers on the Federal Marketplace, she would have to pay $300 per month for catastrophic coverage that wouldn’t even cover her diabetes medications. Her husband had lost his job, and she worked at a grocery store, where she didn’t make a living wage, or have any insurance benefits. She came in crying. She needed help, because she had lost her insurance coverage, and she was about to run out of her insulin. She was afraid of what might happen to her, and what might happen to her little boy, if she ran out of her insulin. We referred her to a social worker who could help her with needed resources, and see if she could qualify for Medicaid, or start social security disability determination so she could get insurance when determined disabled. In the meantime, we spoke with her doctor, and he gave us conversion doses for Renee to switch to the ReliOn brand of insulins at Walmart. She had to take a combination of ReliOn Humulin N injections twi Continue reading >>

Mixing Insulin Glargine With Rapid-acting Insulin: A Review Of The Literature

Mixing Insulin Glargine With Rapid-acting Insulin: A Review Of The Literature

Purpose. To review the literature examining the mixing of insulin glargine with rapid-acting insulin (RAI). Methods. A literature search was conducted via PubMed and Medline (from 1948 to August 2012) using the search terms “diabetes,” “insulin glargine,” “short acting insulin,” “rapid acting insulin,” and “mixing.” Literature was limited to English-language articles reporting on human studies. Studies with data describing mixing glargine with any short-acting insulin or RAI were included. Four studies met inclusion criteria. Results. Of the four studies assessing mixing glargine, one was a pharmacokinetic study. The other three assessed clinical outcomes in “real-world” settings. All of these studies were conducted in pediatric patients with type 1 diabetes. Two of the clinical outcomes studies did not report significant differences in A1C levels or preprandial, postprandial, or nocturnal blood glucose levels from mixing glargine and RAI. One of the clinical outcome studies reported improved blood glucose control (A1C and fasting blood glucose) with RAI mixed with glargine compared to RAI mixed with NPH insulin. There were no significant differences in hypoglycemia in any of the clinical outcome trials at any time measured. Conclusion. Initial small clinical trials indicate that there are no significant changes in clinical outcomes (blood glucose levels, A1C levels, and hypoglycemia) when mixing glargine with RAI. Additional studies with larger patient populations and longer trial durations are needed before mixing glargine with RAI can be recommended on a routine basis in clinical practice. Methodology A literature search was conducted via PubMed and Medline (articles published from 1948 to January 2012) using the search terms “diabetes,” 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 >>

Making Insulin Work

Making Insulin Work

As you all probably experience in your own lives, it often seems like things come in waves. And this past week the wave I have been experiencing has been full of worried emails from people who report that they or a loved one have recently started insulin but that it isn't working. In every case, the insulin is a slow acting insulin, Lantus or Levemir, and there's a good reason why the insulin isn't working. It is because the dose being used is far too low to have an impact on an insulin resistant Type 2. When doctors intially start a person with Type 2 diabetes on a slow acting insulin they start out with a very low dose, usually 10 units. This is prudent. One in ten "Type 2s" is not really a Type 2. Most of these misdiagnosed "type 2s" turn out to be people in the early stages of LADA, Latent Autoimmune Diabetes of Adults, which is a a slow onset form of autoimmune diabetes. People with LADA usually have normal or near normal insulin sensitivity and for them an injection of ten units is a LOT of insulin. One or two percent of people diagnosed as Type 2 turn out to be people like me who have other oddball genetic forms of diabetes that also make them very sensitive to insulin. So starting everyone out at a low dose of insulin makes sense since this way the misdiagnosed people who turn out to have normal insulin sensitivity will avoid hypos caused by too much insulin. But once it is clear that a person really is a Type 2--since they see no response at all to a dose of 10 units of insulin, the doctor is supposed to raise the dose until it gets to the level where it will drop the fasting blood sugars. But many doctors do not explain this to their patients and quite a few raise the dose so slowly that it does seem to the poor patient that insulin won't solve their problems. Continue reading >>

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