Insulin

What is Insulin?

Insulin is prescribed for diabetes when diet modifications and oral medications fail to correct the condition. Insulin is a hormone produced by the pancreas, a large gland that lies near the stomach. This hormone is necessary for the body's correct use of food, especially sugar. Insulin apparently works by helping sugar penetrate the cell wall, where it is then utilized by the cell. In people with diabetes, the body either does not make enough insulin, or the insulin that is produced cannot be used properly.

What is the most important information I should know about Insulin?

Regardless of the type of insulin you use, you should follow carefully the dietary and exercise guidelines prescribed by your doctor. Failure to follow these guidelines or to take your insulin as prescribed may result in serious and potentially life-threatening complications such as hypoglycemia (lowered blood sugar levels).

If you are ill, you should check your urine for ketones (acetone), and notify your doctor if the test is positive. This condition can be life-threatening.

Wear personal identification that states clearly that you are diabetic. Carry a sugar-containing product such as hard candy to offset any symptoms of low blood sugar.

Do not change the type of insulin or even the model and brand of syringe or needle you use without your physician's instruction. Failure to use the proper syringe may lead to improper dosage levels of insulin.

If you become ill from any cause, especially with nausea and vomiting or fever, your insulin requirements may change. It is important to eat as normally as possible. If you have trouble eating, drink fruit juices, soda, or clear soups, or eat small amounts of bland foods. Test your urine and/or blood sugar and tell your doctor at once. If you have severe and prolonged vomiting, seek emergency medical care.

If you are taking insulin, you should check your glucose levels with home blood and urine testing devices. If your blood tests consistently show above-normal sugar levels or your urine tests consistently show the presence of sugar, your diabetes is not properly controlled, and you should tell your doctor.

Who should not take Insulin?

Insulin should be used only to correct diabetic conditions.

What should I tell my doctor before I take the first dose of Insulin?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with this drug. Also, talk to your doctor about your complete medical history, especially about recent episodes of nausea, vomiting, or any other illness.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Your doctor will specify which insulin to use, how much, when, and how often to inject it. Your dosage may be affected by changes in food, activity, illness, medication, pregnancy, exercise, travel, or your work schedule. Proper control of your diabetes requires close and constant cooperation with your doctor. Failure to use your insulin as prescribed may result in serious and potentially fatal complications.

How should I take Insulin?

Take your insulin exactly as prescribed, being careful to follow your doctor's dietary and exercise recommendations. Before taking your injection, carefully read and follow the manufacturer's instructions on how to prepare your pre-filled pen or syringe. Clean the injection area with alcohol first; typical areas of injection are the abdomen, thighs, and arms. Insert the needle and push the plunger as far as it will go. Do not rub the injection area. To avoid skin damage, the next injection should be made at least half an inch from the previous site.

Some insulins should be clear, and some have a cloudy precipitate. Find out what your insulin should look like and check it carefully before using.

What should I avoid while taking Insulin?

To avoid infection or contamination, use disposable needles and syringes or sterilize your reusable syringe and needle carefully. Always keep handy an extra supply of insulin as well as a spare syringe and needle.

Use alcohol carefully, since excessive alcohol consumption can cause low blood sugar. Don't drink unless your doctor has approved it.

What are possible food and drug interactions associated with Insulin?

Follow your physician's dietary guidelines as closely as you can and inform your physician of any medication, either prescription or non-prescription, that you are taking. Specific medications, depending on the amount present, that affect insulin levels or its effectiveness include: alcohol, ACE inhibitors such as the blood pressure medications benazepril and quinapril, anabolic steroids, appetite suppressants such as diethylpropion, aspirin, beta-blocking blood pressure medicines such as atenolol and metoprolol, diuretics such as furosemide and hydrochlorothiazide, epinephrine, estrogens, isoniazid, major tranquilizers such as chlorpromazine and thioridazine, MAO inhibitors (drugs such as the antidepressants phenelzine and tranylcypromine), niacin, octreotide, oral contraceptives, oral diabetes drugs, phenytoin, steroid medications such as prednisone, sulfa antibiotics such as sulfamethoxazole, and thyroid medications such as levothyroxine.

What are the possible side effects of Insulin?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

While side effects from insulin use are rare, allergic reactions or low blood sugar may pose significant health risks. Your doctor should be notified if any of the following occur:

Mild allergic reactions: swelling, itching or redness at the injection site (usually disappears within a few days or weeks)

More serious allergic reactions: fast pulse, low blood pressure, perspiration, rash over the entire body, shortness of breath, shallow breathing, or wheezing

Low blood sugar may develop in poorly controlled or unstable diabetes. Consuming sugar or a sugar-containing product will usually correct the condition, which can be brought about by taking too much insulin, missing or delaying meals, exercising or working more than usual, an infection or illness, a change in the body's need for insulin, drug interactions, or consuming alcohol.

Symptoms of low blood sugar include: abnormal behavior, anxiety, blurred vision, cold sweat, confusion, depressed mood, dizziness, drowsiness, fatigue, headache, hunger, inability to concentrate, light-headedness, nausea, nervousness, personality changes, rapid heartbeat, restlessness, sleep disturbances, slurred speech, sweating, tingling in the hands, feet, lips, or tongue, tremor, unsteady movement

Symptoms of insufficient insulin include: drowsiness, flushing, fruity breath, heavy breathing, loss of appetite, rapid pulse, thirst

An overdose of insulin can cause low blood sugar (hypoglycemia). Symptoms include: depressed mood, dizziness, drowsiness, fatigue, headache, hunger, inability to concentrate, irritability, nausea, nervousness, personality changes, rapid heartbeat, restlessness, sleep disturbances, slurred speech, sweating, tingling, tremor, and unsteady movements. Your doctor should be contacted immediately if these symptoms of severe low blood sugar occur. Eating sugar or a sugar-based product will often correct the condition. If you suspect an overdose, seek medical attention immediately.

Can I receive Insulin if I am pregnant or breastfeeding?

Insulin is considered safe for pregnant women, but pregnancy may make managing your diabetes more difficult. Properly controlled diabetes is essential for the health of the mother and the developing baby; therefore, it is extremely important that pregnant women follow closely their physician's dietary and exercise guidelines and prescribing instructions. Since insulin does not pass into breast milk, it is safe for nursing mothers. It is not known whether genetically engineered insulin lispro appears in breast milk.

What should I do if I miss a dose of Insulin?

Your doctor should tell you what to do if you miss an insulin injection or meal.

How should I store Insulin?

Store insulin in a refrigerator (but not in the freezer) or in another cool, dark place. Do not expose insulin to heat or direct sunlight.

Some brands of pre-filled syringes can be kept at room temperature for a week or a month. The vial or cartridge of genetically engineered insulin lispro can be kept unrefrigerated for up to 28 days. Check your product's label. Never use insulin after the expiration date that is printed on the label and carton.