Insulin Injections Are Prescribed For Treatment Of

Insulin Regular Side Effects

Insulin regular can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking insulin regular . This list does not include all possible side effects.

For more information on the possible side effects of insulin regular , or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

When To See A Doctor

• If you are planning to undergo surgery or have changed your eating or exercise habits, you need to see your doctor as you may require a change in your insulin dosage.
• If your blood sugar levels remain high even after taking insulin, consult your doctor immediately.
• If you are experiencing intense hunger, thirst, pain, tingling in the hands or feet, or any other signs of hypoglycaemia, contact your doctor immediately or seek emergency medical attention.
• If you have fallen ill or feel sick, contact your doctor as you may need a change in your insulin dosage.

What To Do With The Oral Drugs

The patient is asked to remain on all the oral hypoglycaemic drugs that they are currently taking. The only exceptions are:

• if the patient is taking supra-maximal doses of any of the oral drugs, they are reduced to what is recommended in the product information
• if the patient is suffering from the gastrointestinal adverse effects of metformin, it is reduced to a dose which is tolerated
• if the patient is taking three oral hypoglycaemic drugs including acarbose, the acarbose is stopped as its adverse effects usually outweigh its advantage.

Although the oral drugs have ‘failed’ in the situation of ‘secondary failure’, they are still exerting considerable hypoglycaemic effects. Clinical studies have shown that if either the sulfonylurea or metformin are stopped altogether, then each needs to be replaced by an extra 20-30 units of daily insulin. In other words, the insulin dosage would need to exceed about 60 units a day before improvement in glycaemic control could occur. This would require a more aggressive insulin regimen and titration, making the process of starting insulin much more difficult. If a thiazolidinedione has been used, this could be continued initially at least, as it may also contribute an insulin sparing effect.

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Why Is This Medication Prescribed

Human insulin is used to control blood sugar in people who have type 1 diabetes or in people who have type 2 diabetes that cannot be controlled with oral medications alone. Human insulin is in a class of medications called hormones. Human insulin is used to take the place of insulin that is normally produced by the body. It works by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar.

Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication, making lifestyle changes , and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage , eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

Warnings For People With Certain Health Conditions

For people with kidney disease: Insulin is removed from your body by your kidneys. If your kidneys arent working well, insulin may build up in your body and cause low blood sugar. Your doctor may start you at a lower dose and slowly increase your dose if needed.

For people with liver disease: If you have liver failure, this drug may build up in your body. Your doctor may start you at a lower dosage and slowly increase your dosage if needed if you have liver problems. You and your doctor should monitor your blood sugar very closely.

For people with heart failure: Taking certain diabetes medications called thiazolidinediones with insulin regular may make your heart failure worse. Your healthcare provider should watch you closely while youre taking TZDs with insulin regular . Tell your doctor if you have any new or worse symptoms of heart failure.

For people with low blood potassium : Insulin can cause a shift in potassium levels, which can lead to low blood potassium. If youre using potassium-lowering medications with insulin regular , your doctor will check your blood sugar and potassium often.

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Human Insulin As Safe And Effective To Treat Type 2 Diabetes As Costlier Insulin Analogs

Patients with Type 2 diabetes who were treated with the newer generation of insulin analog drugs did not have substantially better outcomes than those treated with less costly human insulin, according to a study by Yale School of Medicine researchers and colleagues at Kaiser Permanente.

The study is published in the June 23 issue of Journal of the American Medical Association.

We compared the newer and older types of insulin in a large and diverse population of Kaiser Permanente type 2 diabetes patients who were newly prescribed insulin, said lead author Kasia J. Lipska, M.D., assistant professor of medicine at Yale School of Medicine. The study was conducted under real-world conditions with uniquely detailed data about possible confounding factors and long-term outcomes.

We found that for patients with type 2 diabetes in usual practice, the use of the more expensive insulin analogs did not appear to result in better safety at least as defined by hospital or emergency visits for hypoglycemia or better blood sugar control compared with NPH insulin, Lipska added. This suggests that many people with type 2 diabetes should consider starting with NPH insulin, instead of insulin analogs, especially if cost is an issue for them.

In addition to Karter and Lipska, co-authors of the study were Melissa Parker, MS, and Howard H. Moffet of Kaiser Permanente Division of Research and Elbert S. Huang, M.D., of the University of Chicago Department of Medicine.

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Impact Of Treatment Adherence On Clinical And Economic Outcomes

Medication adherence has also been shown to be associated with improved glycaemic control in patients with T2D. A retrospective cohort study in the US showed that patients with T2D who were considered adherent to a GLP-1 RA had a significantly greater reduction in HbA1c than nonadherent patients and were more likely to have a reduction in HbA1c of1.0% . Conversely, poor adherence to antidiabetes therapy is associated with failure to achieve HbA1c targets in the real-world setting. Using the four-item Morisky Medication Adherence Scale , patients who self-reported that they forgot to take medications at baseline were shown to have an absolute HbA1c increase of 0.43% after 6 months of treatment with insulin and/or OADs . In another study, a one-point increase in the eight-item Morisky Medication Adherence Scale was found to be associated with a 0.21% increase in HbA1c in patients with T2D using basal insulin analogues .

Hyperglycaemia and long-term complications of T2D are associated with poor adherence to antidiabetes medications and have important clinical consequences for the patient . A narrative review of studies published in English and Spanish identified several studies linking poor adherence to T2D therapies with increased risks of morbidity and premature mortality .

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Dont Have Time To Read

• Insulin is a hormone made by your pancreas, that regulates your blood sugar levels.
• In individuals with diabetes, man-made or human insulin is prescribed to control blood sugar levels when the body is unable to produce or use insulin properly.
• Being chemically similar to natural insulin, it helps in utilising the glucose in food to generate energy and store it for later use.
• Insulin therapy may cause common side effects such as redness, swelling, or itching at the site of injection, weight gain, changes in skin texture at the site of injection, etc., and severe side effects such as hypoglycaemia, hypokalaemia, etc.
• Certain precautions like cleaning and rotating the injection site, proper storage of insulin, limiting alcohol consumption, etc., should be taken into consideration while under insulin therapy.
• Several common myths revolve around the use of human insulin, including that it is ineffective, addictive and painful.

What Are The Different Types Of Insulin

Several types of insulin are available. Each type starts to work at a different speed, known as onset, and its effects last a different length of time, known as duration. Most types of insulin reach a peak, which is when they have the strongest effect. After the peak, the effects of the insulin wear off over the next few hours or so. Table 1 lists the different types of insulin, how fast they start to work, when they peak, and how long they last.

Table 1. Types of insulin and how they work1,2

Another type of insulin, called premixed insulin, is a combination of insulins listed in Table 1. Premixed insulin starts to work in 15 to 60 minutes and can last from 10 to 16 hours. The peak time varies depending on which insulins are mixed.

Your doctor will work with you to review your medication options. Talk with your doctor about your activity level, what you eat and drink, how well you manage your blood glucose levels, your age and lifestyle, and how long your body takes to absorb insulin.

Follow your doctors advice on when and how to take your insulin. If you’re worried about the cost, talk with your doctor. Some types of insulin cost more than others. You can also find resources to get financial help for diabetes care.

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Skin Reactions To Insulin

Insulin injections may cause fat deposits, making the skin look lumpy, or destroy fat, causing indentation of the skin. Although this skin reaction is not an allergic reaction, it can decrease the absorption of injected insulin. It is, therefore, important to rotate the injection sites, for example, using the thigh one day, the stomach another, and an arm the next, to avoid these problems.

What Medicines Might I Take For Diabetes

The medicine you take depends on the type of diabetes you have and how well the medicine controls your blood glucose levels, also called blood sugar levels. Other factors, such as any other health conditions you may have, medication costs, your insurance coverage and copays, access to care, and your lifestyle, may affect what diabetes medicine you take.

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Alternative Medications For People With Type 2 Diabetes

People living with type 1 diabetes must use insulin to help control their blood sugar, but those living with type 2 diabetes may be able to use oral medications to help manage their blood sugar instead of injections.

Oral medication is typically prescribed along with lifestyle changes, such as increased activity, weight loss , and diet changes.

Medications for type 2 diabetes are designed to lower blood glucose levels, but they may not work for everyone. Typically, they work best for people who have recently developed diabetes and do not use supplemental insulin.

• thiazolidinediones

Before prescribing any of these oral medications, your doctor will talk with you about your medical history and any additional medications you take.

If youre living with type 1 diabetes, your body does not produce insulin, so youll need to continue to permanently take insulin.

People living with type 2 diabetes can manage, and maybe even reverse, their diagnosis with lifestyle changes.

According to the , lifestyle changes that can help manage type 2 diabetes are:

• eating a nutrient-dense diet rich in fruits and vegetables
• maintaining a moderate weight
• staying physically active

These lifestyle habits are also helpful for managing type 1 diabetes, but they wont reverse the diagnosis.

Additionally, you can help manage your blood sugar by:

• eating at regular times

Myths About Insulin Therapy

According to the American Diabetes Association , several common myths surround the use of insulin therapy for people with type 2 diabetes.

People who take insulin may sometimes hear others make the following statements, but they have no basis in research or fact:

• Insulin can cure diabetes. There is, at present, no cure for diabetes. However, insulin can help a person control its effects.
• It will cause disruption in your life. While a course of insulin takes some getting used to, a person can enjoy a full and active life, as long as they stick to their insulin schedule.
• Insulin injections cause pain. Many people have a phobia of needles. However, modern insulin pens cause almost no pain. People using pumps can avoid injections altogether.
• Insulin will increase the frequency of severe hypoglycemia. While insulin can increase the risk of hypoglycemia, certain insulins can limit a sudden drop in blood sugar.
• Insulin causes weight gain for as long as a person uses it. Insulin might increase weight at first, but this is not an ongoing effect. The body first needs to adapt to insulin supplementation.
• The injection site is not important. Where on the body a person inserts a needle or pen determines the speed at which insulin has an effect. This can be vital after meals when quick drops in blood glucose levels reduce the impact of the food.
• Insulin is addictive. Insulin is not an addictive drug and is vital for any person whose pancreas does not produce insulin.

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When To Introduce More Complex Insulin Regimens

In some patients, fasting blood glucose concentrations may be quite acceptable and yet HbA1c remains significantly elevated. In this situation, a second dose of insulin is needed, usually given in the morning before breakfast. A small starting dose of medium-acting insulin in the order of 6-12 units would be reasonable.

Other patients who are at the more insulin-deficient end of the type 2 diabetes spectrum may be better starting on a twice-daily insulin regimen. The insulin sparing effects of oral hypoglycaemic drugs would still be present in this situation.

Dosage For Type 2 Diabetes

Adult dosage

• Insulin regular is usually given three or more times per day before meals.
• You should eat your meal within 30 minutes after giving an injection.
• Average insulin requirements range between 0.5 and 1 unit/kg per day.
• If youre just starting insulin therapy, your dosage may be lower, between 0.2 and 0.4 unit/kg per day.
• Youll inject insulin regular under your skin in the fatty part of your abdomen, thigh, buttocks, or back of your arm. This is where insulin is absorbed fastest.

Child dosage

• The total daily insulin requirements for children are usually between 0.5 and 1 unit/kg per day.
• Children who havent gone through puberty yet may need more insulin. Doses may be between 0.7 and 1 unit/kg per day.

Senior dosage

Your body may process this drug more slowly. Your doctor may start you on a lower dosage so that too much of this drug doesnt build up in your body. Too much of the drug in your body can be dangerous.

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What Oral Medicines Treat Type 2 Diabetes

You may need to take medicines to manage your type 2 diabetes, in addition to consuming healthy foods and beverages and being physically active. You can take many diabetes medicines by mouth. These medicines are called oral medicines.

Most people with type 2 diabetes start with metformin pills. Metformin also comes as a liquid. Metformin helps your liver make less glucose and helps your body use insulin better. This drug may help you lose a small amount of weight.

Other oral medicines act in different ways to lower blood glucose levels. Combining two or three kinds of diabetes medicines can lower blood glucose levels better than taking just one medicine.

Read about different kinds of diabetes medicines from the FDA.

Making The Switch To Insulin

Making the transition is much easier than it used to be because most patients are started on a long-acting insulin that does not need to be matched with food intake.

Insulin pens that are preloaded are replacing insulin that needs to be drawn up into a syringe. Patients may still be worried about giving themselves injections, but because the needle is so tiny the adjustment is often quick.

Toujeo and Lantus are long-acting forms of insulin that are available in a prefilled injectable pen.

There’s also a type of rapid-acting insulin, Afrezza, that can be inhaled through the mouth via an inhaler.

And a new class of medication called sodium-glucose cotransporter 2 inhibitors is also available now, according to Mazhari. “It works via a different pathway that’s not pancreas-dependent, offering another medical therapy option for patients with type 2 diabetes.”

The key to an easy transition to insulin is education.

“Patients need to know how to take their insulin properly since there are many formulations on the market, including short- and long-acting insulin and premixed,” Mazhari said. “Most can be started on a long-acting insulin once a day, though for some patients short-acting or mealtime insulin may be necessary as well. Insulin doses need to be further adjusted depending on blood sugar readings.”

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Type 1 Or Type 2 Diabetes: Do You Know The Difference

How well do you know the difference between Type 1 and Type 2 diabetes? While the conditions may be similar, the causes and treatments for each are very different.

Type 1 diabetes is an autoimmune disease often diagnosed in children, teens and young adults, although it can be diagnosed at any age. Type 2 diabetes, however, is more commonly diagnosed in those who are 45 years of age and older. In recent years, Type 2 diagnoses among younger people have become more common than in the past.

Type 2 diabetes is a condition in which your body is still making insulin, but your body is insulin resistant. Insulin is necessary for blood sugars to enter cells, so being insulin resistant means your body doesnt handle blood sugars very well, said Arti Bhan, M.D., an endocrinologist who specializes in diabetes care. On the other hand, Type 1 diabetes is a condition in which your pancreas either does not make insulin at all, or doesnt make enough insulin. This lack of insulin causes your blood sugars to elevate.

To test your knowledge of Type 1 and Type 2 diabetes, see if you can answer these true and false questions correctly.

True or False? Insulin injections are only used to treat Type 1 Diabetes.

True or False? Type 1 Diabetes is far less common than Type 2 diabetes.

TRUE. The estimates show that more than 29 million people have some form of diabetes, but Type 1 affects only around five percent of all people with diabetes in the United States.

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