Indication

Diabetic ketoacidosis, Diabetes mellitus

Administration

Administer within 15 minutes before a meal or immediately after a meal. \r\nAdminister subcutaneously in the upper arm, thigh or abdominal wall. A subcutaneous injection into the abdominal wall results in a faster absorption than from other injection sites.

Adult Dose

$4e

Child Dose

Subcutaneous\r\nType 1 Diabetes Mellitus\r\nInitial: 0.2-0.4 unit/kg/day SC divided q8hr or more frequently \r\n\r\nMaintenance: 0.5-1 unit/kg/day SC divided q8hr or more frequently; in insulin-resistant patients (eg, due to obesity), substantially higher daily insulin may be required\r\n\r\nAdolescents: May require up to 1.5 mg/kg/day during puberty\r\n\r\nThe average total daily insulin requirement for prepubertal children varies from 0.7-1 unit/kg/day but may be much lower

Renal Dose

Renal impairment: Dose adjustments may be needed.

Contraindication

Hypoglycaemia.Hypersensitivity to any of the components.

Mode of Action

$4f

Precaution

Pregnancy (insulin requirements tend to fall during the 1st trimester, increase during the 2nd and 3rd) and lactation. Caution with decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment\r\nHypokalemia may occur\r\nUse with caution in renal and hepatic impairment (dosage requirements may be reduced)\r\nCaution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery\r\n\r\nLactation: Safe to use while breastfeeding

Side Effect

Allergic reactions. Injection site reaction, lipodystrophy, pruritus, rash, lipoatrophy, hypokalaemia, blurred vision. Hypoglycaemia, insulin resistance.\r\nHeadache,Influenza-like symptoms,Dyspepsia,Diarrhea,Back pain,Pharyngitis,\r\n\r\n

Interaction

Possible absence of hypoglycaemic warning symptoms with beta-blockers. Decreased hypoglycaemic effect with corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetic agents, thyroid hormones, oestrogens, progestins (e.g. in oral contraceptives), protease inhibitors and atypical antipsychotic (e.g. olanzapine and clozapine). Increased hypoglycaemic effect with oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates and sulfonamide antibiotics. Decreased insulin resistance with octreotide and lanreotide. Increased risk of wt gain and peripheral oedema with pioglitazone, rosiglitazone. Decreased effect of sermorelin.