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Why is this medication prescribed?
Insulin is a hormone produced in the pancreas. Insulin is necessary to move sugar from the blood into other body tissues where it is needed for energy. Insulin also helps the body to metabolize (process) carbohydrates, fats, and proteins from the diet. In a person with diabetes, the pancreas does not produce enough insulin for the body's needs, so additional insulin is required. It must be injected because stomach acid would destroy it if taken by mouth. Insulin controls, but does not cure, diabetes. It must be taken regularly. People with diabetes gradually develop serious nerve, blood vessel, kidney, and eye problems, especially if the diabetes is not controlled properly.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Insulin usually is given by subcutaneous (beneath the skin) injection. The amount of insulin you need depends on diet, other diseases, exercise, and other drugs you are taking and may change with time. Your doctor will determine how often and at what time of day to inject your insulin, as well as what type of insulin will best control the level of sugar in your blood.
Insulin controls high blood sugar but does not cure diabetes. Continue to take insulin even if you feel well. Do not stop taking insulin without talking to your doctor.
The different types of insulin vary as to how quickly they start to work and how long they go on reducing the amount of blood sugar. For example, rapid-acting insulins, such as regular insulin and Semilente, start to work in 30-60 minutes and go on working for 5-16 hours; long-acting insulins, such as Ultralente, start to work in 4-8 hours and continue working for 36 hours.
All insulin bottles are marked with large black letters to indicate what type of insulin they contain. For example, regular = R and Ultralente = U. You must know both the type of insulin you use and how many units (or how many units of each type of insulin if you take more than one) to take with each injection. There are two different strengths of insulin: U-100 and U-500. Your doctor will determine which strength you should use.
U-100 syringes must be used with U-100 insulin, and different syringes must be used with U-500 insulin. Be sure to get the right kind and the same brand each time.
Plastic syringes are disposable; use a new one for each injection. Used needles will hurt more and may cause an infection. Do not use the insulin if it has changed color or if the expiration date on the bottle has passed. Regular insulin should be a clear, colorless solution (U-500 may be straw colored). Discard the bottle if the solution is cloudy or thickened. Other forms of insulin should be cloudy.
Roll the bottle between the palms of your hands and turn it upside down gently several times to mix it and warm it before preparing your dose. Do not shake the bottle vigorously. Do not use it if the insulin has clumped, if lumps or particles are stuck to the sides of the bottle.
Ask your pharmacist or doctor to show you how to prepare your insulin dose. Wipe the rubber cap with an alcohol pad or cotton dipped in rubbing alcohol. It is easier to withdraw insulin if you first inject air into the bottle. Pull the syringe plunger back to draw up the same number of units of air as insulin that you will be taking. Insert the needle through the rubber cap and inject the air into the bottle. Invert the bottle and syringe, pull back on the plunger to draw insulin into the syringe, and measure the correct number of units of insulin. Be sure that there are no bubbles in the syringe. While the bottle is still inverted, you can tap gently on the syringe to eliminate these bubbles.Preparing Your Dose:
If you have trouble seeing the small markings on the syringe, have someone help you. Also, let your doctor and pharmacist know about this problem. They can provide syringes that are easier to read, special tools to help you fill the syringe, or prefilled syringes. If you take two types of insulin at the same time, such as regular and NPH, do not change the order of mixing. Whenever you mix regular insulin with another type of insulin, draw up the regular insulin (the clear solution) first.
You will be shown how to inject insulin correctly. You can inject it into your abdomen, buttocks, thighs, and arms. Clean the skin at the injection site with an alcohol pad or rubbing alcohol. Pinch a fold of skin with your fingers at least 3 inches apart and insert the needle at a 45-90-degree angle. Then inject the insulin, withdraw the needle, and press lightly (do not rub) on the skin.Injecting Your Dose:
Use a different site for each injection, about 1 inch away from the previous injection but in the same general area (e.g., thigh). Use all available sites in the same general area before switching to a different area (e.g., arm). Do not use the same injection site more often than once every month or two.
What special precautions should I follow?
Before taking insulin,
What special dietary instructions should I follow?
Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthful diet. Alcohol increases blood sugar; ask your doctor for information on how much is safe to drink.
Do not start a diet or an exercise program without talking to your doctor. Your insulin dose may need to be changed.
What should I do if I forget a dose?
When you first start taking insulin, ask your doctor what to do if you forget to take a dose at the correct time. Write down these directions so that you can refer to them later.
What side effects can this medication cause?
Although side effects from insulin are not common, they can occur. If you have any of these symptoms, eat or drink a food or beverage with sugar in it, such as hard candy or fruit juice, and call your doctor immediately; symptoms of low blood sugar (hypoglycemia) include:
If you have any of these symptoms, call your doctor immediately; symptoms of high blood sugar (hyperglycemia) include:
Tell your doctor if any of these symptoms are severe or do not go away:
If you experience any of the following symptoms, call your doctor immediately:
Store insulin in the refrigerator. Never allow insulin to freeze; do not use insulin that has been frozen and thawed. Never heat insulin to warm it.
If no refrigerator is available (e.g., when on vacation), store the bottle at room temperature and away from direct sunlight and extreme heat. Discard any insulin that has been exposed to extreme heat or cold. When traveling, protect your insulin bottles from bumps or other rough handling (wrap them in clothes in the middle of a suitcase). Do not keep insulin in hot areas of a car such as the glove compartment and trunk.
When traveling by airplane, do not put insulin in checked luggage since the luggage may be lost. Always keep insulin with you or in carry-on luggage. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to insulin.
To monitor the effectiveness of insulin, measure the amount of sugar (glucose) in your blood or urine (when blood sugar is above a certain high level, you will have sugar in your urine). For these measurements, you will need special paper tapes, tablets, or plastic strips that change color depending on how much sugar is present. You also can use a blood glucose meter to measure the amount of sugar in your blood. Your doctor also may ask you to test your urine for ketones (substances present when diabetes is not under control). Follow your doctor's directions for testing your urine and blood and for recording the results. If your blood sugar is high or if sugar or ketones are present in your urine, call your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT