INSULIN injectable

Select language:
Permalink

 

Prescription under medical supervision

 

General information on use of insulin by SC route

 

Therapeutic action

  • Pancreatic hormone, antidiabetic

Types of insulin

SC administration

Short-acting

human insulin (a) Citation a. Short-acting insulin is also known as regular insulin.  (Actrapid®)

Intermediate-acting human insulin
(Insulatard®)

Biphasic insulin
human analogue
Onset

30 minutes

to 1 hour

1 to 2 hours 30 minutes 10 to 20 minutes
Peak time 2 to 4 hours 4 to 12 hours 2 to 8 hours 2 to 8 hours
Duration 7 to 8 hours around 24 hours around 24 hours around 24 hours
Dosage form solution suspension suspension suspension
Aspect clear cloudy cloudy cloudy
  • (a)Short-acting insulin is also known as regular insulin.
  • For each preparation, onset and duration of activity are indicated by the manufacturer. Nevertheless, for the same preparation, onset and duration vary from one patient to another.
  • In one same patient, duration of activity varies depending on the dose, site of injection, blood flow, body temperature and exercise.
  • The type of insulin used depends of several factors: type of diabetes, patient's age, patient's response (blood glucose levels).
  • Analogue insulins have a different chemical structure to human insulin that modifies their onset and duration of activity after SC injection.

Indications

  • Type 1 and type 2 diabetes
  • Diabetes during pregnancy
  • Transient therapy of type 2 diabetes during periods of severe infection, trauma, surgery

Dosage

  • Dosage must be individualised. Frequency of administration depends on the type of insulin and the patient's response. 

Duration

  • Type 1 diabetes: life-time treatment
  • Other indications: according to clinical response and laboratory tests

Contra-indications, adverse effects, precautions

  • Do not administer in patients with allergy to insulin (rare).
  • May cause :
    • hypoglycaemia due to overdosage or inadequate diet;
    • local reactions: pain, erythema at the injection site, lipodystrophy. Rotate injection sites systematically and use all available sites (abdomen, thigh, buttock or arm);
    • weight gain.
  • Monitor combination with:
    • drugs enhancing hypoglycaemic effect of insulin: acetylsalicylic acid, angiotensin-converting enzyme inhibitors, beta-blockers (which in addition, may mask symptoms of hypoglycaemia);
    • drugs increasing blood glucose levels: corticosteroids, hydrochlorothiazide, salbutamol, chlorpromazine.
  • Avoid alcohol (enhances and prolongs hypoglycaemic effect of insulin).
  • In the event of renal or hepatic impairment and during the first trimester of pregnancy, reduce insulin doses. 
  • In the event of infection, emotional stress, accident or surgical intervention and during the last 2 trimesters of pregnancy, increase insulin doses.
  • Use sterile technique.
  • Pregnancy and breast-feeding: no contra-indication

Remarks

  • Insulin cannot be administered by mouth since it is inactivated in the gastrointestinal tract.
  • After SC injection, insulin absorption is rapid in the abdomen, slower in thighs, buttocks and arms.
  • When using an insulin pen, hold the needle in the skin at least six seconds to ensure the entire dose is injected.