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General information on use of insulin by SC route
- Pancreatic hormone, antidiabetic
Types of insulin
human insulin (a) Citation a. Short-acting insulin is also known as regular insulin. (Actrapid®)
Intermediate-acting human insulin
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|
- 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.
- Type 1 and type 2 diabetes
- Diabetes during pregnancy
- Transient therapy of type 2 diabetes during periods of severe infection, trauma, surgery
- Dosage must be individualised. Frequency of administration depends on the type of insulin and the patient's response.
- 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
- 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.
- (a)Short-acting insulin is also known as regular insulin.