Antidiabetic Agents Insulins

See also Antidiabetic Agents: Hyypo-glycemic Agents. See also the following individual entries:

Insulin injection Insulin injection concentrated Insulin lispro injection Insulin zinc suspension (Lente) Insulin zinc suspension, Extended (Ultralente) General Statement: Insulin preparations with different times of onset, peak activity, and duration of action have been developed. Such products are prepared by precipitating insulin in the presence of zinc chloride to form zinc insulin crystals and/or by combining insulin with a protein such as protamine. Based on these modifications, insulin products are classified as fast-acting, intermediate-acting, and long-acting. These preparations permit the provider to select the preparation best suited to the life-style of the client.

RAPID-ACTING INSULIN: Insulin injection (Regular Insulin, Crystalline Zinc Insulin, Unmodified Insulin)

INTERMEDIATE-ACTING INSULIN

1. Isophane insulin suspension (NPH)

2. Insulin zinc suspension (Lente)

LONG-ACTING INSULIN: Insulin zinc suspension extended (Ultralente)

NOTE: Insulin preparations with various times of onset and duration of action are often mixed to obtain optimum control in diabetic clients. Action/Kinetics: Decreases in blood glucose. Insulin also aids in the regulation of fat and protein metabolism.

Since insulin is a protein, it is destroyed in the GI tract. Thus, it must be administered SC so that it is readily absorbed into the bloodstream and distributed throughout the extracellular fluid. Metabolized mainly by the liver.

Uses: Replacement therapy in type I diabetes. Diabetic ketoacidosis or diabetic coma (use regular insulin). Insulin is also indicated in type II diabetes when other measures have failed (e.g., diet, exercise, weight reduction) or with surgery, trauma, infection, fever, endocrine dysfunction, pregnancy, gangrene, Ray-naud's disease, kidney or liver dysfunction.

Human insulins are used for local insulin allergy, lipodystrophy at the injection site, immunologic insulin resistance, temporary insulin use (e.g., surgery, acute stress, gestational diabetes), and newly diagnosed diabetes.

Regular insulin is used in IV HA solutions, in IV dextrose to treat severe hyperkalemia, and IV as a provocative test for growth hormone secretion.

Insulin and oral hypoglycemic drugs have been used in type II diabetics who are difficult to control with diet and PO therapy alone.

Diabetic clients should adhere to a regular meal schedule. Contraindications: Hypersensitiv-ity to insulin.

Special Concerns: Pregnant diabetic clients often manifest decreased insulin requirements during the first half of pregnancy and increased requirements during the latter half. Lactation may decrease insulin requirements.

Side Effects: Hypoglycemia

Allergic: Urticaria, angioedema, lymphadenopathy, bullae, anaphy-laxis.

At site of injection: Swelling, stinging, redness, itching, warmth. Insulin resistance Ophthalmologic: Blurred vision, transient presbyopia.

Hyperglycemic rebound (Somogyi effect).

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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