Uses
Diabetes Mellitus
Replacement therapy for the management of diabetes mellitus.
Insulin is required in all patients with type 1 diabetes mellitus, and mandatory in the treatment of diabetic ketoacidosis and hyperosmolar hyperglycemic states.
Also used in patients with type 2 diabetes mellitus when weight reduction, proper dietary regulation, and/or oral antidiabetic agents have failed to maintain satisfactory glycemic control in both the fasting and postprandial state.
Used in combination with intermediate- or long-acting insulin preparations to provide better control of blood glucose concentrations in diabetic patients.
Also used in patients who have intercurrent illness, emotional stress, or trauma, or who are hospitalized for major illness and who require, at least temporarily, multiple injections of rapid-acting insulin.
Diet should be emphasized as the primary form of treatment when initiating therapy for patients with type 2 diabetes mellitus who do not have severe symptoms; caloric restriction and weight reduction are essential in obese patients.
The American Diabetes Association (ADA) and many clinicians recommend the use of physiologically based, intensive insulin regimens (i.e., 3 or more insulin injections daily with dosage adjusted according to the results of multiple daily blood glucose determinations [e.g., at least 4 times daily], dietary intake, and anticipated exercise) in most type 1 and type 2 diabetic patients who are able to understand and carry out the treatment regimen, are not at increased risk for hypoglycemic episodes, and do not have other characteristics that increase risk or decrease benefit (e.g., advanced age, end-stage renal failure, advanced cardiovascular or cerebrovascular disease, other coexisting diseases that shorten life expectancy).
Goals of insulin therapy in all patients generally should include maintenance of blood glucose as close as possible to euglycemia without undue risk of hypoglycemia; avoidance of symptoms attributable to hyperglycemia, glycosuria, or ketonuria; and maintenance of ideal body weight and of normal growth and development in children.
Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic States
Emergency treatment of diabetic ketoacidosis or hyperosmolar hyperglycemic states when rapid control is required. Regular insulin (e.g., insulin human [regular], insulin [regular]) is the insulin of choice in the treatment of such emergency conditions because of its rapid onset of action and because it can be administered IV.
AMI
Has been used IV early in the course of suspected AMI† in combination with IV potassium chloride and dextrose (D-glucose) (referred to as glucose-insulin-potassium or GIK therapy) for metabolic modulation and potential beneficial effects on morbidity and mortality.
Growth Hormone Reserve Test
Used IV to produce hypoglycemia and thus stimulate growth hormone secretion for evaluation of pituitary growth hormone reserve in patients with known or suspected growth hormone deficiency.
Hyperkalemia
Has been used in conjunction with IV dextrose infusions to facilitate the intracellular shift of potassium in the treatment of severe hyperkalemia†.
Critical Illness
Has been used to reduce morbidity and mortality in patients with critical illness† requiring intensive care.
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