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EmailGeneric Name: insulin isophane
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What is insulin isophane?
Insulin is a hormone naturally produced by the pancreas. Insulin enables the body to use the sugar in food as a source of energy. When the body does not produce enough insulin, or when the insulin produced by the body is not effective enough, the condition is called diabetes mellitus. This condition allows sugar levels in the blood to become very high. Diabetics must use man-made insulin or insulin that comes from pigs (which is very similar to human insulin) to lower these high blood sugar levels.
What are the possible side effects of insulin isophane?
Rarely, people have allergic reactions to insulin. Seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).
The side effects of insulin therapy result mostly from blood sugar levels that are either too high or too low. You should be familiar with the symptoms of both high and low blood sugar levels and know how to treat both conditions. Also, be sure your family and close friends know how to help you in an emergency.
Low blood sugar may occur when too much insulin is used; when meals are missed or delayed; if you exercise more than usual; during illness, especially with vomiting or diarrhea; if you take other medications; after drinking alcohol; and in other situations.
Keep sugary candy, fruit juice, or glucose tablets on hand to treat episodes of low blood sugar.
Increased blood sugar may occur if not enough insulin is used, if you eat significantly more food then usual, if you exercise less than usual, if you take other medications, if you have a fever or other illness, and in other situations.
Monitor your blood sugar levels and ask your doctor how to adjust your insulin doses if your blood sugar levels are too high.
Side effects may also occur at the site of injection. If the area becomes thickened, hard, or pitted, talk to your doctor before injecting at that site again.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
How should I use insulin isophane?
Use insulin isophane exactly as directed by your doctor. If you do not understand these instructions, ask your doctor, nurse, or pharmacist to explain them to you. If the insulin has been stored in the refrigerator, it can be warmed to room temperature before use. Roll the container of insulin between your palms 10 times. Then, if you are using a pen or prefilled syringe, turn it upside down so that the glass ball moves from one end to the other. Do this at least 10 times. Repeat this procedure until the suspension appears uniformly white and cloudy. Do not shake the insulin vigorously. Inject immediately. Repeat this procedure before each subsequent injection.
What is the most important information I should know about insulin isophane?
Know the signs and symptoms of low blood sugar (hypoglycemia), which include shaking; nausea; headache; drowsiness; weakness; dizziness; fast heartbeat; sweating; pale, cool skin; anxiety; and difficulty concentrating. Carry a piece of candy or glucose tablets with you to treat episodes of low blood sugar. Follow any diet and exercise plan that you have developed with your doctor or nurse. Changes in what you eat or how much you exercise can change the amount of insulin that you need to control blood sugar levels.
What happens if I miss a dose?
Follow your doctor's directions if you miss a dose of insulin. To prevent missed doses, be sure to always have enough insulin on hand, especially if you are going on vacation.
What other drugs will affect insulin isophane?
Many drugs can interact with insulin or affect blood sugar levels. Do not take any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, without first talking to your doctor or pharmacist during treatment with insulin.
Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?
Insulin has been assigned to pregnancy category B by the FDA. It is the drug of choice for the treatment of diabetes during pregnancy. Data from human pregnancy have revealed an increased incidence of teratogenicity associated with diabetes mellitus; the association with the use of insulin is probably coincidental. Because of the strong association between diabetes or hyperglycemia and perinatal morbidity and multiple congenital malformations, most experts recommend strict control of maternal plasma glucose with the use of insulin during pregnancy. Insulin is only recommended for use during pregnancy when benefit outweighs risk.
Insulin crosses the human placenta in small amounts. In one study, in which 28 cord-serum samples from pregnant women who were receiving animal insulin were evaluated, animal insulin constituted 27% of the total insulin measured from cord serum. The rate of congenital malformations appears to be associated with the severity of maternal diabetes rather than the use of insulin, a naturally-occurring hormone. The question of whether exogenous insulin itself or insulin-induced hypoglycemia causes the significantly elevated incidence of congenital malformations in infants of diabetic mothers has been evaluated. A significantly higher percentage of major malformations has been associated with elevated hemoglobin A1C levels, suggesting that hyperglycemia, or poor control of diabetes, and not insulin, is the causal factor. Diabetes portends risk during pregnancy. In a nationwide, four-year retrospective review of 491 insulin-dependent diabetic pregnancies in Sweden, the rates of pregnancy-induced hypertension or preeclampsia, premature delivery, Cesarean section, large-for-age offspring, and perinatal mortality in the diabetic group were more than four times higher than normal. Insufficient maternal insulin secretion or action may result in increased insulin secretion by the fetus, increased fetal growth and fat deposition, and neonatal hypoglycemia. Maternal diabetes mellitus may be complicated by fetal macrosomia, relatively large-for-age offspring, and predisposes the offspring to diabetes. Gestational age appears to be a determinant of neonatal morbidity. Many experts recommend delivery at 38 weeks, if possible. There is an impaired counterregulatory response to hypoglycemia in pregnant diabetic women. Relative to nonpregnant diabetic women or normal controls, this group demonstrates suppressed basal growth hormone during late pregnancy and blunted or decreased glucagon levels during hypoglycemia. Fortunately, the fetus appears to be protected from maternal hypoglycemia. Neither fetal death nor congenital malformations have been associated with insulin-induced hypoglycemic reactions. Insulin use may significantly increase in pregnant women with diabetes mellitus type I during pregnancy. In one study, the average increase was 52 units per day, and was significantly related to maternal weight gain between 20 and 29 weeks and maternal weight at presentation, and was inversely related to the duration of diabetes. A small number of pregnant patients required less insulin.
Insulin is not excreted into human milk. Breast-feeding, however, may decrease insulin requirements, despite the need for increased caloric intake. Careful observation of increased maternal caloric needs and maternal blood glucose levels are needed. The manufacturer recommends that caution be used when administering insulin to nursing women.
Limited data reveal that the milk of women with insulin dependent diabetes mellitus (IDDM) has significantly lower lactose and higher total nitrogen relative to nondiabetic women. The infants of women with IDDM in this study had significantly less milk intake. The data indicate delayed lactogenesis for women with IDDM. The differences in milk composition of women with IDDM do not preclude them from breast-feeding.
What does my medication look like?
Insulin isophane is available under the brand names Humulin N, Novolin N, Iletin II NPH Pork, and Insulin Purified NPH Pork. The insulin should be a clear, colorless or evenly colored liquid after it is gently rolled or shaken. Do not use it if it appears to be thick, looks sticky, has particles in it, or looks different from previous bottles, pens, or cartridges of insulin isophane. Always use the same brand unless your doctor recommends a change. Ask your pharmacist, nurse, or doctor any questions you have about this medication.
What happens if I overdose?
Seek emergency medical attention if an overdose is suspected. Symptoms of an insulin overdose reflect very low blood sugar levels and include headache, irregular heartbeat, increased heart rate or pulse, sweating, tremor, nausea, increased hunger, and anxiety.
What should I discuss with my healthcare provider before using insulin isophane?
Do not use insulin isophane if you are allergic to insulin or if you have intolerance to a certain insulin isophane product. Before using insulin, tell your doctor if you have any other medical conditions or if you take other prescription or over-the-counter medications, including vitamins, minerals, and herbal supplements. Before using insulin isophane, tell your doctor if you have kidney or liver disease. You may require a dosage adjustment or special monitoring during treatment. Most insulins can be used during pregnancy and breast-feeding. They are not expected to be harmful to an unborn baby. It is very important to control blood sugar levels during pregnancy and breast-feeding and insulin is often chosen as the treatment. Some types of insulin may be better than others for use during pregnancy and breast-feeding. Talk to your doctor about the use of insulin during pregnancy and breast-feeding.
Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.
I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.
Where can I get more information?
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