Exceptions To Insulin Dosing And Timing
Long-acting insulins arenât tied to mealtimes. Youâll take detemir once or twice a day no matter when you eat. And youâll take glargine once a day, always at the same time. Deglutec is taken once a day, and the time of day can be flexible. But some people do have to pair a long-acting insulin with a shorter-acting type or another medication that does have to be taken at meal time.
Rapid-acting products can also be taken right after you eat, rather than 15 minutes before mealtime. You can take some of them at bedtime.
For more information about when to take insulin, read the “dosing and administration” section of the insulin product package insert that came with your insulin product, or talk with your doctor.
Characteristics Of Insulin Action
There are three characteristics that define how insulin medication function:
Insulin is prescribed by matching the characteristics of a particular insulin with the individual needs of the patient. Some people are on only one kind of insulin, while others take a combination of insulin medication to customize good glucose control.
What Is Insulin Used For
Insulin is used in the treatment of people with type 1 diabetes who produce little or no insulin. It may also be used in the treatment of type 2 diabetes if insulin levels remain low despite the use of other types of medications, although most people with type 2 diabetes do not require insulin in the early stages of the disease.
Insulin may also be given to pregnant women who develop a type of diabetes during pregnancy called gestational diabetes.
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How Is Insulin Administered
Insulin is most commonly administered subcutaneously and there are three main delivery methods:
- Insulin Pens: these hold a replaceable cartridge of insulin and use a replaceable needle to puncture the skin and deliver the insulin subcutaneously
- Insulin pumps: these are small computerized devices that deliver a continuous supply of insulin under the skin. They are also known as continuous subcutaneous insulin infusion devices
- Via a syringe and needle using a vial of insulin.
So far, nobody has successfully made an oral insulin tablet that delivers an effective dose of insulin. The problem is that insulin degrades in the stomach and intestine before it even has a chance to get absorbed into the blood stream. In hospital, insulin may be administered directly into a vein or into a muscle under certain circumstances.
What Are The Side Effects Of Insulin
One of the most common side effects of insulin is hypoglycemia .
Symptoms include a headache, sweating, trembling, anxiety, confusion, irritability, rapid breathing, or a fast heartbeat. People with hypoglycemia may also faint and severe hypoglycemia that is left untreated may be fatal.
Hypoglycemia is relatively common because insulin requirements can vary depending on the food you eat, exercise you do, and how well you are. Hyperglycemia from too low an insulin dose can also occasionally occur.
Other common side effects include:
- swelling, itching, redness or lumps around the injection site
- weight gain
- electrolyte disturbances
- blurred vision .
Insulin analogues are less likely to cause weight gain or low night-time blood sugar levels than standard human insulins.
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How Much Do Insulins Cost
The cost of insulin can vary significantly based on the type used , and the delivery method Insulin costs also may vary depending on the type of insurance, since many plans utilize formularies that may price similar insulin products differently depending on the preferred supplier . For people without health insurance, insulin can cost anywhere from $25 to more than $300 per vial. Underinsured or uninsured patients can use free SingleCare coupons to save money on insulin and other diabetes needs.
Description And Brand Names
Drug information provided by: Micromedex US Brand Name Basaglar Lantus Lantus SoloStar Toujeo Descriptions Insulin glargine is a long-acting type of insulin that works slowly, over about 24 hours. Insulin is one of many hormones that help the body turn the food we eat into energy. This is done by using the glucose in the blood as quick energy. Also, insulin helps us store energy that we can use later. When you have diabetes mellitus, your body cannot make enough insulin or does not use insulin properly. This causes you to have too much sugar in your blood. Like other types of insulin, insulin glargine is used to keep your blood sugar level close to normal. You may have to use insulin glargine in combination with another type of insulin or with a type of oral diabetes medicine to keep your blood sugar under control. This medicine is available only with your doctor’s prescription. This product is available in the following dosage forms: Solution Copyright © 2017 Truven Health Analytics Inc. All rights reserved. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.Continue reading > >
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New Product Features Can Come With A High Price Tag
and both contain a long-acting insulin and another non-insulin diabetes medication. Xultophy is a mix of insulin degludec plus liraglutide , and Soliqua is a mix of insulin glargine plus lixisenatide . Average retail prices for Soliqua and Xultophy are more than double the price of cheaper alternatives like Basaglar and Tresiba, which have the same exact kind of insulins.
Fiasp contains insulin aspart, the same insulin in Novolog, but it also has vitamin B3. This added ingredient may speed up insulin absorption, but it doesnt necessarily make Fiasp more effective than Novolog at lowering blood sugar. Interestingly, the retail prices for Fiasp and Novolog are about the same on a per insulin unit basis.
Then theres , an ultra-long-acting insulin that stays active for up to 42 hours. For this unique property, its average retail price is about $624.76 for a carton of 5 KwikPens .
Along with these new formulations, insulin manufacturers have also started offering their insulins at higher concentrations to make them more convenient for people who need more insulin than average. Humulin R, Humalog, and Tresiba all come in higher-concentration versions, and is a higher-concentration version of Lantus. At first glance, their prices may seem high, but they actually go for the same per unit retail price as their lower-concentration counterparts.
Before Using Ozempic Tell Your Health Care Provider If You Have Any Other Medical Conditions Including If You:
- have or have had problems with your pancreas or kidneys.
- have a history of diabetic retinopathy.
- are pregnant or breastfeeding or plan to become pregnant or breastfeed. It is not known if Ozempic® will harm your unborn baby or passes into your breast milk. You should stop using Ozempic® 2 months before you plan to become pregnant.
Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and other medicines to treat diabetes, including insulin or sulfonylureas.
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Dosage For Type 2 Diabetes
The usual starting dose of Lantus for people with type 2 diabetes is 0.2 units/kg.
The maximum starting dose of Lantus is 10 units a day.
Lantus is typically taken once a day, not twice a day.
The drug is given as an injection just under your skin . You can inject Lantus in the skin of your upper arms, belly , or thighs.
What Is Not Covered In This Guide
This guide does not cover all the possible ways to treat type 2 diabetes. It does notinclude information on diet and exercise. It does not cover using insulin in pumpsor non-insulin shots like exenatide or pramlintide. It does not cover the use of insulin by children, pregnantwomen, or people with type 1 diabetes.
If your doctor has recommended pills for your type 2 diabetes, the Agency forHealthcare Research and Quality has published another guide that will beuseful for you. That guide is called and is available at the Web site: www.effectivehealthcare.ahrq.gov
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Insulin A To Z: A Guide On Different Types Of Insulin
Elizabeth Blair, A.N.P., at Joslin Diabetes Center, helps break down the different types of insulin and how they work for people with diabetes. Types of Insulin for People with Diabetes Rapid-acting: Usually taken before a meal to cover the blood glucose elevation from eating. This type of insulin is used with longer-acting insulin. Short-acting: Usually taken about 30 minutes before a meal to cover the blood glucose elevation from eating. This type of insulin is used with longer-acting insulin. Intermediate-acting: Covers the blood glucose elevations when rapid-acting insulins stop working. This type of insulin is often combined with rapid- or short-acting insulin and is usually taken twice a day. Long-acting: This type of insulin is often combined, when needed, with rapid- or short-acting insulin. It lowers blood glucose levels when rapid-acting insulins stop working. It is taken once or twice a day. A Guide on Insulin Types for People with Diabetes Type Brand Name Onset Peak Duration Rapid-acting Humalog Novolog Apidra 10 – 30 minutes 30 minutes – 3 hours 3 – 5 hours Short-acting Regular 30 minutes – 1 hour 2 – 5 hours Up to 12 hours Intermediate- acting NPH 1.5 – 4 hours 4 – 12 hours Up to 24 hours Long-acting Lantus Levemir 0.8 – 4 hours Minimal peak Up to 24 hours To make an appointment with a Joslin diabetes nurse educator, please call 732-2400.Continue reading > >
Traditional Insulins Are Cheaper Than Modern Insulins
Average retail prices of Novolin and Humulin have gone down, or held steady, while prices of modern rapid- and long-acting insulins continue to go up. On average, traditional insulins now cost less than half of what modern insulins cost.
Why? Traditional insulins have historically been cheaper than their newer competitors. Modern insulins offer better blood sugar control but are synthetic analogs of traditional insulins, which makes them more difficult to produce.
Additionally, when patents on Humulin and Novolin expired around 2000, manufacturers Eli Lilly and Novo Nordisk had to test new pricing strategies to remain competitive.
In 2017, for example, Novo Nordisk partnered with CVS to offer Novolin at roughly 80% less than its list price. Both Novo Nordisk and Eli Lilly have also worked with Walmart to heavily discount Novolin and Humulin under Walmarts ReliOn line of insulin products.
Retail partnerships havent been their only strategy. Eli Lilly had been increasing prices for Humulin every 6 months until May 2017, when they decided to stop anymore increases. In fact, prices of traditional Humulin and Novolin insulins, their rapid-acting analogs , and their mixed products have not gone up since then.
and are currently the cheapest traditional insulins, with average unit prices of around $0.10.
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Pregnant Women With Gestational Diabetes
Gestational diabetes refers to diabetes that is diagnosed during a womans pregnancy. Similar to Type 2 diabetes, the insulin present may not be sufficient to maintain normal blood glucose levels and ensure the cells are receiving the fuel they need. Often insulin injections are necessary for the duration of the pregnancy to protect both the mother and the babys health.
How To Inject Lantus Using A Syringe And Vial
If youre going to inject Lantus using a syringe and vial, follow these steps.
Gathering supplies and preparing the vial
Before you inject Lantus, first collect your supplies and get the vial ready.
Preparing your dose
Once you have your supplies and cleaned the vial, youre ready to fill the syringe.
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Side Effects And Risks
Lantus and Levemir both contain long-acting insulins. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.
More common side effects
This list contains examples of more common side effects that can occur with both Lantus and Levemir :
- hypoglycemia
- injection site reactions
- edema , typically in your legs, ankles, or feet
- weight gain
Serious side effects
This list contains examples of serious side effects that can occur with both Lantus and Levemir :
- severe hypoglycemia
- hypokalemia
- allergic reaction
Are Insulins Safe
The most serious risk of taking insulin is low blood sugar, or hypoglycemia. If untreated, low blood sugar can be a medical emergency. Low blood sugar can usually be treated quickly by drinking or eating a food high in sugar . There are also products, such as glucose tablets or glucagon for injection, that healthcare providers may recommend for insulin users to have on hand. Other serious risks with taking insulin are hypersensitivity reactions and hypokalemia .
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How Well It Works
Insulin is effective in reducing blood sugar levels by helping sugar enter the cells to be used for energy.
Some things that affect how fast and how well an insulin dose works are:
- Where the dose is given. If you give insulininto your abdomen , themedicine will get into your system more consistently from day to day. If themedicine is given into a muscle or a small blood vessel instead of fattytissue, the medicine will get into your system faster.
- How muchinsulin is given. Higher doses of insulin reduce the blood sugar level morethan lower doses.
- Whether you have exercised before or just after taking insulin.If you have just exercised the muscles in the area where you give your insulininjection, the medicine will get into your system faster.
- If youapply heat to the area. The medicine will get into your system faster if youtake a hot bath or shower, put on a heat pack, or massage the area where youhave just given your insulin injection.
- If you do not have enoughfluid in your body . You will not have as much blood flowto your skin, so insulin will not be absorbed as well.
Know how to give an insulin injection.
What To Think About
Theinsulin pump provides a way to give insulin with less frequent injections, and it is as effective as multiple daily injections at keeping blood sugar levels in a target range.
Don’t share insulin pens with anyone else who uses insulin. Even when the needle is changed, an insulin pen can carry bacteria or blood that can make another person sick.
The long-acting insulin glargine may help prevent some people from having frequent nighttime low blood sugar levels. It may also help people who have had difficulty keeping their blood sugar levels in their target range with intermediate-acting insulin.
Giving short-acting insulin at the evening meal and NPH at bedtime instead of giving them together at the evening meal may reduce the risk ofnocturnal hypoglycemia andhypoglycemia unawareness.
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Will I Still Use My Mealtime Insulin Or Other Insulins With Lantus
You might. Lantus is a long-acting insulin thats meant work over the course of an entire day. Long-acting insulin is typically called basal or background insulin because it helps control blood sugar levels between meals and overnight while you sleep.
However, Lantus isnt typically used to control blood sugar spikes after meals. You may need a rapid-acting insulin, short-acting insulin, or intermediate-acting insulin to fine-tune your blood sugar level control. Many people who use a long-acting insulin such as Lantus will also need rapid-acting or short-acting insulin to control blood sugar levels after meals.
If you do take more than one type of insulin, dont mix Lantus in the same syringe with any other insulins. This could change how well the insulins work.
If you have any questions about when or how to take each type of insulin, talk with your doctor or pharmacist.
What Are Warnings And Precautions The Diabetes Drug Insulin
- Insulin should not be used if low blood sugar is present.
- Any adjustment of insulin, whether to a different brand, type, strength, or method of administration, must be made under medical supervision.
- Injury, illness, surgery, pregnancy, and changes in activity level can affect blood sugar levels, which might require an adjustment in insulin dose.
- Patients should inform medical providers of previous medical history before using insulin, especially adrenal/pituitary gland problems, infections, kidney or liver disease, thyroid issues, and nerve problems such as tingling or numbness.
- Patients should advise medical providers if they are pregnant.
- Alcohol can increase the risk of developing low blood sugar.
- Children and the elderly may be more sensitive to insulin.
- Discard open vials of insulin after 28 days.
- Do not use insulin after its expiration date.
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