Insulin Regular

What it is and how it works

Soluble (regular) human insulin is identical to endogenous insulin. After subcutaneous injection it acts within about 30 minutes, peaks at 1–4 hours and lasts up to about 8 hours; intravenously it acts immediately. It lowers blood glucose by promoting glucose uptake into muscle and fat and inhibiting hepatic glucose output, and drives potassium into cells.

Indications

Treatment of diabetes mellitus, including meal-time cover; intravenous use in diabetic ketoacidosis, hyperosmolar hyperglycaemic state and peri-operative glycaemic control; emergency management of hyperkalaemia (with glucose).

Dosage and administration (summary)

Subcutaneous injection about 15–30 minutes before meals, dose individualised by blood glucose monitoring; intravenous infusion according to hospital protocol with frequent glucose and potassium monitoring.

Contraindications

Hypoglycaemia; hypersensitivity to human insulin or excipients.

Warnings and precautions

Hypoglycaemia is the main risk; intravenous use requires close monitoring of glucose and potassium because of the risk of hypokalaemia. Rotate injection sites to avoid lipodystrophy and cutaneous amyloidosis. Medication errors between insulin types and strengths should be avoided.

Pregnancy

Insulin is the treatment of choice in pregnancy; requirements change through pregnancy and need close monitoring.

Storage and supply

Store unopened at 2–8 °C; do not freeze. In use, keep below 25–30 °C for up to 4–6 weeks according to the product; protect from light.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.