GLYSOLIN 30/70 Biphasic Isophane Human Insulin (rDNA) 100IU / mL Suspension for SC Injection 3mL
Indications/Uses
Management of patients with type 2 diabetes who are not adequately controlled by diet and/or oral hypoglycemic agents.
For the initial stabilization of diabetes in patients with diabetic ketoacidosis, hyperosmolar non-ketotic syndrome and during period of stress such as severe infections and major surgery in diabetic patients.
Management of gestational diabetes.
Dosage/Direction for Use
The average range of total daily insulin requirement for maintenance in type 1 diabetic patients ranges between 0.5 and 1.0 IU/kg.
Further, in insulin resistance, the daily requirement of insulin may be substantially higher. In patients with type 2 diabetes, the requirements of Insulin are lower i.e. approximately 0.3-0.6 IU/kg/day.
Biphasic Isophane Insulin is administered subcutaneously in the abdominal wall, thigh, gluteal region or the deltoid region.
To avoid lipodystrophy, the site of injection should be frequently changed. Any injection of insulin should be followed by a meal or snack containing carbohydrates within 30 minutes. Adjustment of dosage may be necessary if you undertake increased physical activity or change your usual diet.
Use along with other types of insulin: Biphasic Isophane Insulin (Glysolin 30/70) injection can be used in combination with human insulin regular.
Overdosage
Administration
Contraindications
Hypersensitivity to insulin or any other component of the formulation.
Special Precautions
Laboratory Tests: As with all insulins, the therapeutic response to human insulin should be monitored by periodic blood glucose tests. Periodic measurement of glycosylated hemoglobin is recommended for the monitoring of long-term glycemic control.
Effects on the ability to drive and use machines: The patient's ability to concentrate and react may be impaired as a result of hypoglycemia. This may constitute a risk in situations where those abilities are of special importance (e.g. driving a car or operating machinery). You are therefore advised to avoid hypoglycemia during driving. This is particularly significant in patients who have reduced awareness of the warning signs of hypoglycemia or have frequent episodes of hypoglycemia.
Use in Pregnancy: There are no restrictions on the use of insulin during pregnancy since insulin does not cross the placental barrier.
Published studies with human insulin suggest that optimizing overall glycemic control, including postprandial control, before conception and during pregnancy improves fetal outcome. Although fetal complications of maternal hyperglycemia have been well documented, fetal toxicity also has been reported with maternal hypoglycemia. Insulin requirements usually fall during the first trimester and increase during the second and third trimesters.
During perinatal period, careful monitoring of infants born to mothers with diabetes is warranted.
Use in Lactation: There are no restrictions on the use of insulin in lactating mothers as insulin treatment of nursing mothers does not involve any risk to the baby. However, caution should be exercised when administered to nursing mothers and the dosage of insulin may be reduced.
Use In Pregnancy & Lactation
Published studies with human insulin suggest that optimizing overall glycemic control, including postprandial control, before conception and during pregnancy improves fetal outcome. Although fetal complications of maternal hyperglycemia have been well documented, fetal toxicity also has been reported with maternal hypoglycemia. Insulin requirements usually fall during the first trimester and increase during the second and third trimesters.
During perinatal period, careful monitoring of infants born to mothers with diabetes is warranted.
Nursing mothers: There are no restrictions on the use of insulin in lactating mothers as insulin treatment of nursing mothers does not involve any risk to the baby. However, caution should be exercised when administered to nursing mothers and the dosage of insulin may be reduced.
Adverse Reactions
Strenuous exercise.
Disease of the adrenal, pituitary, or thyroid gland, or progression of kidney or liver disease may also lead to hypoglycemia.
Concomitant administration with other drugs that lower blood glucose such as oral hypoglycemics, salicylates (i.e. Aspirin), sulfa antibiotics, and certain antidepressants may lead to hypoglycemia.
Symptoms of mild to moderate hypoglycemia may occur suddenly and can include: sweating, dizziness, palpitation, tremor, hunger, restlessness, tingling of the hands, feet, lips or tongue, lightheadedness, inability to concentrate, headache, drowsiness, sleep disturbances, anxiety, blurred vision, slurred speech, depressive mood, irritability, abnormal behavior, unsteady movement, personality changes.
Signs of severe hypoglycemia can include: disorientation. unconsciousness, seizure, death.
Therefore it is important that assistance be obtained immediately. Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions, such as long duration of diabetes, diabetic nerve disease, co-administration of medications such as beta-blockers, change in insulin preparations, or intensified control (3 or more insulin injections per day) of diabetes. The use of preparations of (Glysolin 30/70) should minimize the incidence of adverse effects associated with the use of animal insulins.
Oedema: Oedema and refraction anomalies may occur upon initiation of insulin therapy. These symptoms are usually of transitory nature.
Allergy to insulin: Systemic Allergy: Less common, but potentially more serious, is generalized allergy to insulin, which may cause rash over the whole body, shortness of breath, wheezing, reduction in blood pressure, fast pulse, or sweating. Severe cases of generalized allergy may be life threatening.
Local Allergy: Patients occasionally experience redness, swelling and itching at the site of injection of insulin. This condition called local allergy, usually clears up in a few days to a few weeks. In some instances, this condition may be related to factors other than insulin, such as irritants in the skin cleansing agent.
Lipoatrophy and lipodystrophy: Lipodystrophy occurs at the site of injection after long usage. However, this is less common with the newer preparations of insulin.
Insulin resistance: When insulin requirement is increased (>200 IU/day), insulin resistance is said to have developed. The following are the different grades of insulin resistance: Acute: Acute insulin resistance develops rapidly and is usually a short term problem. It usually occurs due to an underlying infection, trauma, surgery and emotional stress. Treatment is to overcome the precipitating factor and to give high doses of regular insulin.
Chronic: This type of insulin resistance is generally seen in patients treated for years with conventional preparations of beef or pork insulin and it is more common in patients with type 2 diabetes. Development of such type of insulin resistance is an indication for switching patients to the newer preparations of insulin. After instituting the newer preparations, insulin requirement gradually declines over weeks and months, Majority of patients stabilize at approximately 60 IU/day.
Drug Interactions
Renal Impairment: The requirements of insulin may be reduced in patients with renal impairment.
Hepatic Impairment: Although impaired hepatic function does not affect the absorption or disposition of Biphasic Isophane Insulin (Glysolin 30/70), careful glucose monitoring and dose adjustments of insulin may be necessary.
Storage
Action
This uptake occurs following the binding of insulin to its receptors present in the muscle and adipose tissue.
The blood glucose lowering effect of insulin also occurs due to the simultaneous inhibition of glucose output from the liver.
Pharmacokinetics: Insulin has a half-life of a few minutes in the blood stream. Consequently, the time course of action of any insulin may vary considerably in different individuals or at different times in the same individual. As with insulin preparations, the intensity and duration of action of Biphasic Isophane Insulin (Glysolin 30/70) is dependent on the dose, site of injection, blood supply, temperature, and physical activity.
An average action profile after subcutaneous injection indicates: Onset within 0.5 hours; Peak levels attained between 2-12 hours; Duration of action approximately 18-24 hours.
MedsGo Class
Features
- Insulin Biphasic Isophane