INSUGET 70/30 Insulin Human (rDNA) 100IU / mL Suspension for IM/SC Injection 10mL

Treatment of patients with type I diabetes mellitus; type II diabetes mellitus either alone or in combination with oral antidiabetic agents; gestational diabetes.
Emergency management of diabetic ketoacidosis.

 

The type of formulation, its dose and the frequency of administration should be determined by the physician, according to the needs suitable to the patient. The dose should be adjusted as necessary according to the results of regular monitoring of glucose concentrations in the blood glucose (or occasionally urine concentrations). A total dose in excess of about 80 units daily would be unusual and may indicate the presence of a form of insulin resistance.
The average daily requirement for diabetes therapy ranges between 0.5 IU/kg and 0.1 IU/kg, depending on the individual needs of the patient. Optimized metabolic control, including glucose monitoring, is therefore recommended during insulin treatment.
Elderly: The primary aim of treatment may be relief of symptoms and avoidance of hypoglycemic events.
Insuget R: May be taken 1-4 times daily, before meals and possibly at bedtime. Regular or rapid-acting insulin should be administered 30-45 min before a meal. It can be mixed in the same syringe with intermediate-acting insulins, but in such situations, the regular insulin is drawn first. Insuget R should be given by SC injection but may, although not recommended, also be given by IM injection. It may also be administered IV. Insuget R is administered SC into the thigh or abdominal wall. If convenient, the gluteal or deltoid region may be used.
Insuget N (NPH): Administered SC into the thigh or abdominal wall, preferably before meals, 1-2 times daily depending upon the requirement of the individual. If convenient, the gluteal or deltoid region may be used. It should be administered about 30 min before a meal. It can also be mixed in the same syringe with short-acting soluble insulins, and in such situations, the regular insulin is drawn first. Insuget N (NPH) cannot be given IV.
Insuget 70/30: A premixed insulin is usually given once or twice daily, preferably just before meals when rapid initial effect together with a more prolonged effect is desired.
Ketoacidosis: Only Insuget R should be used. Treatment includes adequate fluid replacement, usually by infusing sodium chloride 0.9% initially and the administration of potassium salts to prevent or correct hypokalemia. Insulin should be given by continuous IV infusion if possible, although other routes have also been used. Insulin can also be given by IM injection.
Adults: Initial loading dose of 20 units is followed by 6 units every hour until the blood glucose concentration falls to 10 mmol/L, when the dose is given every 2 hrs.
Since insulin normally corrects hyperglycemia before ketosis, it is usually necessary to continue administration of insulin once normoglycemia has been achieved but to change the rehydration fluid to glucose-saline so that the additional glucose prevents the development of hypoglycemia.
Administration: Shake well before use.
Pinch the skin between 2 fingers, push the needle into the skinfold and inject the insulin under the skin.
Keep the needle under the skin for at least 6 sec to make sure all the insulin has been injected.
If blood appears after the needle has been withdrawn, press the injection site lightly with a finger.

Hypersensitivity to any components of Insuget R/Insuget N/Insuget 70/30.
Patients with hypoglycemia; coma due to hyperglycemia.
Under no circumstances should Insuget formulation, other than Insuget R, be given IV.

Insulin requirements may change significantly in diseases of the adrenal, pituitary or thyroid glands and in the presence of renal or hepatic impairment.
Insulin requirements may be increased during illness or emotional disturbances.
Care is also necessary during excessive exercise. Hypoglycemia caused by metabolic effects and increased insulin absorption is the usual response, but hyperglycemia may sometimes occur. Adjustment of insulin dosage may also be necessary if patients change their level of physical activity or change their usual diet.
The use of insulin necessitates monitoring of therapy eg, testing of blood or urine for glucose concentrations and the urine for ketones, by the patient.
Local reactions, characterized hypersensitivity may produce urticaria, angioedema and very rarely anaphylactic reactions. If continued therapy with insulin is essential, hyposensitization procedures may need to be performed.
Missed Dose: Timing of insulin doses is extremely important. The best approach is to measure blood glucose and add a dose of regular insulin if glucose levels are too high. Otherwise, wait for the next scheduled dose.
Stopping Insuget: Do not stop taking insulin injections unless ordered by the doctor. Patients with diabetes are often given general instructions for modifying their insulin doses based on home blood glucose measurements.
Use in pregnancy: It is essential to maintain good control of the insulin-treated (insulin-dependent or gestational diabetes) patients throughout pregnancy. Insulin requirements usually fall during the 1st trimester and increase during the 2nd and 3rd trimesters. Patients with diabetes should be advised to inform their doctors if they are pregnant or are contemplating pregnancy.
Careful monitoring of glucose control, as well as general health, is essential in pregnant patients with diabetes.
Use in lactation: There are no restrictions in insulin treatment while treating a diabetic nursing mother, as it involves no risk to the baby. However, the insulin dosage may need to be reduced.

 

Use In Pregnancy & Lactation

Hypoglycemia is the most frequently occurring undesirable effect of insulin therapy that a patient with diabetes may suffer. Symptoms of hypoglycemia usually occur suddenly. They may include cold sweat, cool pale skin, nervousness or tremor, anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, headache, nausea and palpitation.
Severe hypoglycemia may lead to unconsciousness and may result in temporary or permanent impairment of brain function or even death.
Weight gain is common when taking insulin.
Edema and refraction anomalies may occur upon initiation of insulin therapy. Local hypersensitivity reactions (redness, swelling and itching at the injection site) are those transitory reactions, which may occur during the treatment with insulin and normally disappear during continued treatment.
Lipodystrophy may occur at the injection site as a consequence of failure to rotate injection site within an area.
Generalized hypersensitivity reactions may occur occasionally and can cause generalized skin rash, itching, sweating, gastrointestinal upset, angioneurotic edema, difficulties in breathing, palpitation and reduction in blood pressure. These are potentially life-threatening.

 

Beta-blocking agent may mask the symptoms of hypoglycemia. Some of the drugs leading to reduced insulin requirement: Oral hypoglycemic agents. octreotide, monoamine oxidase inhibitor, nonselective β-blocking agents, angiotensin-converting enzyme inhibitors, salicylates, alcohol and alcohol steroids.
Some of the drugs leading to increase insulin requirement: Oral contraceptives, thiazides, glucocorticoids, thyroid hormones and sympathomimetics, danazol.
Incompatibilities: In general terms, insulin should only be added to compounds with which it is known to be compatible. Insulin suspensions should not be added in infusion fluids.

 

Caution For Usage

Storage

Action

Insulin Preparations