Drug reference
Diabetes mellitus ▶BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR INJECTION, OR BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: According to requirements Diabetic ketoacidosis | Diabetes during surgery ▶BY INTRAVENOUS INFUSION ▶Adult: (consult local protocol)
PDF page 773
A sterile solution of insulin (i.e. bovine or porcine) or of human insulin; pH 6.6–8.0.
PDF page 774
NICE decisions ▶Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus (type 1) (July 2008) NICE TA151 Continuous subcutaneous insulin infusion is recommended as an option in adults and children 12 years and over with type 1 diabetes: . who suffer repeated and unpredictable hypoglycaemia, whilst attempting to achieve optimal glycaemic control with multiple-injection regimens, or . whose glycaemic control remains inadequate (HbA1c over 8.5% [69 mmol/mol]) despite optimised multiple- injection regimens (including the use of long-acting insulin analogues where appropriate). Continuous subcutaneous insulin infusion is also recommended as an option for children under 12 years with type 1 diabetes for whom multiple-injection regimens are considered impractical or inappropriate. Children on insulin pumps should undergo a trial of multiple-injection therapy between the ages of 12 and 18 years. www.nice.org.uk/guidance/TA151
PDF page 774
→Appendix 1: insulins
PDF page 773
▶Uncommon Skin reactions ▶Rare or very rare Refraction disorder
PDF page 773
Short-acting injectable insulins can be given by continuous subcutaneous infusion using a portable infusion pump. This device delivers a continuous basal insulin infusion and patient-activated bolus doses at meal times. This technique can be useful for patients who suffer recurrent hypoglycaemia or marked morning rise in blood-glucose concentration despite optimised multiple-injection regimens. Patients on subcutaneous insulin infusion must be highly motivated, able to monitor their blood-glucose concentration, and have expert training, advice and supervision from an experienced healthcare team. Some insulin preparations are not recommended for use in subcutaneous insulin infusion pumps—may precipitate in catheter or needle— Endocrine system consult product literature. ▶With intravenous use For intravenous infusion give continuously in Sodium chloride 0.9%. Adsorbed to some extent by plastic infusion set; ensure insulin is not injected into ’dead space’ of injection port of the infusion bag.
PDF pages 773, 774
There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: solution for injection, solution for infusion Solution for injection ▶Actrapid (Novo Nordisk Ltd) Insulin human (as Insulin soluble human) 100 unit per 1 ml Actrapid 100units/ml solution for injection 10ml vials | 1 vial P £7.48 DT = £15.68 ▶Humulin R (Imported (United States)) Insulin human 500 unit per 1 ml Humulin R 500units/ml solution for injection 20ml vials | 1 vial P s Humulin R KwikPen 500units/ml solution for injection 3ml pre-filled pens | 2 pre-filled disposable injection P s ▶Humulin S (Eli Lilly and Company Ltd) Insulin human (as Insulin soluble human) 100 unit per 1 ml Humulin S 100units/ml solution for injection 10ml vials | 1 vial P £15.68 DT = £15.68 Humulin S 100units/ml solution for injection 3ml cartridges | 5 cartridge P £19.08 DT = £19.08 ▶Hypurin Porcine Neutral (Wockhardt UK Ltd) Insulin porcine (as Insulin soluble porcine) 100 unit per 1 ml Hypurin Porcine Neutral 100units/ml solution for injection 10ml vials | 1 vial P £34.43 DT = £34.43 Hypurin Porcine Neutral 100units/ml solution for injection 3ml cartridges | 5 cartridge P £51.64 DT = £51.64 ▶Insuman Infusat (Sanofi) Insulin human 100 unit per 1 ml Insuman Infusat 100units/ml solution for injection 3.15ml cartridges | 5 cartridge P £250.00 DT = £250.00 ▶Insuman Rapid (Sanofi) Insulin human (as Insulin soluble human) 100 unit per 1 ml Insuman Rapid 100units/ml solution for injection 3ml cartridges | 5 cartridge P £17.50 DT = £19.08 eiiii F 751
PDF page 774
According to requirements
First-line fragment. Read the complete Indications and Dose section above.
PDF page 773
(consult local protocol)
First-line fragment. Read the complete Indications and Dose section above.
PDF page 773
