The abdomen is the preferred site for insulin injection, but the sites of injection must be rotated in order to prevent erosion of the fat beneath the skin, a condition called lipodystrophy. Dosing is adjusted for each patient. A combination of short acting/rapid acting and intermediate insulin or long acting insulin are typically used.
- Beta blockers (for example, propranolol [Inderal, Indearl LA, Innopran XL], atenolol [Tenormin]) may mask symptoms of low blood glucose and affect how the body uses glucose. Repaglinide (Prandin) increases the risk of low blood glucose while rosiglitazone (Avandia) increases the occurrence of low blood glucose, fluid retention, and heart failure.
- Thiazide diuretics, steroids, and estrogens reduce the effect of insulin by increasing blood glucose.
- Levofloxacin (Levaquin) and other fluoroquinolones increase the risk of high or low blood glucose.
- Monoamine oxidase inhibitors (for example selegiline), sulfonylureas (for example, glyburide [Diabeta, Glynase]), and yohimbe (Pausinystalia yohimbe) increase the risk of low blood glucose.
- Thyroid hormones increase insulin requirements. Insulin alters the chemical properties of pramlintide (Symlin). Therefore, pramlintide and insulin should not be mixed in the same syringe.
Quick GuideType 2 Diabetes Diagnosis, Treatment, Medication
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