- What is diabetes?
- What are the types of diabetes?
- What are the symptoms of diabetes?
- What are examples of insulin preparations available?
- For what type of diabetes is insulin prescribed?
- What are the side effects of insulin?
- What is the dosage and how is insulin administrated?
- What are the contraindications, warnings, and precautions for insulin?
- Which drugs interact with insulin?
- How well does insulin treat diabetes?
- What is the mechanism of action (how it works) for insulin?
What is diabetes?
What are the types of diabetes?
The related diseases of diabetes include:
Quick GuideType 2 Diabetes Diagnosis, Treatment, Medication
What are the symptoms of diabetes?
Symptoms of diabetes include
What are examples of insulin preparations available?
Examples of rapid acting insulin
- Apidra (insulin glulisine): Supplied in a cartridge, vial, prefilled pen (Solostar)
- Novolog (insulin aspart): Supplied in a cartridge, vial, prefilled pen (FlexPen)
- Humalog: (insulin lispro): Supplied in a cartridge, vial, prefilled pen (Kwik Pen)
Examples of short acting insulin
- Novolin R, Humulin R (regular insulin): Supplied in a vial
Examples of intermediate acting insulin
- Humulin N, Novolin N (NPH): Supplied in a vial, pen (Humulin N pen)
Examples of long acting insulin
For what type of diabetes is insulin prescribed?
Indications for insulin
What are the side effects of insulin?
|Common Side Effects||Frequency||Serious||Frequency|
|Headache||12% to 35%||Allergic reactions||n/a|
|Injection site reaction||n/a|
|* n/a = not available|
Quick GuideType 2 Diabetes Diagnosis, Treatment, Medication
What is the dosage and how is insulin administrated?
Dosage and Administration of insulin
- A meal should be consumed within 30 minutes after administering regular insulin
- Insulin usually is administered by subcutaneous injection into the abdominal wall, thigh, buttocks (gluteal region), or upper arm. Injection sites should be rotated within the same region.
- Some insulins (for example, regular insulin) also may be administered intravenously.
- The dose is individualized for each patient.
- A combination of short or rapid acting and intermediate or long acting insulin typically are used
- Some patients may develop resistance to insulin and require increasing doses.
- Multiple daily insulin injections or continuous subcutaneous infusions via a pump closely mimic pancreatic insulin secretion.
- Insulin sliding scales (doses of insulin that are based on the glucose level ) may be used for managing critically ill hospitalized patients.
What are the contraindications, warnings, and precautions for insulin?
- Hypoglycemia (low blood sugar)
- Hypersensitivity to insulin or its excipients (inactive co-ingredients)
Warnings and Precautions
- Hypoglycemia may occur and is the most common side effect of insulin treatment.
- Severe, life-threatening allergic reactions, including anaphylaxis, may occur.
- Hypokalemia (low blood potassium) may occur because insulin stimulates movement of potassium from blood into cells. Combining insulin with potassium-lowering drugs may increase the risk of hypokalemia.
- Hepatic (liver) impairment may reduce the insulin requirement.
- Renal (kidney) dysfunction may reduce the insulin requirement.
- Illness, emotional disturbance, or other stress may alter the insulin requirement.
- Intravenous administration increases the risk of hypoglycemia and hypokalemia.
Which drugs interact with insulin?
Insulin Drug Interactions
|Drug or Drug Class||Effect||Recommendation|
|Beta blockers (for example, propranolol [Inderal, Inderal LA, Innopran XL], atenolol [Tenormin])||Beta blockers may mask symptoms of hypoglycemia or prolong hypoglycemia and alter glucose metabolism||Avoid combination if possible|
|repaglinide (Prandin)||Increased risk of hypoglycemia and heart attack (myocardial infarction)||Avoid combination if possible|
|rosiglitazone (Avandia) or rosiglitazone combination products||Increased incidence of hypoglycemia, fluid retention, ischemia (manifest by angina or heart pain), congestive heart failure||Avoid combination if possible|
|Thiazides and thiazide combination products||Hyperglycemia; may reduce effect of insulin||Monitor glucose levels and adjust accordingly|
|Corticosteroids||Hyperglycemia; may reduce effect of insulin||Monitor glucose levels and adjust accordingly|
|Estrogens||Hyperglycemia; may reduce effect of insulin||Monitor therapy and adjust as needed|
|levofloxacin (Levaquin) and other fluoroquinolones||Increased risk of hypoglycemia or hyperglycemia||Use with caution, monitor therapy|
|Monoamine oxidase inhibitors (MAOIs)||MAIOs may increase insulin secretion. Combination increases risk of prolonged hypoglycemia.||Monitor glucose levels and adjust accordingly|
|Sulfonylureas||Increased risk of hypoglycemia and||Monitor glucose levels and adjust accordingly|
|Thyroid hormones||Thyroid hormones may increase insulin requirement||Monitor glucose levels and adjust accordingly|
|Yohimbe||Yohimbe may increase risk of hypoglycemia||Caution is advised|
How well does insulin treat diabetes?
Efficacy of insulin
- In a 24 week study of patients with type 1 diabetes, regular human subcutaneous insulin (mean dose = 18.3 IU) before breakfast and dinner plus human insulin isophane suspension twice daily (mean dose = 37.1 IU) reduced HbA1c by 0.4% from baseline and fasting glucose by -6 mg/dl.
- In a 24 week study of patients with type 2 diabetes, regular human subcutaneous insulin (mean dose = 25.5 IU) before breakfast and dinner plus human insulin isophane suspension twice daily (mean dose = 52.3 IU) reduced HbA1c by 0.6% from baseline and fasting glucose by -6 mg/dl.
Quick GuideType 2 Diabetes Diagnosis, Treatment, Medication
What is the mechanism of action (how it works) for insulin?
Pharmacology (mechanism of action) of insulin
Insulin is a hormone secreted by the pancreas. It regulates the movement of glucose from blood into cells. Insulin lowers blood glucose by stimulating peripheral glucose uptake primarily by skeletal muscle cells and fat, and by inhibiting glucose production and release by the liver. Insulin inhibits lipolysis (breakdown of fat), proteolysis (breakdown of proteins), and gluconeogenesis (manufacture of glucose). It also increases protein synthesis and conversion of excess glucose into fat. Insulins used to treat diabetes are pharmacologically similar to the naturally produced hormone. Patients with diabetes are insensitive to insulin and do not produce enough insulin which leads to hyperglycemia and symptoms of diabetes. Exogenous insulin preparations replace insulin in diabetics, increasing the uptake of glucose by cells and reducing the short and long term consequences of diabetes.
REFERENCES: FDA Prescribing Informaiton.
There are a variety of types and preparations of insulin for the treatment of type 1 and type 2 diabetes, gestational diabetes, diabetes during pregnancy, metabolic syndrome, and insulin resistance. Human insulin preparations and regular insulin are made by recombinant DNA technology. Examples of preparations of insulin include rapid acting insulin (Apirda, Novolog, Humalog), short acting insulin (Novolin R, Humulin R), intermediate acting insulin (Humulin N, Novolin N, and long lasting insulin (Lantus, Levemir). Common side effects of insulin include hypoglycemia, headache, weight gain, rash, itching, flu-like symptoms, lipoatrophy, and reaction at the site of injection. Warnings, precautions, and drug interactions should be reviewed prior to taking insulin.
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Type 2 Diabetes
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Treatment & Diagnosis
Medications & Supplements
Prevention & Wellness
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Daily Health News
Subscribe to MedicineNet's Diabetes Newsletter
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top Insulin for Diabetes Treatment: Types Side Effects Related ArticlesComplete List
Common Medical Abbreviations and Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
Diabetes Foot ProblemsLearn more about diabetes related foot problems. For people with diabetes, too much glucose in the blood can cause serious foot complications such as nerve damage, infection, and ulcers. Find tips for proper foot care to help prevent serious complications.
Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Take the Diabetes QuizTake the Diabetes Quiz and learn the causes, signs, symptoms, and types of this growing epidemic. What does diabetes have to do with obesity and diet? Learn about life as a diabetic.
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Diabetes TreatmentThe major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with:
- and a diabetic diet.
- weight reduction,
- a diabetic diet,
- and exercise.
Foot Problems (Diabetes)Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
Gestational diabetes is a condition that is first recognized during pregnancy and is characterized by high blood sugar. Approximately 4% of all pregnancies are diagnosed with gestational diabetes. Low blood sugar is prevented by hormones produced by the placenta during a woman's pregnancy. The actions of insulin are stopped by these hormones. Gestational diabetes is the result of the pancreas' inability to produce enough insulin to overcome the effect of the increase hormones during pregnancy. Risk factors for gestational diabetes include:
- Previous history of gestational diabetes
- Having a parent or sibling with type 2 diabetes
- Personal history of PCOS
There typically are no signs and symptoms of gestational diabetes. Treatment includes diet modifications and if necessary, insulin.
Hemoglobin A1c Test
Hemoglobin A1c or HbA1c is a protein on the surface of red blood cells. The HbA1c test is used to monitor blood sugar levels in people with type 1 and type 2 diabetes over time. Normal HbA1c levels are 6% or less. HbA1c levels can be affected by insulin use, fasting, glucose intake (oral or IV), or a combination of these and other factors. High hemoglobin A1c levels in the blood increases the risk of microvascular complications, for example:
- Diabetic neuropathy
- Diabetic eye disease
- Diabetic kidney disease
Insulin Pump For Diabetes MellitusAn insulin pump is designed to deliver insulin directly to a patient with diabetes. They are about the size of a standard beeper. The pump is attached to under the skin (usually on the abdomen). The amount of insulin required will depend on lifestyle (exercise, sleep patterns, activity level, and diet).
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. There are no signs or symptoms of insulin resistance. Causes of insulin can include conditions such as
- metabolic syndrome, and
- steroid use.
Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
Metabolic SyndromeThe main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese. Lifestyle modification such as the Mediterranean diet, exercise, and quitting smoking are the preferred treatment of metabolic syndrome.
Metabolic SyndromeMetabolic syndrome is serious and you should be concerned. Learn the causes, symptoms, treatments, and complications of metabolic syndrome with our quick quiz.
Blood Sugar SwingsLearn to better control your glucose levels by preventing blood sugar swings. Beware of caffeine, sugary foods, spices, exercise, sleep, alcohol, and stress because these can all impact blood sugar levels and increase diabetes complications
Type 2 Diabetes
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body. Causes of type 2 diabetes are a sedentary lifestyle, eating excess sugar and carbohydrates, lack of exercise, being overweight, and genetics. Symptoms of type 2 diabetes are often subtle, but may include:
- Urine odor
- Unintentional weight gain or loss
- Frequent urination
- Dark skin under the chin, armpits, or groin
Type 2 diabetes is diagnosed by a blood test. Treatment for type 2 diabetes are a healthy type 2 diabetes diet, exercise, stress reduction, and medication. Type 2 diabetes is a preventable disease. Incorporating healthy lifestyle changes (for example, eating a healthy diet, exercising more, and reducing stress) can prevent type 2 diabetes.
Type 2 Diabetes SlideshowLearn about type 2 diabetes warning signs, symptoms, diagnosis, and treatment options. Read how diet and exercise can help manage type 2 diabetes.