Insulin

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Insulin is a hormone that the body manufacters in the pancreas. and is absolutely necessary to the body’s ability to burn sugar. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle. It is given by injection to supplement or replace natural insulin in the treatment of some forms of diabetes mellitus. Indivuduals with Type 1 diabetes mellitus depend on external insulin (most commonly injected subcutaneously) for their survival because the hormone is no longer produced internally. Individuals with Type 2 diabetes mellitus (formerly referred to as non-insulin dependent diabetes (NIDDM)) are insulin resistant, and because of such resistance, may suffer from a relative insulin deficiency. Type 2 diabetes is a progressive condition and can be treated with diet, lifestyle changes, such as increasing your activity levels. If your diabetes is still not controlled, you may need tablets or insulin therapy.

Some patients with Type 2 diabetes may eventually require insulin if other medications fail (eg. antidiabetic medication or diet) to control blood glucose levels adequately, though this is somewhat uncommon. If you take insulin it should be used along-side a carefully controlled diet. Illness, vomiting, alterations in your diet or exercise may require a dosage ajustment. Those people who use insulin should carry a warning card or tag. This will help alert others should you find yourself in a position where you are unable to speak (eg. loss of concsiousness).

Those individuals who are Insulin dependant when attending a dental appointment to under go treatment under local anaesthesia should inject insulin and eat meals as normal. If food is omitted the blood glucose will fall to an abnormally low level causing (hypoglycaemia). However, it is most important to tell your dentist you are diabetic, before such treatment, and be guided by his or her advice.

Symptoms and signs of low blood glucose (sugar) may include: Shaking and trembling, sweating, pins and needles (in lips and tounge), hunger, palpatitions, occasional headaches, double vision, difficulty in concentration, slurring of speach, confusion, convultions, change of behaviour and unconsciousness. If you recognise these symptoms in yourself or some other person, you know to be diabetic, sugar in water or a few lumps of sugar will help reverse the process. In the case of unconsciousness seek medical help immediately. Children may not have such prominent changes but may appear unduly lethargic.

Quick Guide

• Diabetes drug with danger of overdose – HIGH.
• Dependency is said to be – LOW.
• Prescription only drug – YES.
• Available as generic – NO (generic drugs, short: generics) is a drug which is produced and distributed without patent protection.
• Alcohol Avoidance – YES.
• Alcoholic drinks may upset diabetic control.

Side Effects

You may if taking insulin suffer one or more of these side effects, in the initial stages. However, you may find you do not suffer any at all it does not follow that being on this medication will cause unwanted adverse effects.

Common: Sweating, Weakness, Injection Site Irritation.
Rare: Rash, Dimpling At An Injection Site, Eyesight Problems, Facial Swelling, Shortness Of Breath.

If you suffer sweating, dizziness, confusion or weakness this could be an indication of low blood glucose (sugar). Suffering a rash, swelling and shortness of breath may be indication of a serious allergic reaction, these symptom are rare.

The side effects listed here are the most common and rare problems reported by patients using insulin It may not include all of the side effects reported by the drug’s manufacturer. If common side effects persist you need to inform your doctor. Notify your doctor if you suffer any of the rare or some other side effects not listed here. For total peace of mind, seek information from your doctor or pharmasict/chemist.

Prolonged Use

There would be no known problems. As all diabetes suffers are aware careful monitoring of the blood sugar levels are necessary (urine/blood).

Driving, Hazardous Work & Alcohol

Alcohol should be avoided as alcoholic drinks upset diabetic control. There is usually no problems with driving/hazardous work. However, strenuous exercise may alter your insulin and sugar requirements. If you have warning signs of low blood sugar you should avoid these activities.

Pregnancy and Breast-Feeding

There is no evidence of risk to the baby. However, poor control of diabetes increases the risk of birth defects. Careful monitoring should be a concern. There is no evidence of risk if breast feeding. You may require an adjustment in dosage during the breast feeding stage.

Surgery and Dental Treatment

There may be a need for an insulin increase during surgery. Blood glucose levels will need to be monitored during and after an operation. You should notify your doctor or dentist before any kind of surgery. If you need to take painkillers following a tooth extraction do not take aspirin as it thins the blood and would interfere with blood clotting.

Tell Your Doctor Or Pharmacist

You should tell your doctor if you have a current health problem. For example: heart disease, kidney problems, if you are pregnant or you intend to become pregnant, or if you think you may be at risk from drug treatment for any other reason. Some types of medication can cause serious adverse effects when taken side by side so it is important to tell your doctor of any other medication you are already taking. This should also include any over-the-counter medication. For example: Painkillers, cold remedies, herbal and complimentary / alternative medication.

Over 60’s & Children

For the over sixties there would be no special problems. Infants and children would require a reduced dose.

Overdose

You should seek immediate medical advice. noticeable symptoms of low blood sugar, such as faintness, hunger, sweating, trembling. Eat or drink something sugary. Emergency action would be called for if fits or loss of consciousness occurs.

Other Medication Reactions

Beta Blockers may affect insulin needs and mask signs of low blood sugar. As a general guide…… check with your doctor or pharmacist before taking any medicines. This is because some medicines may contain sugar and would upset control of your diabetes. Many drugs including some antibiotics, monoamine oxidase inhibitors and oral antidiabetic drugs increase the risk of low blood sugar levels.

Missed A Dose

You should discuss missing a dose with your doctor as appropriate action depends on the type of insulin and its dosage.

Reducing or Stopping Medication

Confusion and coma may occur if you stop taking this drug without informing your doctor of your intentions.

Effect Of Medication (from one dose)

Effects can be felt 15 to 60 minutes for the short acting, and 1 to 2 hours for the medium and long lasting. The effects are likely to last 6 to 8 hours for the short lasting. 18 to 26 hours for the medium acting and 28 to 36 hours for the long lasting

Safety and Storage

• Keep Insulin in its original container, in a cool dry place, away from the reach and eye sight of children.
• Never take more than the original dosage prescribed by your doctor.
• If your due to have treatment like an operation or dental work tell the person carrying out the treatment which medicines you are taking.
• It is important that you follow any dietary instructions that you have been given by your doctor or diabetic nurse.
• Humulin should be kept in a fridge (Not a freezer). Between 2° & 8° C.
• Do not keep the cartride you are using in the fridge.
• When in use, or when refridgeration is not possible do not store your humulin above 30° C.
• When you buy any medicines over-the-counter check with the pharmacist that they are safe to take with your other medicines.
• Never inject Insulin if it has past the expiry date shown on the box or container.
• Do not discard old or unwanted drugs into your trash, sink or toilet.
• Return all unused or old medicines/drugs to your pharmacist. who will dispose of them safely.

If this medication has been prescribed for you never allow anyone else to use it, even if you know or others feel their symptom are similar to your own.

Do not leave your doctors surgery until you have a clear understanding of what the drug your doctor has prescribed for you does, and why you have been prescribed it. It is common for people who do not understand the reason behind there treatment to take their medication correctly.