- Type I DM:
- SC 0.5-1 unit/kg/day divided TDS
- IV dose is individualized
- Type II DM:
- Initially SC 10 units/day (or 0.1-0.2 unit/kg/day) in evening or divided BD
- Morning give 2/3 of dose and evening 1/3 of dose
- Severe hyperglycemia/diabetic ketoacidosis (Off-label)
- IV 0.1 unit/kg IV *1, then 0.1 unit/kg/hr continuous infusion OR14 units/kg/hour
- If blood glucose decreases by <10% in 1st hour, give IV 0.14 units/kg/dose*1, then resume usual dose
- When blood glucose 200mg/dL, dose decreased to IV 0.02-0.05 units/kg/hour
- Maintain blood glucose at 150-200mg/dL until DKA resolves
Pre-filled pen/injection: 100 IU/mL
- Injected SC 30 minutes before meals into the thigh, upper arm, abdomen or buttocks
- Injection sites should be rotated within the same region from 1 injection to the next to reduce the risk of lipodystrophy
- Insulin isophane is a intermediate-acting insulin while regular insulin is an short-acting insulin.
Short to intermediate acting insulin
It stimulates peripheral glucose uptake, inhibits hepatic glucose production, inhibits lipolysis and proteolysis regulating glucose metabolism
- Hypoglycemia
- Injection site reaction
- Injection site lipodystrophy
- Myalgia
- Pruritus
- Rash
- URI
- Weight gain
- Headache
- Peripheral edema
- Hypersensitivity reaction
- Influenza
- Hypersensitivity to components
- Hypoglycemia
- Pramlintide
Drug Status
| Availability | Prescription only |
| Pregnancy | Category B; Can be used |
| Breastfeeding | Can be used |
| Schedule | Not controlled |
| BRAND NAME | API | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR | |
|---|---|---|---|---|---|---|---|
| Actrapid | Regular insulin | 100 IU/mL | Injection | 10mL | Novo Nordisk | Phillips Therapeutics | |
| Actrapid Flexpen | Regular insulin | 100 IU/mL | Injection | 5*3mL | Novo Nordisk | Phillips Therapeutics | |
| Biosulin N | Insulin isophane | 100 IU/mL | Injection | 10mL | M.J. Biopharm | Europa Healthcare | |
| Biosulin R | Regular insulin | 100 IU/mL | Injection | 10mL | M.J. Biopharm | Europa Healthcare | |
| Humodar B 100R | Insulin isophane | 100 IU/mL | Injection | 10mL | Pharmasell Ltd | Pharmasell Ltd | |
| Humulin N | Insulin isophane | 100 IU/mL | Injection (cartridge) | 3mL | Eli Lilly | Statim Pharma | |
| Humulin N | Insulin isophane | 101 IU/mL | Injection (vial) | 10mL | Eli Lilly | Statim Pharma | |
| Humulin R | Regular insulin | 100 IU/mL | Injection (cartridge) | 3mL | Eli Lilly | Statim Pharma | |
| Humulin R | Regular insulin | 100 IU/mL | Injection (vial) | 10mL | Eli Lilly | Statim Pharma | |
| Insulatard | Insulin isophane | 100 IU/mL | Injection | 10mL | Novo Nordisk | Phillips Therapeutics | |
| Insulatard Flexpen | Insulin isophane | 100 IU/mL | Injection | 5*3mL | Novo Nordisk | Phillips Therapeutics | |
| Jusline N | Insulin isophane | 100 IU/mL | Injection | 10mL | Julphar Pharma | Pharmamed Solution | |
| Jusline R | Regular insulin | 100 IU/mL | Injection | 10mL | Julphar Pharma | Pharmamed Solution | |
| Wosulin N | Insulin isophane | 100 IU/mL | Injection | 10mL | Wockhardt Ltd | Pharma Specialities | |
| Wosulin R | Regular insulin | 100 IU/mL | Injection | 10mL | Wockhardt Ltd | Pharma Specialities |