Insulin is the foundation of treatment for many people with diabetes. People with type 1 diabetes, and some with type 2 diabetes, have to take several injections of insulin per day. The insulin keeps blood sugar in a normal range and prevents high blood sugar levels. This can help prevent complications. The amount of insulin you should take can be determined in several different ways:.
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They must take their dose 5 to 10 minutes before eating. Please click here for Prescribing Information. Text: double click to edit. General dosing instructions. Step 1: Start.
Step 2: Adjust. Titrate daily based on blood glucose. Today's reading Tomorrow's dose adjustment. Today's reading. Tomorrow's dose adjustment.
Step 3: Intensify. Important Safety Information. Warnings and Precautions. Sharing poses a risk for transmission of blood-borne pathogens. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site to an unaffected area has been reported to result in hypoglycemia.
Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed. Hypoglycemia is the most common adverse effect of insulin therapy.
The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is recommended for all patients with diabetes and is particularly important for patients using external pump infusion therapy. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated. Patients should be observed for signs and symptoms of heart failure.
If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered. Malfunction of the insulin pump or insulin infusion set or insulin degradation can rapidly lead to hyperglycemia and ketoacidosis.
Patients using insulin infusion pump therapy must be trained to administer insulin by injection and have alternate insulin therapy available in case of pump failure. Adverse Reactions. Use in Specific Populations.
These patients may require more frequent blood glucose monitoring and dose adjustments. Increase glucose monitoring with changes to: insulin dosage, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with renal impairment or hepatic impairment or hypoglycemia unawareness.
Pump or infusion set malfunctions can lead to a rapid onset of hyperglycemia and ketoacidosis. Prompt identification and correction of the cause of hyperglycemia or ketosis is necessary. Monitor blood glucose levels closely in pediatric patients.
References: Fiasp [package insert]. NovoLog [package insert]. Treatment intensification with stepwise addition of prandial insulin aspart boluses compared with full basal-bolus therapy FullSTEP Study : a randomised, treat-to-target clinical trial. Lancet Diabetes Endocrinol. Data on file.
Sliding-Scale Insulin Therapy
They must take their dose 5 to 10 minutes before eating. Please click here for Prescribing Information. Text: double click to edit. General dosing instructions. Step 1: Start. Step 2: Adjust. Titrate daily based on blood glucose.
Sliding Scale Therapy