Indications
Diabetes mellitus, Type 1 DM, Type 2 DM
Therapeutic Class
Combination Insulin
Pharmacology
Insulin aspart, a rapid-acting analog of human insulin, lowers blood glucose levels; it regulates carbohydrate, protein and fat metabolism by inhibiting hepatic glucose production and lipolysis, and enhancing peripheral glucose disposal.
Dosage & Administration
Combination rapid-onset (faster than regular insulin) and intermediate-acting insulins in fixed dose.
Adult: Dosage should be individualised and adjusted based on patient’s glycaemic response. Usual range: 0.5-1 Unit/kg/day.
Interaction
Reduce insulin requirements with oral hypoglycemics, octreotide, MAOIs, Â ACE inhibitors, salicylates, alcohol, anabolic steroids & sulfonamides; increase insulin requirements with OCs, thiazides, glucocorticoids, thyroid hormones, sympathomimetics & danazol. Alcohol may intensify & prolong the glucose lowering effect of insulin.
Contraindications
Hypoglycaemia. Hypersensitivity to any of the components.
Side Effects
Adverse events commonly associated with human insulin therapy include the following: Allergic reactions. Injection site reaction, lipodystrophy, pruritus, rash, lipoatrophy, hypokalaemia, blurred vision. Hypoglycaemia, insulin resistance.
Pregnancy & Lactation
Pregnancy Category-B. Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Lactation: Unknown whether distributed in breast milk; compatible with breast feeding, but lactating women may require dosage adjustment; caution advised
Precautions
Pregnancy (insulin requirements tend to fall during the 1 st trimester, increase during the 2nd and 3rd) and lactation. Regular monitoring of HbAlc and blood glucose concentrations. Caution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery
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