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Back to Endocrinology Drug Index

Back to Insulins

Name: Insulin

Pregnancy Category B

Drug classes

  • Antidiabetic agent
  • Hormonal agent

Therapeutic actions

Insulin is a hormone that, by receptor-mediated effects, promotes the storage of the body's fuels, facilitating the transport of metabolites
and ions (potassium) through cell membranes and stimulating the synthesis of glycogen from glucose, of fats from lipids, and proteins from amino acids.

Indications

  • Treatment of diabetes mellitus type I
  • Treatment of diabetes mellitus type II that cannot be controlled by diet
  • Treatment of severe ketoacidosis or diabetic coma (regular insulin injection)
  • Treatment of hyperkalemia with infusion of glucose to produce a shift of potassium into the cells
    Highly purified and human insulins promoted for short courses of therapy (surgery, intercurrent disease), newly diagnosed patients, patients with poor metabolic control, and patients with gestational diabetes Insulin injection concentrated indicated for treatment of diabetic patients with marked insulin resistance (requirements of 200 U/d)

Contraindications/cautions

Allergy to beef, pork products (varies with preparations; use of human insulin removes this caution); pregnancy (keep patients under close supervision; rigid control is desired; following delivery, requirements may drop for 24-72 h, rising to normal levels during next 6 wk); lactation (monitor mother carefully; insulin requirements may decrease during lactation).

Adverse effects

  • Hypersensitivity: Rash, anaphylaxis or angioedema, may be life threatening
  • Metabolic: Hypoglycemia; ketoacidosis
  • Local: Allergy-local reactions at injection site-redness, swelling, itching; usually resolves in a few days to a few weeks; a change in type or species source of insulin may be tried
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