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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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