Regular Insulin

[dr.joan]

Trade names: Humulin R, Insulin-Toronto, Novolin R, Iletin II Regular, Velosulin BR

Class: Short-acting insulin

Pregnancy: (Category B)

Action:

• Lower blood glucose by increasing transport into cells and promoting the conversion of glucose to glycogen
• Promote the conversion of amino acids to proteins in muscle and stimulate triglyceride formation
• Inhibit the release of free fatty acids
• Sources include pork, beef/pork combinations, semisynthetic, biosynthetic, and recombinant DNA.
• Therapeutic Effects:
  • Control of blood sugar in diabetic patients.

Uses:

• Treatment of insulin-dependent diabetes mellitus (IDDM, type 1)
• Management of non–insulin-dependent diabetes mellitus (NIDDM, type 2) unresponsive to treatment with diet and/or oral hypoglycemic agents
• Concentrated insulin U-500: Only for use in patients with insulin requirements >200 units/day.

Dose:

by subcutaneous, intramuscular, or intravenous injection or intravenous infusion, according to requirements " usually bolus 0.1 unit/kg followed by infusion 0.05-0.1 unit/kg/hour

Contraindications:

• Allergy or hypersensitivity to a particular type of insulin, preservatives, or other additives.

Side effects:

Derm: urticaria.
Endo: Hypoglycemia, rebound hyperglycemia (Somogyi effect).
Local: lipodystrophy, itching, lipohypertrophy, redness, swelling.
Misc: allergic reactions includingAnaphylaxis.

Nursing considerations:

• Read the product information & any important notes inserted into the package.
• Refrigerate stock supply of insulin but avoid freezing.
• Follow the guidelines with respect to mixing the various types of insulin.
• Invert the vial several times to mix before the material is withdrawn “avoid vigorous shaking”.
• Assist patient for self-administration of insulin.
• Rotate the sites of S.C. injections to prevent the problem of hypertrophy or atrophy at injection site.
• Allow insulin to remain at room temperature 1 hour before administration.
• Apply pressure for 1 minute, don’t massage since it may interfere with rate of absorption.
• If breakfast must be delayed, delay the administration of morning dose of insulin.
• Obtain a thorough nursing history from the client / family.
• If the client has symptoms of hyperglycemia reaction:
• Have regular insulin available for administration.
• Monitor client closely after administration.
• Check blood glucose, urine glucose, and acetone.
• Check for early symptoms of hypoglycemia.
• Assess diabetic more closely for infection or emotional disturbances that
• may increase insulin requirements.
• Explain the necessity for close regular medical supervision.
• Explain to patient how to test the urine for sugar & acetone.
• Explain the use & care of equipment & the storage of medication.
• Explain the importance of exercise & adhering to the prescribed diet.
• Explain the importance of carrying candy or sugar at all times to counteract
• hypoglycemia should it occur.
• Provide the client & family with a printed chart explaining symptoms of hypoglycemia , hyperglycemia & instructions concerning what to do for each.
• Instruct client that blurring of vision will subside within 6-8 weeks.
• Advise client to check vials of insulin carefully before each dose. Regular
• insulin should be clear, where as other forms may be cloudy.

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