Diabetis Insulin and Insulin Administration.pdf

Diabetes

1. Diabetis: Insulin and Insulin
Administration
Sameera Liyanaarachchi
B.Sc.(special) (Faculty of Medical Sciences, University of Sri Jayewardenepura),
M.Phil.(reading) in Pharmacology, MBA in Health Care Administration (Reading)
(Coventry-UK), Registered Pharmacist (Sri Lanka Medical Council), Senior Lecturer)
)

2. Insulin
•Insulin is a hormone produced by the pancreas
that plays a crucial role in regulating blood
sugar (glucose) levels
•Insulin is produced by the beta cells in the
islets of Langerhans within the pancreas.Its
release is triggered by rising blood glucose
levels, such as after eating.

•Daily secretion 30-40 units

3. MOA of Insulin
•Insulin helps cells throughout the body absorb
glucose from the bloodstream to be used for
energy or stored as glycogen in the liver and
muscles.
•It lowers blood sugar levels by facilitating this
uptake.

4. Insulin usage:

•Type 1 Diabetes: The body's immune system
attacks and destroys the beta cells, leading to
little or no insulin production. Patients require
insulin therapy.

•Type 2 Diabetes: The body becomes resistant to
insulin, or the pancreas does not produce enough
insulin. Management includes lifestyle changes,
oral medications, and sometimes insulin therapy

5. Preparations of Insulins.
•Source of Insulin(Human,Bovine,Porcine)
•Formulation
•Short acting
•Intermediate acting
•Long acting
•Bi phasic

6. Short Duration Of action Insulin
Rapid-Acting Insulin:

Onset: 10-30 minutes
Peak: 30 minutes to 3 hours
Duration: 3-5 hours
Insulin lispro (Humalog)
Insulin aspart (NovoLog)
Insulin glulisine

Short-Acting Insulin:

Onset: 30 minutes to 1 hour
Peak: 2-5 hours
Duration: Up to 12 hours

Regular insulin (Humulin R, Novolin R)

•Can be given IV/ IM/Sc

7. Intermediate duration of action

•Insulin zinc suspension
Intermediate-Acting Insulin:

Onset: 1-2 hours
Peak: 4-12 hours
Duration: 12-18 hours

Examples:
Insulin NPH (Humulin N, Novolin N)

8. Longer duration of action
Insulin
•Insulin Zinc suspension –Crystalline

Long-Acting Insulin:
Onset: 1-2 hours
Duration: Up to 24 hours

Examples:
Insulin glargine (Lantus)
Insulin detemir (Levemir)

9. Biphasic Insulins
•Combination of two types of insulin (usually
rapid-acting or short-acting with
intermediate-acting) in one formulation
(Mixture of soluble insulin & Isophane insulin)
Eg
Humalog Mix 75/25 (75% insulin lispro protamine and 25% insulin
lispro)
NovoLog Mix 70/30 (70% insulin aspart protamine and 30%
insulin aspart)

Each type of insulin is used to manage blood sugar levels in different ways,
depending on the individual's needs and the timing of their meals and activities
OR

10. •Mixtard insulin is a type of premixed insulin that contains both
short-acting and intermediate-acting insulin.
•This combination helps manage blood glucose levels throughout
the day by covering both immediate insulin needs around meals
and longer-term basal insulin requirements.

–Mixtard 30: Contains 30% regular insulin and 70% NPH insulin.
–Mixtard 50: Contains 50% regular insulin and 50% NPH insulin.

•These pre-mixed formulations are convenient as they reduce the
number of injections needed and simplify the insulin regimen,
especially for people with diabetes who have difficulty managing
multiple types of insulin separately

11. Indications for use of Insulin.
•Type 1 Diabetes mellitus
•Type 11 Diabetes
Coma
Surgery
Infections
Pregnancy

12. Side effects of Insulin
•Hypoglycemia
•Coma ,Convulsions & Death
•Allergic reactions

13. Dose of Insulins
•100u/ml
•Daily increment is 4 units a day.

14. Advice to the patient
•Don’t skip a meal
•Signs of hypoglycemia
•Glucose

15. Insulin Administration

16. STEPS FOR INSULIN INJECTION
1> Get supplies
►Insulin
►Syringe
►Alcohol wipe
►Sharp containers

17. 2> Wash hands
3> Roll bottle (if needed)

18. 4> Wipe top of the bottle with alcohol
swab
5> Pull plunger down to required units

19. 6> Push needle
into bottle
7>Pull plunger down

20. 8>Pull plunger down to required
units
9>Pick injection site wipe with alcohol swab

21. 10>Pinch up skin, push needle into skin,
push plunger in
11>Pull needle out
Count slowly to 10 before removing the
syringe from the skin to ensure that the
dose has been properly delivered

22. 12>Dispose syringe
safely

23. INSULIN PENS
An insulin pen looks like a large fountain pen.
There are two basic types:
►Disposable: already filled with insulin
►Reusable: have a replaceable cartridge of
insulin

24. ►Disposable pen:
When pen is empty, expired, or has been open
for a month, it is simply discarded
►Reusable pen:
A new pen needle to be screwed onto the pen
with each injection

25. STEPS FOR USING PEN DEVICE
►Remove the cover
►Attach the pen needle to the insulin pen
►Expel the air from the needle
►Dial the dose to the number of units of insulin
needed
►Insert the pen needle into the layer of fat
under
the skin
►Press the button at the top of the pen

26. ►Count slowly to 10 before removing the
insulin pen device from the skin for proper
delivery of insulin
►Take the pen needle off after use and dispose
of it properly

28. INSULIN PUMP
•Battery operated device about the size of a
pager
•Reservoir filled with insulin
•Computer chip with user control of insulin
delivery
•Worn 24 hours per day
•Delivers one type of insulin

29. THANK YOU