Insulin Preparations

Drug Dosage Remarks
Rapid-Acting Insulins Individualized dosing by SC injection
Using a regimen of multiple injections of long- or intermediate-acting insulin plus short-acting insulin:
Pregnant patients with gestational-onset diabetes
Usual starting dose:
0.7-1 unit/kg/day
Pregnant patients with pre-existing type 1 or 2 diabetes
Usual dose:
First trimester: 0.7-0.8 unit/kg/day
Second trimester: 0.8-1 unit/kg/day
Third trimester 0.9-1.2 units/kg/day 		Adverse Reactions
  • Most common: Hypoglycemia
    • Dependent on the type and preparation used
    • Usually secondary to high Insulin dose, increased physical activity or omission of a meal
    • Symptoms may include hunger, pallor, sweating, palpitation, anxiety, headache, visual disturbance; if untreated may lead to convulsion and coma
  • GI effects (weight gain, nausea); CNS effects (transient blurred vision, headache, fatigue); CV effects (transient peripheral edema, pallor, tachycardia); Dermatologic effects (pruritus, rash, urticaria); Local effects (injection site reaction, lipoatrophy/lipohypertrophy); Hypersensitivity reactions
Special Instructions
  • Dose should be increased during infection, stress, trauma
  • Dose should be decreased in patients with renal or hepatic impairment
  • Avoid inadvertent change of Insulin from one dosage type to another
  • Monitor blood or urine glucose levels and urine ketones
  • Dose of rapid- and short-acting insulin and biphasic/premixed insulin should be taken before each meal
  • Intermediate-acting insulin is typically taken at bedtime
  • Long-acting insulin is taken at the same time every day, regardless of meals
  • Injection site should be rotated regularly to avoid lipodystrophy
Insulin aspart
Insulin lispro
Short-Acting Insulin
Insulin regular
(Neutral solution human monocomponent insulin/Regular human insulin)
Intermediate-Acting Insulin
Insulin isophane/NPH
(Human insulin isophane/Neutral isophane of human monocomponent insulin)
Long-Acting Insulins
Insulin detemir
Insulin glargine
Combination Insulin
Insulin regular 30%/
Insulin NPH 70% 		Individualized dosing by SC injection
Type 1 diabetes: 0.5-1 IU/kg/day
Type 2 diabetes: 0.3-0.6 IU/kg/day

Disclaimer

All dosage recommendations are for non-elderly adults with normal renal and hepatic function unless otherwise stated. 
Not all products are available or approved for above use in all countries. 
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs. 
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information. 

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