Insulin Regular

Drug Information: Insulin Regular

Insulin Regular is a short-acting, human insulin used to improve glycemic control in adults and children with diabetes mellitus. It is a synthetic form of human insulin, identical in structure to the insulin produced by the pancreas. Insulin Regular is typically administered subcutaneously before meals to manage postprandial hyperglycemia. It can also be administered intravenously in emergency situations, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS).

Category

Hormones – Insulin

Mechanism of Action

Insulin Regular lowers blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Specifically, insulin binds to insulin receptors on target cells, initiating a cascade of intracellular events. This cascade promotes the translocation of glucose transporter protein 4 (GLUT4) to the cell membrane, facilitating glucose entry into the cell. Insulin also inhibits glycogenolysis (breakdown of glycogen into glucose) and gluconeogenesis (synthesis of glucose from non-carbohydrate sources) in the liver, further contributing to reduced blood glucose levels. In addition, insulin promotes the conversion of glucose to glycogen for storage in the liver and muscles, and it stimulates the conversion of glucose to triglycerides in adipose tissue.

Clinical Uses

Insulin Regular is primarily used in the treatment of hyperglycemia associated with type 1 and type 2 diabetes mellitus. It’s also used to treat gestational diabetes when diet and exercise are insufficient to control blood glucose levels. Furthermore, Insulin Regular is a crucial component in the management of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), where rapid correction of hyperglycemia is essential. It may also be used in conjunction with other insulin formulations to achieve optimal glycemic control. In some cases, it might be employed to stimulate potassium uptake into cells, treating hyperkalemia.

Dosage

Dosage is highly individualized and based on blood glucose monitoring, metabolic needs, meal size, and response to therapy. Insulin Regular is typically administered subcutaneously 30 minutes before meals. Intravenous administration is reserved for emergency situations like DKA.

Adults: Initial subcutaneous dose is often 0.1 units/kg/day, divided into multiple injections. Intravenous bolus for DKA/HHS may be 0.1-0.15 units/kg, followed by a continuous infusion.

Pediatrics: Dosage is also individualized, with careful monitoring. Subcutaneous dose may start at 0.05-0.1 units/kg/day, divided into multiple injections. IV bolus dose for DKA is similar to adults, followed by continuous infusion. Close monitoring is crucial in pediatric patients to prevent hypoglycemia. Dosing must be closely supervised by a physician.

Indications

Common indications for Insulin Regular include:

• Type 1 Diabetes Mellitus
• Type 2 Diabetes Mellitus (when other treatments are insufficient)
• Gestational Diabetes (when diet and exercise fail)
• Diabetic Ketoacidosis (DKA)
• Hyperosmolar Hyperglycemic State (HHS)
• Hyperkalemia (in conjunction with other treatments)

Contraindications

Contraindications for Insulin Regular include:

• Hypoglycemia (low blood sugar)
• Hypersensitivity to Insulin Regular or any of its excipients

Caution is advised in patients with:

• Renal or hepatic impairment
• Conditions that affect food absorption
• Concomitant use of medications that affect blood glucose levels

FAQ

Q: How quickly does Insulin Regular work?
A: Insulin Regular is a short-acting insulin, meaning it starts working within 30 minutes of injection, peaks in 2-4 hours, and lasts for about 5-8 hours.

Q: How should I store Insulin Regular?
A: Unopened vials should be stored in the refrigerator (36°F to 46°F [2°C to 8°C]). Once opened, Insulin Regular can be stored at room temperature (below 86°F [30°C]) for up to 28 days.

Q: What are the common side effects of Insulin Regular?
A: The most common side effect is hypoglycemia (low blood sugar). Other potential side effects include injection site reactions (redness, swelling, itching), weight gain, and, rarely, allergic reactions.

Q: What should I do if I experience hypoglycemia?
A: If you experience symptoms of hypoglycemia (shakiness, sweating, confusion, dizziness), consume a fast-acting carbohydrate source like glucose tablets, juice, or hard candy. Check your blood sugar and repeat if necessary.

Q: Can I mix Insulin Regular with other insulins?
A: Insulin Regular can be mixed with intermediate-acting insulins, such as NPH insulin. Always consult with your doctor or pharmacist for guidance on mixing insulins and the correct order of drawing them into the syringe. It should be drawn into the syringe *before* the longer acting insulin.

Q: What medications can interact with Insulin Regular?
A: Many medications can affect blood glucose levels and interact with insulin, including corticosteroids, beta-blockers, thiazide diuretics, and some antidepressants. Be sure to inform your doctor of all medications you are taking.

Q: How often should I check my blood sugar?
A: The frequency of blood sugar monitoring depends on your individual needs and treatment plan. Your doctor will provide specific recommendations, but typically, blood sugar should be checked before meals and at bedtime, and sometimes after meals.

Q: What is the difference between Insulin Regular and other types of insulin?
A: Insulin Regular is a short-acting insulin with a quicker onset and shorter duration of action compared to intermediate-acting or long-acting insulins. Other insulins may have a longer duration of action and are used to provide basal insulin coverage.