Regular Insulin
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:
o
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 including Anaphylaxis.
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times to mix before the material is withdrawn “avoid vigorous shaking”.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.
