Insulin Injection
Biphasic Isophane Insulin Injection. Biphasic isophane insulin is a type of mixed insulin that contains both soluble and isophane insulin. It is a good choice for patients who have difficulty injecting insulin or whose hand dexterity is poor.
Doses are titrated every three days, with blood glucose readings before breakfast and evening meal. Generally, morning doses are increased by 2 units per day until evening glucose levels reach a target of 4-7 mmol/l.[1]
What should I avoid while using insulin isophane?
Besides insulin, you should also avoid foods that may increase your blood sugar levels. Some examples include alcohol, coffee, and caffeine-rich drinks. It is a good idea to consume more fruits, vegetables, and whole grains as they can help control your blood sugar levels.
Insulin should be administered at regular intervals as advised by a doctor. Your dose should be adjusted every two to three days according to your pre-breakfast blood glucose level. If you are unable to self-titrate your insulin, ask a diabetes specialist nurse for help.[2]
Injection sites should be moved regularly to prevent lipohypertrophy (fatty build-up around injections) developing. Injections should be made in the upper thigh, abdomen, or upper arm. You should never inject insulin in the vein or intravenously.
It is best to use insulin syringes with a different needle each time for ease of administration and to avoid clumps and white particles forming on the bottom or wall of the vial. Vials of insulin that contain isophane should be resuspended before use by gently rotating them. It is important not to use the same dose of insulin more than once a month, as this can lead to unpleasant side effects. It is also important to rotate your insulin supplies, as this can reduce the risk of leaking from the injection site.[3]
May improve heart health
The most impressive thing about this type of insulin is that it can be delivered directly into the bloodstream, without the need for an epidural or a needle. This has the advantage of being able to be given more frequently and with greater accuracy, without the risk of hypoglycaemia. This is especially important if you have diabetes.[4]
A biphasic isophane insulin injection is a mix of 30 percent soluble insulin and 70 percent isophane. This mixture is used to treat diabetes mellitus and has a number of positive attributes, including a long action and a short half-life (the time it takes for a dose to be fully absorbed into the bloodstream).
Its most notable attribute is that it can be delivered at the subcutaneous injection site without the need for an epidural or needle, making it ideal for people with insulin resistance.[5]
Slows macular degeneration
One of the gizmos atop my insulin pump is a small silver trinket. A slick little trinket is a great way to remind yourself that your diabetes medication is not as bad as you once thought it was and is still a worthwhile endeavour. Getting the right type of insulin at the right time of day and on the right schedule is the key to keeping your diabetes in check and your eyes happy.[6]
There are many different types of insulin to choose from but only a few are available for purchase and most have a hefty price tag. Fortunately, my GP has access to the best insulin in town and he is only too happy to recommend his latest and greatest as well as a few tried and tested gems he has tucked away under his bed.
Safety and side effects
Insulin is a protein hormone that is absorbed from the intestine and enters the blood stream where it stimulates the release of glucose from fat and muscle cells. It has several anabolic (making muscles grow) and anti-catabolic (stopping them from wasting) actions on muscle tissue.[7]
It can also increase glycogen, fatty acid, and glycerol production as well as increasing protein synthesis and amino acid uptake. This reduces the amount of sugar in the blood and improves glycaemic control.
Isophane insulin is often used in combination with soluble insulin, zinc suspensions or protamine insulin suspensions to enhance a patient’s absorption of insulin by the body. This may be done by mixing the two together in a syringe and using them at once.
For initial initiation of insulin therapy, biphasic insulins offer similar levels of PPG control to basal-bolus regimens but with a simpler treatment schedule. They are titrated every 3 days, with morning doses increased by 2 units at a time until evening blood glucose is within the target range of 4-7 mmol/l.
This approach is particularly useful in patients who are overweight or not able to titrate themselves, and it reduces the risk of hypoglycaemia. If the titration process becomes difficult, or a patient experiences low glucose at night, cut the appropriate insulin dose by 10% or four units whichever is greater.[8]
In addition to the titration process, it is important to monitor glucose at frequent intervals while on a biphasic insulin regimen. This is because biphasic insulin peaks and troughs can cause changes in blood sugar levels, which can affect the effectiveness of the regimen.
Occasionally, patients will experience mild side effects from biphasic insulin such as dizziness, nausea or vomiting. In these cases, it is recommended to talk to a healthcare professional and consider changing the product or dosage.
Another possible side effect is an allergic reaction to the product. If you experience an allergic reaction to Insucare M-50 50/50 Biphasic 40IU Injection 10 ml, stop taking it and tell your doctor immediately. Insucare M-50 50/50 Injection 10 ml should not be administered to patients with asthma.[9]
Biphasic Isophane Insulin Injection
Biphasic isophane insulin injection is an intermediate-acting complex insulin, made by mixing soluble insulin with protamine. The combination has been shown to provide good blood glucose control with minimum risk of hypoglycemia.
A regimen of twice-daily isophane insulin is recommended for those with type 1 diabetes. This is typically combined with a short-acting (soluble) insulin taken before meals.[10]
What is insulin isophane?
Biphasic isophane insulin injection is an intermediate-acting preparation which combines insulin with the highly basic protein protamine. It is available in various ratios to reduce the number of injections, most commonly 30% soluble insulin with 70% isophane (biphasic).
Injections may be used for many conditions, including long-term maintenance of diabetes. They are particularly effective in elderly patients, who may have difficulty maintaining blood glucose control due to changes in their lifestyle and mealtimes.
They are also useful in treating hyperglycaemia, especially in diabetic ketoacidosis or diabetic neuropathy. They can be given at bedtime or before meals to help limit blood glucose levels.[11]
Soluble insulin is usually given before meals. This can help limit increases in blood sugar after meals and delays the absorption of the insulin from the injection site. However, a meal can still cause an increase in blood sugar after subcutaneous administration of soluble insulin. It is recommended that soluble insulin is given 15-30 minutes before eating. It should not be given before bedtime or at the same time as isophane insulin.[12]
Before taking this medicine
Biphasic isophane insulin injection is a type of medicine that combines the best qualities of short-acting and prolonged insulin. It has been shown to produce good blood glucose control, with a minimum risk of hypoglycaemia. The medicine can be administered in several different ways, including as a subcutaneous injection, intravenous injection or infusion.[13]
The most common way of using this medicine is to combine it with soluble insulin in various ratios. The most popular is a 30% short-acting/70% isophane combination, but mixtures ranging from 10% soluble/90% isophane to 50% soluble/50% isophane are also available. The medicine can be used to initiate insulin therapy, or to increase the intensity of treatment following a basal insulin regimen. The medication may also be used to treat patients with postprandial hyperglycemia.[14]
What happens if I miss a dose?
There are many different insulin preparations available, each with a slightly longer or shorter duration of action. Biphasic insulin is a type of insulin preparation that contains a combination of short-acting and long-acting insulin in equal proportions. It is usually used as a once-daily injection to achieve glycaemic control.[15]
Several studies have shown that biphasic insulin is effective in treating patients with T2DM who are failing to obtain glycaemic control on basal-bolus regimens. These formulations have also been found to be highly effective in reducing FPG and HbA1c, especially if a simple dosing algorithm is applied and a titration strategy is used. For these reasons, biphasic insulin may be an attractive option for initiation in primary care and for intensification following a basal-bolus regimen.[16]
