What Type Of Insulin Is Nph
NPH insulinNPH insulininsulininsulin
. Also know, is NPH insulin Long acting?
NPH insulin has a longer duration of action than the rapid-acting insulins and the short-acting insulins . NPH insulin usually has an onset about 1 to 3 hours after injection, peaks 4 to 12 hours later, and is effective for about 12 to 16 hours.
Also, what are the 4 types of insulin? The types of insulin include:
What Are Some Other Side Effects Of Insulin Nph
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Irritation where the shot is given.
- Weight gain.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
What Side Effects May I Notice From Receiving This Medicine
Side effects that you should report to your doctor or health care professional as soon as possible:
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- breathing problems
- signs and symptoms of high blood sugar such as dizziness, dry mouth, dry skin, fruity breath, nausea, stomach pain, increased hunger or thirst, increased urination
- signs and symptoms of low blood sugar such as feeling anxious, confusion, dizziness, increased hunger, unusually weak or tired, sweating, shakiness, cold, irritable, headache, blurred vision, fast heartbeat, loss of consciousness
Side effects that usually do not require medical attention :
- increase or decrease in fatty tissue under the skin due to overuse of a particular injection site
- itching, burning, swelling, or rash at site where injected
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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People With Type 2 Diabetes
Type 2 diabetes is typically a progressive disease and most do not require insulin when first diagnosed. Blood glucose levels are often manageable with lifestyle changes such as more careful meal planning and exercise. Antidiabetic drugs, such as oral medications like metformin or non-insulin injectables, may be added if blood glucose level goals are not being met. Because Type 2 diabetes is a progressive disease, at some point the production of insulin in the pancreas may not be sufficient and insulin injections may be necessary.
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Enhancing Healthcare Team Outcomes
For a patient to achieve successful treatment with NPH insulin, an interprofessional team effort is necessary. Patient education is imperative to improve outcomes from NPH insulin treatment. Healthcare workers should teach patients how to resuspend NPH premixed insulin before injection. Health care professionals, particularly the diabetes nurse educator, should demonstrate the correct injection technique and educate patients about the importance of timing and accuracy of dosage. Regular monitoring is vital to avoid adverse effects. Patients need a detailed explanation of the side effects of insulin, and if available, a dedicated diabetic education session by a certified diabetic educator is necessary this can be a nurse or pharmacist, preferably with specialty training in diabetes management. This interprofessional approach will drive improved patient compliance and outcomes with fewer adverse effects.
Recent clinical trials have shown that modern basal insulin analogs such as insulin glargine and insulin detemir have a lower risk of hypoglycemia and lower variability of fasting blood glucose compared to NPH insulin. But in clinical practice, these new analogs may not have better outcomes regarding the quality of life, morbidity, or cost.
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Synthetic Human Insulin Is Identical To Your Own
However, relative to the rapid-acting insulin analogs, regular human insulin has several undesirable features.
Synthetic human insulin is identical in structure to your own natural insulin. But when it is injected under the skin it doesnt work as well as natural insulin. This is because injected human insulin clumps together and takes a long time to get absorbed. The activity of this synthetic human insulin is not well synchronized with your bodys needs.
Storing Opened Nph Insulin:
- Never refrigerate an in-use injection pen. An in-use NPH insulin should be kept at room temperature below 30 degrees C . Protect opened insulin from heat and light.
- An in-use NPH insulin is stable for only a certain number of days. So be sure to throw away the medication not used within the specified time. Usually, opened insulin is thrown away after 14 days of opening. This may differ based on other brands.For example, if youre using Humulin N brand vials, the open insulin has to be thrown out after 31 days. And if youre using Novolin N brand vials, the open insulin has to be thrown out after 42 days.
- Also, after using open insulin its better stored in a suitable safe container.
NOTE: The above explanation is only a summary of storage instructions. The above explanation may not cover all possible storage guidelines. If you have any more questions regarding the insulin, talk to your doctor, health care provider, or pharmacist.
Another common question many have with NPH insulin or any insulin is on missing the dose. Lets look at that as well.
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Know Your Insulins And Their Timing
A good way to improve glucose levels is to track the peaks and drops in your glucose and relate how the peak and action times of your insulins correspond to low or high patterns in your glucose. Identify your glucose patterns , and work to understand when each of your insulins is active. This allows you to adjust your insulin doses or food choices to stop unwanted ups and downs in your readings.
The table below shows the start, peak, and end times for various insulins.
|Action Times for Insulins|
|covers meals and lowers high BGs|
|Regular||covers meals and lowers high BGs|
|very flat, long-acting background insulin action|
How Long Does Nph Insulin Take To Peak
NPH insulin generally acts within 1 to 3 hours and has a peak time of about 6 to 8 hours.
Peak time is the period when a medication has its strongest effect. It varies based on the type and brand of insulin you use. Its essential to know the peak time of your insulin so that you can predict how much and when you should eat to keep your blood sugar constant.
NPH insulin can last for up to 12 hours and is typically injected once or twice per day. It can last longer than 12 hours in people with certain medical conditions like kidney failure.
When you inject NPH insulin into the subcutaneous layer of your skin, the insulin spreads through your fat tissue and connective tissue until it reaches small blood vessels called capillaries. Various factors can affect how long it takes for the insulin to reach your bloodstream and start acting. These include:
- injection depth
- thickness of your fat tissue
- temperature of your fat tissue
- your level of activity and exercise
- the part of your body injected
- whether youre a smoker
- body position during the injection
- impaired concentration and reaction time
People with kidney or liver conditions are at a higher risk of developing severe low blood sugar. Its important to talk with your doctor if you develop side effects so that your doctor can help you adjust your insulin dose.
Before taking NPH insulin, its important to talk with your doctor about the pros and cons of this type of insulin and to get clear instructions on:
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Precautions To Be Taken While Using Nph Insulin
Before using this medication or when the doctor prescribes you this medication, make sure you inform your doctor regarding all your allergies. Especially regarding allergies to any other type of insulin.
Also, make sure to tell your doctor if you also take pioglitazone or rosiglitazone . This is because NPH insulin may contain inactive ingredients that can cause allergic reactions or other related problems.
At the same time tell your doctor or pharmacist your medical history, especially of cases such as thyroid problems, liver disease, adrenal/pituitary gland problems, kidney disease, and low levels of potassium in your blood . Before undergoing surgery, tell your doctor all about the NPH insulin you have been using along with other prescription drugs, nonprescription drugs, and herbal products you use.
Never give NPH insulin to children without advice from a physician, and dont use this medication if you tend to experience episodes of low blood sugar . Older adults and children are more sensitive to the side effects of this drug, especially low blood sugar. Also, in case you are traveling across time zones, consult your doctor regarding how to adjust the insulin schedule. You might as well take extra insulin and related supplies with you as a precaution in case of emergencies.
After precautions, another thing anybody using NPH insulin has to be cautious about is its correct storage.
How Do I Store And/or Throw Out Insulin Nph
- Store unopened containers in a refrigerator. Do not freeze.
- Do not use if it has been frozen.
- If an unopened container has been stored at room temperature, be sure you know how long you can leave insulin NPH at room temperature before you need to throw it away. If you are not sure, talk with the doctor or pharmacist.
- After opening, be sure you know how long the product is good for and how to store it. Ask the doctor or pharmacist if you are not sure.
- Protect from heat and light.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
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How Does Nph Work
Although broadly classified as a long-acting insulin, it may be more accurate to say that NPH is an intermediate-acting insulin in comparison to the newer generation of long-acting insulins. The medication begins to take effect between one and four hours after injection. Its peak effect occurs four to 12 hours after injection and keeps working for 12 to 18 hours after injection. For some people, it can take 24 hours to clear out of their system.
This insulin can also be mixed with certain other insulins, such as regular insulin. Consult with your doctor on whether mixing insulins is right for you. They can also instruct you on the correct way to do so.
What Is This Medicine
ISOPHANE INSULIN is a human-made form of insulin. This medicine lowers the amount of sugar in the blood. It is an intermediate-acting insulin that starts working about 1.5 hours after it is injected.
This medicine may be used for other purposes ask your health care provider or pharmacist if you have questions.
COMMON BRAND NAME: Humulin N, Novolin N, ReliOn
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What About Walmart Insulin
Walmart retail stores across the country carry Novolin insulins under the brand ReliOn. They typically cost the same as their Novolin counterpartsabout $25 for a 10ml vial of 100 units/ml.
Its important to keep in mind that ReliOn, like all other human insulins, is less predictable than insulin analogs, with more variability in glucose-lowering effects from one person to another. If youve read this far, youll know that this blog post and the studies it cites are only relevant to those with type 2 diabetes. Human insulins are less effective for those with type 1 diabetes, and type 1 advocacy group T1International has even issued a statement against relying on ReliOn, or Walmart insulin, in non-emergency situations.
What Should I Watch For While Using This Medicine
Visit your health care professional or doctor for regular checks on your progress.
A test called the HbA1C will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.
Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.
Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.
Tell your doctor or health care professional if you have high blood sugar. You might need to change the dose of your medicine. If you are sick or exercising more than usual, you might need to change the dose of your medicine.
Do not skip meals. Ask your doctor or health care professional if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.
Insulin pens and cartridges should never be shared. Even if the needle is changed, sharing may result in passing of viruses like hepatitis or HIV.
Each time you get a new box of pen needles, check to see if they are the same type as the ones you were trained to use. If not, ask your health care professional to show you how to use this new type properly.
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Research Design And Methods
Four open-label, randomized, parallel-group studies, conducted in Europe and North America, were identified in the Aventis research and development database using a predefined search criteria: insulin glarginecontrolled studies with NPH insulin in patients with type 2 diabetes. Each study compared insulin glargine administered at bedtime with NPH insulin administered once or twice daily in patients with type 2 diabetes. A summary of all studies included in the analysis is shown in all studies were of a similar design, consisting of a 1- to 4-week screening phase and a 24- to 28-week treatment phase with similar end points. It should be noted that while study 1 was a 52-week study, a complete interim analysis of the study was performed for the database at 20 weeks for the original U.S. New Drug Application. These interim data were used in the integrated analysis in order to compare patients with a similar treatment duration. The intent-to-treat population was used in the integrated analysis. Individual study definitions for the ITT population varied slightly but essentially included all patients who were randomized and treated with at least one dose of study medication. There was no post hoc definition of the ITT population. This applied to all hypoglycemia-related end points, in addition to HbA1c- and glycemic controlrelated end points.
Is Newer Always Better
Newer insulin analogs were developed so patients could worry less about mealtime planning without sacrificing glucose control. Such innovations deserve a higher price tag, but are they absolutely necessary? The JAMA study says maybe not.
Though a more flexible schedule may mean a higher quality of life for some patients, the reality is that many Americans cannot afford these insulins. As the study suggests, older, more cost-efficient insulins may lead to better treatment adherence and overall better health outcomes because people are actually filling and taking their medications as prescribed. After all, you cant take a medication if you dont have the money to purchase it.
There are a couple of other financial considerations. For one, fewer senior participants in the study reached the Medicare coverage gap, or donut hole, since they paid less for the older insulin. However, the relatively unpredictable nature of older insulins should be managed with more frequent testing, which translates to more money spent on test strips.
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Lantus Insulin Vs Novolin N
Diabetes is a condition in which a person’s blood sugar level is higher than normal. Novolin N and Lantus are types of insulin used to keep blood sugar within normal limits. Classification Lantus and Novolin N are classified therapeutically as antidiabetics or hormones. Their pharmacologic classification is pancreatics. Action Both medications lower blood sugar levels by stimulating absorption of glucose in skeletal muscle and fat. They also inhibit the production of glucose in the liver. Onset Novolin N is an intermediate-acting insulin that starts acting in from one to four hours after being taken. Lantus is a long-acting insulin that starts acting in from one to 10 hours after being injected. Peak The peak time of an insulin is the time during which the blood sugar is most affected. The peak time for Novolin N is four to 12 hours after administration. Lantus does not have a peak time because it is released at a constant rate. Duration Novolin N lasts for from 12 to 18 hours, while Lantus has a duration of up to 24 hours.Continue reading > >
What Are Newer Insulins
Newer insulins refer to insulin analogsessentially, human insulins whose proteins have been tweaked to change how quickly the insulin gets absorbed. Insulin analogs were introduced in the late 90s.
Bolus insulin analogs, or rapid-acting insulins, are absorbed into the bloodstream more quickly than human, short-acting insulins. Taken only 15 minutes before a meal, they peak in 1 2 hours, half the time it takes for human insulins. Because of this sharper peak, they offer more flexibility in routine: You can have an earlier or later meal and adjust injection times accordingly.
On the flip side, long-acting insulin analogs more closely mimic natural basal or background insulin profiles than intermediate-acting insulins as they have a short onset, no real peak, and stay at a steady level for a very long time. They are generally more stable and more predictable than intermediate-acting insulins, and require fewer injections throughout the day.
Rapid-acting insulin brands include Humalog and Novolog, and long-acting insulin brands include Lantus and Levemir. Then theres Tresiba, an ultra long-acting insulin, and Toujeo, which is the same insulin as Lantus, only three times more concentrated. They are both designed to last much longer than other basal insulins, so in theory, youll need a smaller dose each day.
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