insulin (Humulin R, Humulin N, Afrezza, Fiasp/NovoLog, Tresiba, Levemir, Lantus/Toujeo, Apidra, Admelog/Humalog)
common ADRs: injection site reaction, weight gain
rare ADRs: severe hypersensitivity, insulin resistance, severe hypoglycemia
interactions: BB (altered glucose metabolism and increased risk of hypoglycemia), FQs (altered glucose metabolism and increased risk of hypoglycemia and hyperglycemia), MAOIs (stimulation of insulin secretion, hypoglycemic effects), somatostatin analogues (altered glucose metabolism and increased risk of hypoglycemia), psyllium (psyllium may delay absorption of glucose from meals, leading to less postprandial hyperglycemia and potentially allowing a reduced dosage of antidiabetic agent)
efficacy: preprandial BG 80-130 mg/dL, HbA1c < 7%
-
-
-
counseling: monitor BG in frequent intervals; if < 70 mg/dL, eat non-sugar free candy, glucose tablets, or drink glass of juice and contact prescriber; store unopened vials in the fridge; keep open vials at room temp if it is painful to inject cold insulin; dispose needles in sharps container; do not share needles; rotate injection sites