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Common/useful drugs
Published in Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson, Pocket Prescriber Psychiatry, 2019
Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson
HUMALOG short-acting recombinant insulin. Also available as biphasic preparations (Mix 25, Mix 50), are combined with longer-acting isophane suspension.
Diabetes in Pregnancy
Published in Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu, Medical Management of Diabetes Mellitus, 2000
Regimens that achieve tight glycemic control usually require three to four injections per day of a combination of an intermediate-acting insulin such as NPH and a short-acting regular insulin. Ultralente insulin is discouraged, as its longtime course does not allow for the rapid changes often necessary in managing diabetes in pregnancy. Likewise, premixed 70/30 insulin lacks the flexibility needed. A safety and efficacy trial of Humalog (lispro insulin) is currendy underway at our center. With its unique rapid onset of action, Humalog (lispro insulin) may be especially useful in the pregnant diabetic women with problematic postprandial blood sugar levels. If the patient currendy in good control with an insulin pump, she may continue. However, we recommend that the pump insulin be switched to regular insulin rather than lispro insulin so that should the pump malfunction or be dislodged, the patient may have a little added protection against entering ketosis.
Clinical characteristics and patient treatment satisfaction with Humalog U-200 in patients with type 2 diabetes mellitus: an observational study
Published in Journal of Drug Assessment, 2020
Jil Mamza, Uchena Anyanwagu, Mohammed Alkharaiji, Iskandar Idris
Insulin lispro 200 units/ml (Humalog U-200 KwikPen) is a concentrated rapid-acting insulin analog bio- and therapeutically equivalent to the 100 units/ml Humalog formulation1. However, U-200 KwikPen holds 600 total units of insulin in the same sized pen that previously could only hold 300 total units. Specific advantages of U-200 compared with conventional U-100 insulin include less volume for injection resulting in an easier glide force for injection2. Given the importance of simplifying insulin injection3 by using less volume and less force required for injection, it is hypothesized that the use of Humalog U-200 may contribute to improving treatment adherence and, consequently, metabolic control. Additionally, since each pen last longer, patients will not be required to request repeat prescription as frequently, which would ensure less risks of missing injections due to pen running out of insulin. Although, Humalog U-200 is a practical alternative regimen to people with diabetes who take higher doses of rapid-acting (e.g. >0.5 units/kg), post-marketing surveillance or real-world evidence assessing the use of U-200 insulin in routine practice is lacking.
A comparative evaluation of written medicine information of antidiabetic medicines from Qatar, Australia and Europe
Published in Cogent Medicine, 2019
Emad Eldin Munsour, Ahmed Awaisu, Mohamed Azmi Ahmad Hassali, Hamda Ali, Zeinab Dabbous
Thirty-six WMI documents were considered for evaluation from the three sources; each source was represented by 12 WMI with the same brand names to avoid inter-generic variability as discussed in a previous study (Munsour et al., 2017). All of the evaluated WMI documents described brand-name products, namely: Galvus® (vildagliptin), Januvia® (sitagliptin), Lantus® (insulin glargine) vial, Lantus® (insulin glargine) SoloSTAR®, NovoRapid® (insulin aspart) FlexPen®, NovoRapid® (insulin aspart) vial, NovoMix® (insulin aspart) FlexPen®, Humalog® Mix 75/25 (75% insulin lispro protamine suspension and 25% insulin lispro injection) KwikPen®, Actrapid® (human insulin) vial, Victoza® (liraglutide) injection, Levemir® (insulin detemir) FlexPen®, and Actos® (pioglitazone). We considered only the English version of the evaluated WMI. The 12 WMI from Qatar do not follow a specific format, while those from Australia and the EMA follow the CMI and PIL formats, respectively. The mean number of words of the 36 WMI was 3461.69 ± 1092.43; the minimum and maximum number of words were 1429 (Januvia-Qatar) and 6605 (Victoza-Qatar), respectively. A One Way ANOVA test of the evaluated WMI showed no significant effect of the source on the number of words (F = 0.39, p = 0.675). The details about the number of words from the different sources are described in Table 1.
Finally, after 56 years of type 1 diabetes: a regimen that works
Published in Postgraduate Medicine, 2018
A 62-year-old white female developed type 1 diabetes at age 6. For the next 12 years she was treated with a single daily injection of NPH insulin. At age 18 and for the next 12 years she was treated with twice daily injections of mixed NPH and regular insulin. At the time due to poor glycemic control and hyperglycemia, she was converted to a basal bolus regimen with subcutaneous injections of regular human insulin (Humalog) three times daily before meals and a single subcutaneous injection of NPH at bedtime. On these regimens, she had managed to maintain reasonable glycemic control (HbA1c between 6.8% and 7.8%) and avoid any microvascular (retinopathy, nephropathy, neuropathy) or macrovascular (ischemic heart disease, cerebrovascular disease, peripheral vascular disease) complications. However, this excellent glycemic control was obtained at the expense of frequent, severe, and nocturnal hypoglycemia. In addition, because of her small stature (5ʹ 0ʺ, 123 lbs, BMI 24), one unit of insulin would reduce her serum glucose by 100 mg/dl which led to both hyperglycemia and hypoglycemia due to the inability to accurately calculate and deliver a dose of regular insulin.