Insulin Isophane

Introduction To Insulin Isophane

Insulin Isophane is used to improve blood sugar control in adults and children with type 1 and type 2 diabetes mellitus. It is an intermediate-acting type of insulin that helps to lower blood sugar levels and reduce the chances of developing serious complications of diabetes.

Insulin Isophane is often prescribed along with short-acting insulin or other oral diabetes medicines. Your doctor or nurse will teach you the correct way of injecting it under the skin. Don't stop taking it unless your doctor tells you to. It is only part of a treatment program that should also include a healthy diet, regular exercise, and weight reduction as advised by your doctor.

Check your blood sugar levels regularly, keep track of your results and share them with your doctor. This is very important to work out the correct dose of the medicine for you.

The most common side effect of this medicine is low blood sugar levels (hypoglycemia). To prevent this, it's important to always inject the correct dose of medicine only, have regular meals, and monitor your blood sugar levels regularly. Drinking excessive alcohol can also lead to a fall in your blood sugar levels. Other side effects include reactions at the injection site like redness or swelling. Repeated puncturing of the same site of the skin may lead to lipodystrophy (skin thickening or pits at the injection site). Some people may gain weight or develop edema (swelling over the whole body due to fluid retention) while taking insulin.

Do not use this medicine when you have low blood glucose levels (hypoglycemia). Tell your doctor if you have ever had kidney, liver or heart problems before starting treatment. Pregnant or breastfeeding women should also consult their doctor as the dose may need to be changed.

Uses of Insulin Isophane

  • Diabetes

Benefits of Insulin Isophane

Diabetes
Insulin Isophane is an intermediate-acting type of insulin that is usually used along with other diabetes medication for controlling blood sugar levels. It replaces the insulin that is normally produced in the body. This helps the glucose get into your muscle and fat cells so your body can use it for energy. It also decreases glucose production in the liver.

Lowering of blood sugar level helps reduce the risk of getting any of the serious complications of diabetes such as kidney damage, eye damage, nerve problems, and loss of limbs. Learn exactly how, where, and when to inject this insulin for it to be most effective. Take it regularly along with proper diet and exercise for a normal, healthy life.

Side effects of Insulin Isophane

Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them

Common side effects of Biosulin N

  • Hypoglycemia (low blood glucose level)

How to use Insulin Isophane

Your doctor or nurse will give you this medicine. Kindly do not self administer.

How Insulin Isophane works

Insulin Isophane is an intermediate-acting insulin, that starts working in 1-2 hours after injection. It works similar to the insulin that is produced by the body. Insulin facilitates reuptake of sugar in muscle and fat cells and also suppresses the production of sugar in the liver. This helps to lower the blood sugar levels in diabetes mellitus.

Quick tips

  • Hypoglycemia (low blood sugar level) is a common side effect. Hence, regular monitoring of blood sugar levels is required while taking this medicine.

  • Injection below the skin of the abdomen results in faster absorption than other injection sites.

  • Injection sites must be rotated to prevent hard lumps from developing at one site.

  • Opened vials/cartridge are good at room temperature for up to 4 weeks, while unopened vials must be placed in the refrigerator (2°C–8°C).

Safety Advice

sdsPregnancySAFE IF PRESCRIBED

Can I take Insulin Isophane if I’m pregnant?

Insulin Isophane is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies.

sdsBreastfeedingSAFE IF PRESCRIBED

Can I take Insulin Isophane if I’m breastfeeding?

Insulin Isophane is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.

sdsAlcoholUNSAFE

Is drinking alcohol while taking Insulin Isophane safe?

It is unsafe to consume alcohol with Insulin Isophane.

sdsDrivingCAUTION

Can I drive after taking Insulin Isophane?

Your ability to drive may be affected if your blood sugar is too low or too high. Do not drive if these symptoms occur.

sdsKidneyCAUTION

Can I take Insulin Isophane if I have/had kidney diseases?

Insulin Isophane should be used with caution in patients with kidney disease. Dose adjustment of Insulin Isophane may be needed. Please consult your doctor. Regular monitoring of blood glucose levels is recommended for dose adjustment.

sdsLiverCAUTION

Can I take Insulin Isophane if I have/had liver diseases?

Insulin Isophane should be used with caution in patients with liver disease. Dose adjustment of Insulin Isophane may be needed. Please consult your doctor. Regular monitoring of glucose levels is recommended for dose adjustment.

Frequently Asked Questions

Q. How does biphasic isophane insulin work?

Insulin isophane is a recombinant human insulin analogue (genetically modified insulin that is grown in a laboratory and similar to human insulin). It is an intermediate acting insulin preparation. Insulin isophane acts by replacing the normal production of insulin and by helping transfer sugar from the blood into other body tissues where it is utilized to generate energy. It also stops the liver from producing more sugar. Intermediate acting insulin preparations start acting within an hour or 2 of injection, and reach a period of peak activity that lasts up to 7 hours, following which the action trails off; overall duration of action ranges from 18 to 24 hours.

Q. What is Insulin Isophane?

How is it made? Insulin Isophane is a man-made version of human insulin, produced by the process of biotechnology called recombinant DNA technology. It is sold as a sterile, aqueous, clear, and colorless solution that contains insulin aspart along with other constituents like glycerin, phenol, metacresol, zinc, sodium chloride etc.

Q. Can Insulin Isophane cause hypoglycemia?

How do I prevent it? Yes. The most common side effect of Insulin Isophane is hypoglycemia. It happens more often if you miss or delay your food, drink alcohol, over-exercise or take other antidiabetic medicine along with it. So, don’t skip meals and be consistent in the timing and amount of your meals. Take some snacks as per your requirement if you over exercise. Regular monitoring of the blood sugar level is important. Always carry some glucose tablets, honey or fruit juice with you. Take all your medicines prescribed by the doctor on time and consult your doctor if you notice any fluctuations in your blood sugar levels.

Q. What are the other side effects of Insulin Isophane?

How to prevent them? The other side effects of Insulin Isophane are injection site reactions such as redness, itching, pain and swelling. However, these are temporary and usually resolve on their own. Rarely, it can also cause lipodystrophy, which means abnormal changes in the fat tissues due to repeated insulin injections in the same area of the skin. It includes lipohypertrophy (thickening of adipose tissue) and lipoatrophy (thinning of adipose tissue), and may affect insulin absorption. Rotate insulin injection or infusion sites within the same region to reduce the risk of lipodystrophy.

Q. How should Insulin Isophane be used?

Insulin Isophane is injected under the skin (subcutaneously). Your doctor will show you the area of your skin where you should inject it. Try not to inject on the same spot every time. Rotate between the typical injection sites, such as abdomen, buttocks, upper legs, or upper arms. Never inject Humalog into a muscle or vein. Move to a new injection site every week or two. Inject in the same area of the body, making sure to move around within that area with each injection, for one or two weeks.Then move to another area of your body and repeat the process. Use the same area for at least a week to avoid extreme blood sugar variations.

Q. Is Insulin Isophane given as an injection into a vein (intravenous)?

Yes, sometimes, in specific situations like diabetic ketoacidosis, severe hyperglycemia etc, Insulin Isophane may be given as an injection into a vein (intravenous). However, it is only given by a doctor, under continuous monitoring of blood sugar levels in a hospital setting.

Q. Is Insulin Isophane safe to use in pregnancy?

Yes. Insulin Isophane is safe to use in pregnancy if prescribed by a doctor. However, please inform your doctor if you are pregnant, planning to conceive or breastfeeding before using Insulin Isophane. You may require dose modifications and your doctor will advise you to monitor your blood sugar levels regularly. You must follow the instructions of your doctor to get maximum benefit.

Q. When does the dosage of Insulin Isophane need to be changed?

You should consult your doctor for dose adjustment if you experience weight gain or loss, increased stress, illness, changes in diet such as missed meals or if you are taking alcohol. Your dose may also change if you have recently changed your exercise regime or are taking any medicines. Also, you must be vigilant on the changes you experience while first using Insulin Isophane. For eg, you may notice certain side effects that are usually temporary but if these are very severe, you may need dose modifications.

References

Written By:

Dr Advikka Ridhy

Dr Advikka Ridhy

MBBS

RMO, Aster MIMS

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