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INSULIN THERAPY
supplementary or absolute
depending upon the indication.
Intermediate acting isophane insulin works well on its own in these patients but a soluble component is often needed to achieve good glycemic control. Soluble insulin can be added if postprandial hyperglycemia 2 hours after a meal is excessive (> 180 mg/dl).
A few elderly patients can be managed on once daily lente insulin. Lente insulin is regular insulin complexed with zinc to form a long acting suspension and cannot be mixed with soluble insulin.
When mixing of two different types of insulin is required in a single syringe then mutual contamination of the two vials must be avoided. What is equally important is that you must always load the rapid acting insulin first and then the intermediate or long acting insulin. If you do the reverse then you are likely to change the time action profile of the short or rapid acting insulin. Once the injection is prepared inject immediately and definitely not after 5 minutes.
Intermediate acting isophane insulin works well on its own in these patients but a soluble component is often needed to achieve good glycemic control. Soluble insulin can be added if postprandial hyperglycemia 2 hours after a meal is excessive (> 180 mg/dl).
A few elderly patients can be managed on once daily lente insulin. Lente insulin is regular insulin complexed with zinc to form a long acting suspension and cannot be mixed with soluble insulin.
Mixing
of Insulin :
When mixing of two different types of insulin is required in a single syringe then mutual contamination of the two vials must be avoided. What is equally important is that you must always load the rapid acting insulin first and then the intermediate or long acting insulin. If you do the reverse then you are likely to change the time action profile of the short or rapid acting insulin. Once the injection is prepared inject immediately and definitely not after 5 minutes.
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