PRE. MIXED INSULIN

Pre-mixed insulin is a combination of intermediate-acting and short-acting insulin in one formulation. It is designed to provide both basal (long-term) and prandial (mealtime) insulin coverage in a single injection, simplifying insulin regimens for patients with diabetes mellitus.

Indications

Pre-mixed insulin is indicated for the management of type 1 and type 2 diabetes mellitus in patients who require both basal and prandial insulin coverage. It is particularly useful for patients who have difficulty managing multiple daily injections or complex insulin regimens.

Dosage

-Initial dose: Varies based on individual patient needs, typically starting with 10-12 units or 0.2-0.4 units/kg body weight per day. -Maintenance dose: Adjusted according to blood glucose monitoring results. Regular monitoring and dose adjustments are crucial to achieving optimal blood glucose control. -Administration: Usually injected subcutaneously before meals, typically twice daily.

Contra-Indications

-Hypersensitivity to insulin or any of the excipients in the formulation. -Episodes of hypoglycemia. -Patients with diabetic ketoacidosis.

Special Precautions

-Monitor blood glucose levels regularly to avoid hypoglycemia and hyperglycemia. -Adjust doses during periods of increased physical activity, stress, illness, or changes in diet. -Caution in patients with renal or hepatic impairment. -Educate patients on proper injection techniques to avoid injection site reactions and ensure consistent absorption. -Use with caution in elderly patients, who may be more susceptible to hypoglycemia.

Side Effects

-Hypoglycemia -Weight gain -Injection site reactions (e.g., redness, swelling, itching) -Lipodystrophy at the injection site -Allergic reactions (e.g., rash, pruritus, anaphylaxis) -Edema

Drug Interactions

-Hypoglycemic agents: Enhanced blood glucose-lowering effect when combined with other anti-diabetic drugs. -Beta-blockers: May mask the signs of hypoglycemia. -Corticosteroids, thyroid hormones, and sympathomimetics: May reduce the blood glucose-lowering effect of insulin. -Alcohol: May enhance or reduce the blood glucose-lowering effect of insulin.