Insulin Glulisine (Subcutaneous)

Overview

Diabetic patients are either unable to produce insulin or their insulin is ineffective in metabolizing glucose. As a result, their blood sugar levels can increase to dangerous levels if the patient is not given adequate treatment.

Although patients with diabetes suffer with similar symptoms, the condition is classified in two ways. Patients with type 1 diabetes are unable to produce insulin and, therefore, must be treated with medication. Type 2 diabetics are able to produce insulin but it is ineffective in processing glucose. Whilst type 2 diabetes can sometimes be treated by dietary and lifestyle changes, medication may also be needed.

Whilst Insulin Glulisine acts in a similar way to the natural insulin hormone, it is chemically different. Insulin Glulisine has lysine in place of the amino acid asparagine and also contains glutamic acid. Due to its fast-acting nature, Insulin Glulisine can be used to regulate blood sugar quickly and is often more fast-acting than natural insulin.

Without treatment, patients are likely to experience periods of high blood sugar, or hyperglycemia. This can involve increased thirst, fatigue, difficulty concentrating, increased urination, headaches, blurred vision and weight loss. If the patient's blood sugar levels continue to rise, they can suffer from seizures and may lose consciousness. As extreme hyperglycemia or hypoglycemia (low blood sugar) can be life-threatening, it's vital that patient's blood sugar is well-regulated.

Although Insulin Glulisine is used to treat diabetes mellitus, it is not a cure for the condition. Patients will need to have their blood sugar levels monitored regularly and their treatment modified in order to control their condition on a long-term basis. Whilst patients with type 2 diabetes may return to a pre-diabetic state with lifestyle and dietary changes, patients with type 1 diabetes are considered to have an autoimmune disease and will need medication on a permanent basis.

In most cases, Insulin Glulisine is prescribed alongside another diabetic medication. As Insulin Glulisine is fast-acting, patients are typically treated with a long-acting form of insulin as well. This enables greater blood sugar stability and can help to maintain healthy blood sugar levels. When used as part of a comprehensive treatment plan, Insulin Glulisine can effectively reduce the symptoms associated with diabetes mellitus and ensure that the patient does not suffer extreme episodes of either high or low blood sugar.

Conditions Treated

  • Diabetes mellitus

Type Of Medicine

  • Fast-acting insulin analogue

Side Effects

Any medication can cause patients to experience side-effects, although these tend to occur most commonly when patients first start using a new medicine. In some cases, these side-effects are fairly mild and do not require additional medical treatment. When patients first start using Insulin Glulisine, for example, they may experience the following adverse effects:

  • Difficulty with moving
  • Irritated, hot, red or dry skin
  • Ear congestion
  • Muscle aches
  • Loss of voice
  • Pain in the joints
  • Muscle stiffness or pain
  • Accumulation or redistribution of body fat
  • Blistering, discoloration of the skin, hives, lumps or infection at the injection site
  • Numbness, bleeding, coldness, warmth or feeling of pressure at the injection site
  • Scarring, burning, itching, rash, stinging, tenderness or pain at the injection site
  • Inflammation, swelling, soreness, redness, ulceration or tingling at the injection site

If the above side-effects are not troublesome to the patient and diminish over time, it may not be necessary for the patient to seek medical help. However, if the side-effects are severe or continue for some time, the patient should obtain medical advice.

In addition to this, patients will need to access medical assistance if they experience any of the following adverse effects when using Insulin Glulisine:

  • Blurred vision
  • Loss of consciousness
  • Anxiety
  • Pounding in the ears
  • Fast or slow heartbeat
  • Sore throat
  • Chest tightness
  • Body pain or aches
  • Sneezing
  • Chills
  • Slurred speech
  • Cold sweats
  • Shakiness
  • Confusion
  • Runny nose
  • Convulsions
  • Pale, cool skin
  • Nightmares
  • Cough
  • Loss of voice
  • Depression
  • Nasal congestion
  • Difficulty with breathing
  • Increased hunger
  • Dizziness
  • Headache
  • Ear congestion
  • Unusual weakness and/or tiredness
  • Difficulty with swallowing
  • Lightheadedness, faintness or dizziness when getting up suddenly from a sitting or lying position
  • Increased sweating
  • Pounding, irregular or fast pulse or heartbeat
  • Hives
  • Swelling or puffiness around the face, lips, tongue, eyes or of the eyelids
  • Itching
  • Rash on the skin

Furthermore, patients should obtain medical help if they experience any other side-effects whilst they are being treated with diabetes medication, such as Insulin Glulisine.

Dosage

Insulin Glulisine is used to regulate blood sugar and the patient's dose will, therefore, depend on their existing blood sugar levels. These will be checked by a healthcare professional so that the patient knows how much Insulin Glulisine to use. Patients should also be taught how to monitor their own blood sugar levels so that they can respond to emergencies, when it is necessary to do so.

Patients may also be advised to use this medicine at specific times of the day. If Insulin Glulisine is prescribed as a meal time medication, for example, patients may be instructed to administer it fifteen minutes before eating or meal or within twenty minutes of having started a meal.

Insulin Glulisine is typically administered via a subcutaneous injection. In most cases, patients will be taught how to inject the medicine themselves. Before doing so, patients should always check the dose and concentration of the medicine. In addition to this, patients should confirm that the Insulin Glulisine solution is colorless and clear before injecting it. If the solution contains any particles, is cloudy or appears thickened, patients should not use it. Instead, they should use another vial of medicine or contact their physician in order to obtain more medication.

Patients should not change the type or brand of Insulin Glulisine they use, unless their doctor has advised them to do so. When patients are given additional supplies of medicine, they should confirm that the correct type of insulin and the same brand is being prescribed to them.

When Insulin Glulisine is administered, it can usually be injected into the upper arm, the thigh, the stomach or the abdomen. Patients will need to inject the medicine into a different area each time and should never inject Insulin Glulisine into an area which is painful, swollen or has broken skin.

In some cases, Insulin Glulisine may be administered with an insulin pump. If so, patients should be shown how to use the pump and should not leave medication in it for longer than forty eight hours. Whether or not a pump is used to administer Insulin Glulisine, it should never be mixed with another medicine or diluted.

When patients are prescribed Insulin Glulisine, they may be given instructions to change their lifestyle and diet as well. Many diabetic patients will be given a special meal plan to follow and this can be extremely beneficial in controlling their symptoms. It's vital that patients adhere to any specific meal plans which have been prescribed to them.

Generally, Insulin Glulisine should be administered on a regular schedule and it's important that patients use the medication at the relevant times. If patients forget to administer a dose of Insulin Glulisine, they should contact their physician or pharmacist for advice. Patients should not attempt to administer a double dose of Insulin Glulisine or just miss a dose of medication as serious adverse effects may occur.

If patients are unsure how to administer Insulin Glulisine or when to use their medication, they could contact their pharmacist or physician for assistance.

Potential Drug Interactions:

Although some medicines can be used in conjunction with one another, others cannot. In fact, some medicines can cause an interaction when they are used at the same time and this could be dangerous for the patient. Generally, patients are not advised to use any of the following medications when they are being treated with Insulin Glulisine:

  • Balofloxacin
  • Pramlintide
  • Besifloxacin
  • Norfloxacin
  • Ciprofloxacin
  • Moxifloxacin
  • Enoxacin
  • Rosiglitazone
  • Fleroxacin
  • Pefloxacin
  • Levofloxacin
  • Prulifloxacin
  • Flumequine
  • Gatifloxacin
  • Lomefloxacin
  • Gemifloxacin
  • Lanreotide
  • Pazufloxacin
  • Liraglutide
  • Pioglitazone
  • Metreleptin
  • Rufloxacin
  • Nadifloxacin
  • Sparfloxacin
  • Octreotide
  • Thioctic Acid
  • Ofloxacin
  • Tosufloxacin
  • Pasireotide

Although the use of these medications alongside Insulin Glulisine is not usually recommended, it may be appropriate in some cases. If patients are prescribed Insulin Glulisine in conjunction with one of the above medicines, their dose may be altered to prevent an interaction or they may be advised to take their medication at a specific time.

If Insulin Glulisine is used in conjunction with any of the following medicines, it may increase the chance of side-effects occurring:

  • Acebutolol
  • Penbutolol
  • Albiglutide
  • Esmolol
  • Atenolol
  • Celiprolol
  • Betaxolol
  • Labetalol
  • Bisoprolol
  • Metipranolol
  • Bitter Melon
  • Methylene Blue
  • Carteolol
  • Nialamide
  • Carvedilol
  • Nadolol
  • Dulaglutide
  • Metoprolol
  • Exenatide
  • Oxprenolol
  • Fenugreek
  • Nebivolol
  • Furazolidone
  • Moclobemide
  • Glucomannan
  • Selegiline
  • Guar Gum
  • Timolol
  • Practolol
  • Iproniazid
  • Pindolol
  • Isocarboxazid
  • Propranolol
  • Levobunolol
  • Safinamide
  • Linezolid
  • Procarbazine
  • Lixisenatide
  • Rasagiline
  • Phenelzine
  • Sotalol
  • Psyllium
  • Tranylcypromine

Patients should also be aware that interactions can occur between prescription medications, foods, drinks, over-the-counter medicines, supplements and/or vitamins. For example, consuming ethanol (alcohol) is not recommended when patients are being treated with Insulin Glulisine.

In order to prevent an interaction occurring, patients should tell their doctor if they are using any over-the-counter medicines, supplements or vitamins before they begin using Insulin Glulisine. Similarly, patients should obtain medical advice before using any supplements, vitamins or over-the-counter medicines once they have begun treatment with Insulin Glulisine.

Warnings

If patients have any other health problems, they should notify their physician before they start using this medicine. Similarly, if patients have a history of certain conditions, they will need to notify their doctor. There are certain conditions which may be particularly relevant if the patient is due to undergo treatment with Insulin Glulisine. These may include:

  • Liver disease
  • Kidney disease
  • Low levels of potassium in the blood (Hypokalemia)
  • Low blood sugar (Hypoglycemia)
  • Stress
  • Infection
  • Illness
  • Fever
  • Emotional disturbance

To date, specific studies regarding the effects of Insulin Glulisine on pediatric patients have not been carried out. Due to this, children and infants are not usually prescribed Insulin Glulisine and may not be treated with this medication.

Insulin Glulisine can be prescribed to elderly patients but they are more likely to suffer from side-effects when using this medicine. As a result, geriatric patients may require more frequent monitoring when they are being treated with this medicine.

Patients should never share needles, medicine pens or insulin cartridges with anyone else. Sharing medical equipment in this way can lead to the transmission or viruses and other blood-borne illnesses.

When patients are diagnosed with diabetes mellitus, they may be given specific advice, such as:

  • Not to take any other medicines unless approved by their doctor, particularly aspirin, cold, flu and cough remedies, asthma medication, allergy or hay fever medicine, appetite control supplements or medicines and/or sinus medications.
  • Not to drink or consume alcohol due to the effect it can have on blood sugar levels
  • To take part in counselling in order to make effective and permanent lifestyle changes
  • To educate their family and close friends about their condition
  • To take additional medication and copies of prescriptions and medical records with them when they travel

During treatment with Insulin Glulisine, patients should have regular consultations with their physician and regular blood and urine tests should be performed. This will enable the patient's doctor to determine how the medicine is working and ensure that it's not having any harmful effects on the patient.

As well as being prescribed Insulin Glulisine, patients may be advised to wear a medical identification bracelet when they are diagnosed with diabetes mellitus. This will inform people that the patient is diabetic if a medical emergency occurs. Similarly, patients may be instructed to carry a medical information card with them as this can contain crucial details about their treatment and condition.

Patients should keep an extra supply of needles and Insulin Glulisine with them at all times in case an episode of high blood sugar occurs.

Patients should also keep some form of fast-acting sugar with them in case they experience a period of low blood sugar. In addition to this, patients should be given an emergency glucagon kit in case of severe hypoglycemia. It's important that patients carry this with them at all times and instruct family members how to administer the medication. Extremely low blood sugar can cause the patient to lose consciousness so they may be unable to administer emergency medication themselves. Family members or close friends should, therefore, be aware of when and how to administer glucagon.

If patients use Insulin Glulisine too often or administer too much medication, they may experience low blood sugar. Similarly, drinking alcohol, missing a meal, using additional diabetes medication, doing more exercise than usual or being unable to eat due to nausea, vomiting and diarrhea can cause low blood sugar levels. Symptoms of low blood sugar can include:

  • Dizziness
  • Abnormal behavior
  • Confusion
  • Blurred vision
  • Appearing drunk
  • Nightmares
  • Nervousness
  • Anxiety
  • Difficulty thinking
  • Depression
  • Cold sweats
  • Confusion
  • Lightheadedness
  • Fast heartbeat
  • Headache
  • Irritability
  • Shakiness
  • Restless sleep
  • Excessive hunger
  • Tingling in the lips, feet, hands or tongue
  • Slurred speech

However, everyone experiences different symptoms when they have low blood sugar. Patients should learn to recognize their own symptoms of low blood sugar so that they can take action when an episode of hypoglycemia occurs. If patients start to experience the symptoms of low blood pressure, they can do one of the following in order to increase their blood sugar:

  • Drink fruit juice
  • Consume honey
  • Drink a non-diet soft drink
  • Use a glucose tablet or gel
  • Eat something containing fast-acting sugar
  • Eat sugar cubes
  • Drink sugar dissolved in water

If symptoms persist or worsen, patients should obtain urgent medical assistance. If the symptoms associated with extremely low blood sugar occur, such as a loss of consciousness or convulsions, emergency medical help must be sought and the patient's glucagon kit may need to be administered.

If patients forget to administer a dose of Insulin Glulisine, do not follow their meal plan, have an infection or fever, do not exercise as much as usual or overeat, they may experience an episode of high blood sugar. Symptom of high blood sugar may include:

  • Increased urination
  • Fruit-like breath odor
  • Flushed, dry skin
  • Blurred vision
  • Dry mouth
  • Drowsiness
  • Loss of appetite
  • Ketones in the urine
  • Stomach pain or ache
  • Trouble breathing (may be rapid and deep)
  • Nausea
  • Vomiting
  • Unusual thirst
  • Unconsciousness
  • Tiredness

If patients experience an episode of high blood sugar, they should check their blood sugar levels and contact their doctor for assistance.

Using Insulin Glulisine can make patients feel drowsy, dizzy or less alert than normal. Similarly, episodes of hyperglycemia and hypoglycemia can cause these symptoms. If affected, patients should not attempt to operate machinery, drive or carry out potentially dangerous tasks.

Patients may find it more difficult to control their blood sugar if they become pregnant. If patients are planning to become pregnant, they should consult their physician before trying to conceive so that an appropriate form of treatment can be put in place.

Insulin Glulisine is classified as category C drug by the Food and Drug Administration and may, therefore, cause harm to an unborn fetus if it is used by a pregnant patient. Due to this, Insulin Glulisine is not usually used to treat pregnant women, unless the benefits of the medication clearly outweigh any risks.

If patients become pregnant whilst using Insulin Glulisine, they should contact their physician immediately.

It is not known whether Insulin Glulisine poses a risk to infants if patients breastfeed whilst receiving treatment with this medication. Due to this, patients are generally advised not to breastfeed whilst using this medication and should obtain medical advice before doing so.

Prior to using Insulin Glulisine, patients should discuss any existing allergies with their physician. In rare cases, Insulin Glulisine can cause patients to exhibit an allergic reaction which includes anaphylaxis. This is a life-threatening medical emergency and patients will require immediate treatment. The symptoms of an allergic reaction may include:

  • Itching
  • Swelling of the tongue, face, throat, lips, tongue or mouth
  • Shortness of breath
  • Rash on the skin
  • Trouble breathing
  • Difficulty swallowing
  • Hoarseness
  • Hives
  • Wheezing
  • Chest pain

Storage

As patients are usually advised to use Insulin Glulisine on a regular basis, they will need to store their medication at home. Similarly, patients are normally instructed to carry a supply of Insulin Glulisine with them at all times in case a medical emergency occurs. When storing Insulin Glulisine, however, patients must ensure that it's kept safe and that no-one else can access it. It is particularly important that children and/or pets cannot gain access to this medicine.

When storing Insulin Glulisine, patients should follow the manufacturer's guidelines. Generally, unused and prefilled insulin pens should be kept refrigerated until they are needed. They should not be frozen and should be protected from the light.

Patients may also be able to keep Insulin Glulisine at room temperature, providing they are used within twenty eight days. Even when Insulin Glulisine vials are kept at room temperature, they should be stored in a relatively cool location and kept away from heat and/or sunlight. Prefilled Insulin Glulisine pens which are currently in use should not usually be kept in a refrigerator.

If patients are unsure how to store Insulin Glulisine safely, they should contact their pharmacist or physician for advice.

If the medication expires or patients are advised to stop using it, they will need to dispose of it carefully. Instead of throwing Insulin Glulisine and medical equipment out with regular household waste, patients should contact their pharmacist or physician's office and use a specialist medicine waste disposal service.

Summary

Without treatment, diabetes mellitus can be a potentially fatal condition and can increase the patient's risk of suffering serious health complications. As well as causing a number of severe symptoms, diabetes can precede conditions, such as strokes, heart attacks and retinal neuropathy.

In order to prevent these complications occurring, patients should aim to keep their blood sugar levels within a normal range. By using Insulin Glulisine, patients can keep their blood sugar levels stable and avoid periods of high and low blood sugar. With careful monitoring, Insulin Glulisine can be used to successfully treat diabetes and to significantly improve the patient's quality of life.