Insulin human

Insulin is a hormone that primarily regulates glucose metabolism. Human insulin, a short-acting preparation, binds to insulin receptors on target cells (e.g., muscle, adipose tissue) to promote glucose uptake and utilization. It also inhibits hepatic glucose production and lipolysis, thereby lowering blood glucose levels.

Adult

T1DM: total 0.5-1.0 U/kg/day, ~40-50% basal (NPH) + 50-60% prandial (regular insulin pre-meals). T2DM after oral failure: basal insulin 10 U/day or 0.1-0.2 U/kg/day, titrate to fasting glucose. DKA: IV regular insulin 0.1 U/kg/h after initial assessment. Hyperkalaemia: 10 U regular insulin IV + 25 g dextrose.

Pediatric

Continuous subcutaneous insulin infusion is recommended as an option for children 12 years and over with type 1 diabetes. Also recommended for children under 12 years with type 1 diabetes if multiple-injection regimens are impractical/inappropriate. Children on insulin pumps should undergo a trial of multiple-injection therapy between ages 12 and 18 years.

Renal adjustment

Requirements typically decrease in renal impairment (reduced renal insulin clearance) — reduce dose and monitor closely for hypoglycaemia. [Precise eGFR-banded % reductions: NEEDS MANUAL SOURCING]

Hepatic adjustment

Requirements may decrease in hepatic impairment (reduced insulin clearance and gluconeogenesis → hypoglycaemia risk); individualize and monitor

Max dose

No fixed maximum; individualized to glucose pattern. Typical T1DM total daily dose 0.5-1.0 U/kg/day; severe insulin resistance may require >2 U/kg/day

• Hypersensitivity to insulin human or any excipient
• Active hypoglycaemia
• Hypoglycaemia unawareness (relative — individualize and monitor closely)