Diabetes is a condition that many people in our society are now experiencing. So your doctor may have told you to use an insulin injection. Among them, we are going to talk about the type called Isophane Insulin, or NPH, today. There are many important things to know when using this. Let's talk about it precisely, simply.
What is Isophane Insulin (NPH)?
Simply put, Isophane Insulin is a medicine used to control diabetes. It works by increasing the level of insulin in our body and reducing the level of sugar (glucose) in the blood. It belongs to the category of 'intermediate-acting insulin' . This means that after it is given to the body, it works for a few hours, controlling the level of sugar in the blood.
In most cases, along with this medication, it is also very important to control your diet and exercise . It is only when these three come together that diabetes can be best controlled.
Things you need to tell your doctor before using the medicine
Before prescribing this medicine, your doctor will need to know your complete medical history. Therefore, if you have any of the conditions listed below, be sure to tell them about it.
| Your situation | Why is it important? |
|---|---|
| If blood sugar levels drop frequently (Hypoglycemia) | This is important for adjusting the dose, as insulin can cause blood sugar levels to drop even lower. |
| Eye diseases, vision impairment | Since diabetes affects the eyes, the doctor should be aware of the existing conditions. |
| Kidney disease | Because insulin is removed from the body by the kidneys, kidney patients may need a lower dose. |
| Liver disease | The liver affects insulin action, so the dosage may need to be adjusted. |
| Allergies to insulin or other medications, foods, or dyes | This is essential to prevent allergies and to choose the most appropriate medication. |
| If you are pregnant or trying to get pregnant | Insulin needs change during pregnancy, so you should follow your doctor's advice. |
| If you are a breastfeeding mother | To be mindful of how insulin dosage affects mother and baby. |
How exactly do you use this medicine?
This is an injection that is given under the skin. Your doctor or nurse will tell you exactly how to use it. It is very important to follow those instructions exactly .
- Check the appearance: This insulin should be a clear, milky liquid that is usually white in color . Do not use it if it is not uniformly cloudy or has a different color.
- Mix properly: Before use, mix the vial or pen well by rolling it between your palms. Do not shake.
- Disposing of needles: Do not throw used needles and syringes in the trash. Put them in a special container (sharps container). If you don't have one, you can ask your doctor for one.
- If using a pen: If using an insulin pen, remember to remove the outer needle cover from the needle before injecting.
Warning: If you think you have taken more than the prescribed dose, immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
What if I miss a dose of medicine?
This is something you should discuss with your doctor. He or she will give you a plan for what to do at such times. Do it that way. Never take two doses at once.
Other things that may interact with this insulin
Other medications, vitamins, or herbal products you may be taking can affect the way this insulin works. So, give your doctor a complete list of everything you use. Be especially careful about these:
- Alcohol
- Painkillers such as aspirin
- Some medications for blood pressure (e.g. Atenolol, Metoprolol)
- Female hormones (including birth control pills) and male hormones
- Weight loss medication
- Medicines for colds, coughs, and allergies
- Some medications for mental illness
- Other diabetes medications (e.g., Glyburide, Glipizide)
- Steroid-containing medications (e.g. Prednisone)
- Thyroid hormone medication
- Some herbal supplements
This list is not complete. Therefore, it is safest to tell your doctor about everything you take.
Things to consider when using insulin
- HbA1C test: Your doctor will ask you to take a blood test called HbA1C (A1C) . This measures how well you have controlled your blood sugar over the past 2-3 months.
- Test your blood sugar: Learn how to test your blood sugar at home. Learn the symptoms of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) and how to manage them.
- Keep something sweet nearby: Always keep something sweet, such as a candy bar or glucose tablet, nearby to eat quickly if you experience symptoms of low blood sugar.
- Don't skip meals: Eat at regular times. Ask your doctor about alcohol.
- Do not change medications: Do not change insulin brand or syringe type without your doctor's advice.
- Never share: Never share your insulin pen or cartridge with anyone else. Even if you change the needle, you can still spread viruses like HIV and Hepatitis.
- Wear a medical ID: It is very important to have a medical ID bracelet or card with you in case of an emergency, which contains details about your medical condition and medications.
Possible side effects of the medicine
Like any medicine, insulin can cause some side effects, some of which can be life-threatening.
| Nature of the side effect | Symptoms |
|---|---|
| Things to report to your doctor immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Low blood sugar (Hypoglycemia) | Tremors, excessive sweating, restlessness, dizziness, rapid heartbeat, confusion. |
| Decreased potassium in the blood | Muscle pain or cramps, unusual weakness, irregular heartbeat. |
| If it persists or is bothersome, tell your doctor. | |
| Changes at the injection site (Lipodystrophy) | Repeated piercings in the same spot can cause thickening of the tissue under the skin or scarring. |
| Pain or redness at the injection site | Slight pain, redness, or swelling at the injection site. |
| Weight gain | Some people experience weight gain with insulin use. |
How to store insulin?
It is very important to store insulin properly. Otherwise, it may lose its effectiveness. These instructions may vary slightly depending on the brand you use.
| Status | Storage instructions |
|---|---|
| Unopened bottles and pens | |
| Where to store | Keep it in the fridge , but not in the freezer. Do not use frozen insulin. |
| Expiration | Do not use after the expiration date. |
| In-use bottles and pens | |
| Where to store | Store at room temperature. Do not refrigerate after use. Keep away from excessive heat and direct sunlight. |
| Time to throw away | This varies from type to type. For example, some pens should be discarded after 14 days, some after 28 days, and some bottles after 31 or 42 days. Ask your doctor about the expiration date for your type of insulin. After the expiration date, throw away any remaining insulin. |
Take-Home Message
- Take insulin at the exact dose and time prescribed by your doctor. Never change the dose yourself.
- Be aware of the symptoms of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia). Keep something sweet nearby in case of an emergency.
- Do not share your insulin pen, syringe, or needle with anyone else for any reason.
- Tell your doctor about all other medications, vitamins, and herbal products you are taking.
- Store insulin correctly. Protect from excessive heat, sunlight, and freezing.
- If you have any concerns or doubts, talk to your doctor immediately.
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