Insulatard (Insulin Human)

Insulatard is used to provide basal insulin therapy in the management of diabetes mellitus.

• Type 1 diabetes mellitus: supplies long‑acting insulin to control fasting glucose and reduce hyperglycaemia.
• Type 2 diabetes mellitus: adds basal insulin to supplement endogenous secretion and improve overall glycaemic control.

• Insulin Human binds to insulin receptors on muscle, adipose and hepatic cells, activating the receptor’s intrinsic tyrosine kinase activity. This triggers intracellular signaling cascades that promote translocation of GLUT‑4 transporters, increasing glucose uptake, and suppresses hepatic gluconeogenesis, thereby lowering circulating blood glucose levels. The intermediate‑acting formulation releases insulin gradually after subcutaneous injection, providing a prolonged basal effect.

Insulatard may be associated with a range of adverse reactions, which are classified by frequency and severity.

Common Side Effects

• Hypoglycaemia: low blood glucose episodes, especially if meals are missed or dosing is excessive.
• Injection‑site pain or erythema: mild discomfort or redness at the injection site.
• Lipodystrophy: localized thickening or loss of subcutaneous fat with repeated injections.
• Weight gain: modest increase in body weight over time.
• Edema: mild fluid retention, often in the lower extremities.
• Allergic skin reaction: itching or rash at the site.

Serious or Rare Side Effects

• Severe hypoglycaemia: profound low glucose requiring assistance.
• Anaphylactic reaction: life‑threatening systemic allergy with airway compromise.
• Insulin antibodies: formation of antibodies that may alter insulin action.
• Hypokalemia: low potassium levels secondary to rapid glucose shift.

When using Insulatard, several precautions should be observed to ensure safe and effective therapy.

• Dose titration: adjust the dose gradually based on self‑monitored blood glucose and clinical response.
• Hypoglycaemia risk: educate patients to recognise and treat low glucose promptly.
• Renal or hepatic impairment: monitor closely and consider dose reduction in severe dysfunction.
• Pregnancy and lactation: use only if the potential benefit outweighs uncertain risk, as safety data are limited.
• Concomitant medications: review other glucose‑lowering agents to avoid additive hypoglycaemic effect.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake the suspension.

Insulatard can interact with other medicines, influencing glucose control or insulin action.

Major Interactions (Avoid)

• Sulfonylureas or meglitinides: combined use markedly increases risk of severe hypoglycaemia.
• Beta‑blockers: may mask typical hypoglycaemia symptoms such as tachycardia.
• MAO‑inhibitors: rare reports of potentiated insulin effect leading to hypoglycaemia.

Moderate Interactions (Monitor Closely)

• Oral hypoglycaemic agents (e.g., metformin, DPP‑4 inhibitors): additive glucose‑lowering effect may require dose adjustment.
• Corticosteroids: can raise blood glucose, potentially necessitating higher insulin doses.
• Thiazide diuretics: may cause modest hyperglycaemia, requiring closer monitoring.