Isophane insulin suspension (also called NPH)
(Humulin N, Novolin N)
Insulin zinc suspension (also called Lente)
(Humulin L, Novolin L)
Onset - 1-2 Hrs.
Duration - 10-18 Hrs.
Glargine (Lantus) Humulin L
Ultralente, Humulin U
Glargine (Lantus) Humulin L Onset - 1 Duration - 24+
Ultralente, Humulin U Onset - 6-10Hrs. Duration - 20-24Hrs.
Action / Side Effects
ACTION: Stimulate insulin secretion from beta cells of pancreas Beta cell function must be present for these drugs to work Improve sensitivity to insulin in tissues Result: Lower blood glucose levels First-generation drugs not frequently used
SIDE EFFECTS: Hypoglycemia, hematologic effects, nausea, epigastric fullness, heartburn, many others
ACTION: similar to sulfonylureas Increase insulin secretion from pancreas *most* effective within one hour of taking
SIDE EFFECTS: Headache, hypoglycemic effects, dizziness, weight gain, joint pain, URI or flu-like symptoms
ACTION: Do not give if NPO – Food Available soon inhibits liver and production Decrease production of glucose Increase uptake of glucose by tissues Does NOT increase insulin secretion from pancreas (does not cause hypoglycemia)
SIDE EFFECTS: Primarily affects GI tract: abdominal bloating/fullness, nausea, cramping, diarrhea May also cause metallic taste, reduced vitamin B12 levels (form of pernicious anemia) Lactic acidosis is rare, lethal if it occurs.
Pioglitazone (Actos), Rosiglitazone (Avandia) Also known as “glitazones”
Action/ Side Effects
ACTION: Genetic developer - Decrease insulin resistance, Are known as “insulin sensitizing drugs” Increase glucose uptake and use in skeletal muscle Inhibit glucose and triglyceride production in liver
SIDE EFFECTS: Moderate weight gain, edema, mild anemia Hepatic toxicity – monitor ALT levels closely
Amylin Mimetics - Sub Q
ACTION: Decreases postprandial plasma glucose levels. Slows gastric emptying, suppresses glucgon secretions and hepatic glucose production, increases satiety (sense of having eating enough)
SIDE EFFECTS: N/V/D/Anorexia, HA
ACTION: Stimulate insulin secretion from beta cells of pancreas Reduce postprandial glucagon production. Slow gastric emptying. Increases satiety. Take 60 min prior to meal