Lupinsulin N/Lupinsulin R:
The most frequent complication of insulin therapy is hypoglycemia, the speed of onset and duration of which may vary according to the type of preparation used and the route of administration. It is usually associated with an excessive dosage of insulin, the omission of a meal by the patient or increased in physical activity. Patients, especially the elderly or those with diabetes of long standing, may not experience the typical early warning symptoms of a hypoglycemic attack. There have been reports of hypoglycemia, sometimes with decreased warning symptoms, in patients changing from bovine or porcine to human insulin. Symptoms of hypoglycemia resulting from increased sympathetic activity include hunger, pallor, sweating, palpitations, anxiety and tremulousness. Symptoms resulting from neuroglycopenia include headache, visual disturbances eg, blurred or doubled vision, slurred speech, paresthesia of the mouth and fingers, alterations in behavior and impaired mental or intellectual ability. If untreated, hypoglycemia may lead to convulsions and coma which should not be confused with hyperglycemic coma. Insulin administered SC, may cause either lipohypertrophy or lipoatrophy. Lipoatrophy appears to occur less frequently with purified insulin than with conventional insulin; if it has occurred, it may be reversed by the injection of a pure animal or human insulin into and around the atrophied site. Lipohypertrophy is usually associated with repeated injections at the same site and may usually be overcome by rotating the site of injection, although it should be remembered that absorption of insulin may vary from different anatomical areas.
Insulin may occasionally cause local or systemic hypersensitivity reactions. Local reactions, characterized by erythema and pruritus at the injection site usually disappear with continued therapy. Generalized hypersensitivity may produce urticaria, angioedema and very rare anaphylactic reactions; if continued therapy with insulin is essential hyposensitization procedures may need to be performed. Many patients treated with insulin, develop antibodies but the significance of such antibody formation with regard to the clinical management of the patient is not entirely clear.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Human insulin may cause hypoglycaemia (low blood sugar). The symptoms of low blood sugar include the following: tiredness, rapid heartbeat, nervousness or shakiness, feeling sick, headache, cold sweat.
Do not use Lupinsulin 30:70 if the patient thinks hypoglycaemia (low blood sugar) is starting. If the blood sugar is low, eat glucose tablets, sugar or drink a sugary drink. Then eat fruit, biscuits, or a sandwich, as the doctor has advised the patient and have some rest.
This will often get the patient over mild hypoglycaemia or a minor insulin overdose. If the patient gets worse and the breathing is shallow and the skin gets pale, tell the doctor at once. A glucagon injection can treat quite severe hypoglycaemia. Eat glucose or sugar after the glucagon injection. If the patient does not respond to glucagon, he/she will have to go to hospital. Ask the doctor to tell the patient about glucagon.
Alcohol and some medicines can affect blood sugar levels.
Hyperglycaemia and diabetic ketoacidosis.
Hyperglycaemia (too much sugar in the blood) means that the body does not have enough insulin.
Hyperglycaemia can lead to 6abetic ketoacidosis.
The symptoms include the following: feeling sleepy, no appetite, flushed face, fruity smell on the breath, thirst, feeling or being sick.
Severe symptoms are heavy breathing and a rapid pulse.
If hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar) are not treated they can be very serious and cause headaches, nausea, vomiting, dehydration, unconsciousness, coma or even death.
The following additional adverse reactions have been identified: Systemic allergy is very rare. The symptoms are as follows: fall in blood pressure, rash over whole body, difficulty in breathing, wheezing, fast heart beat, sweating.
Local allergy is common. Some people get redness, swelling or itching around the area of the insulin injection. This usually clears up in anything from a few days to a few weeks. Lipodystrophy (thickening or pitting of the skin) is uncommon.
Oedema (e.g. swelling in arms, ankles; fluid retention) has been reported, particularly at the start of insulin therapy or during a change in therapy to improve control of blood glucose.
The most frequent adverse effects in insulin treatment include: Hypoglycemia (drop in glucose concentration in blood).
Symptoms of hyperglycemia are: over sweating, dizziness, trembling, sensation of hunger, anxiety, tingling sensation in hand, feet and lips or tongue, concentration disturbances, sleepiness, sleep disturbances, loss of self control, mydriasis, visual disorder, speech disturbances, depression, impaired reaction.
Hyperglycemia (increase of glucose concentration in blood) in patients suffering from Type 1 diabetes prolonged hyperglycemia leads to ketoacidosis and diabetes coma, which is life-threatening. First ketoacidosis symptoms that gradually appear within hours, or even days, are sleepiness, reddening of the face, thirst, loss of appetite, acetone like smell of the breathed out by the ill air, increased amount of glucose and ketone bodies, fast breath and heart beat. Other adverse events that occasionally occur during biosynthetic insulin treatments are: post-insulin lypodystrophy (atrophy or over growth of fat tissue in the area of puncture), allergy to insulin, insulin resistance.