Insulin glulisine, Apidra
Description: Rapid Acting Insulin
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does it Work
Insulin glulisine, Apidra works on the liver, muscle, and adipose (fat) tissue to regulate the metabolism of carbohydrates, protein, and fats. In the liver and muscles, it increases glycogen synthesis which is the immediate storage form of glucose. It increases fat production by increasing fatty acid release from the liver in the form of lipoproteins which adipose tissue converts to fatty acids than to triglycerides for storage whilst also stopping the metabolism of triglycerides (fat). Insulin also increases the cellular uptake of amino acids and some electrolytes such as potassium into the cell. In muscle tissue, protein synthesis is increased.
Normally insulin is produced by the pancreas however insulin products for pharmaceutical use have been produced via recombinant DNA technology using certain bacteria (they splice the gene for insulin production into bacterial DNA so the cell produces insulin – a gene is a portion of DNA or RNA that produces one specific protein). Insulin glulisine is different from human insulin as it has some modifications to make it work faster. This is done by swapping the asparagine and lysine found at B3 and B29 in human insulin with lysine and glutamic acid respectively (these are all names of amino acids which are the building blocks of proteins such as insulin).
Indications For Use
Insulin glulisine, Apidra is officially indicated for Diabetes mellitus types 1 and 2. It is also used off-label for diabetic ketoacidosis and hyperglycemia during critical illness.
Before starting Insulin glulisine, Apidra makes sure your physician is aware of any allergies or medications you currently take, if you have had bariatric surgery, cardiovascular disease, have kidney disease, liver disease, are pregnant, or breastfeeding.
Insulin glulisine, Apidra is rapid-acting mealtime insulin. It is injected subcutaneously in multiple daily dosages depending on the number of meals the patient consumes. It should be given 15 minutes prior to the meal up to 20 minutes after the first bite. In type 2 diabetes someone usually starts around 4-5 units per day or 10% of basal insulin dose prior to the largest meal of the day and the dosage is slowly increased until glucose control is achieved. In type 1 diabetes 50-60% of total daily insulin is given as fast-acting mealtime insulin with the rest going to intermediate or long-acting basal insulins. If converting from another insulin the number of units given may need to be lowered as a precaution
Pharmacist Tips On Using
How to Take Insulin glulisine, Apidra: Follow instructions provided by physician/pharmacy label, use consistently at same times each day unless otherwise directed, refrigerate product not in use (36-46 Fahrenheit, 2-8 Celsius), the vial in use may be kept at room temperature (below 86 Fahrenheit, 30 Celsius) for up to 28 days (discard if not used by this point). Injection generally into abdomen, thighs, buttocks, or arms with absorption rates varying from site to site. Be consistent with the part of the body you inject into but rotate the injection site to avoid redistribution of fat and excessive irritation to the area. For example, if you choose the abdomen which is the most common, inject in circular order at least 2 inches from the navel.
You Need to Avoid: Do not use if the solution seems viscous (thick) or appears cloudy, only use if clear, colorless, and with no visible particles. Avoid injecting cold insulin as it may be painful.
Hypoglycemia, injection reaction, nasopharyngitis, upper respiratory injection, headaches, peripheral edema, and arthralgia (joint pain). Hypoglycemia is the largest concern with rapid-acting insulin and can be life-threatening so extra care should be taken when using insulin. If you feel unsure of your dose contact your health care professional and always err on the side of caution.
Note- this is not a complete list of side effects, only common ones, are dose-dependent and vary based on other medical conditions or state of health
Frequently Asked Questions
What is hypoglycemia?
Hypoglycemia is a condition of low blood sugar (>3.9mmol/L-Canada; 70mg/dL-US) which is considered a medical emergency whereas hyperglycemia is a slowly progressive condition. It generally occurs with irregularities in diet, exercise, and medications in diabetic patients. It is preferably treated with simple sugars such as dextrose; regular table sugar can work but is slower acting as it needs to be digested and if blood sugar is extremely low this delay can be a problem. Hypoglycemia has a large host of progressive symptoms from hunger, headache, nausea, sweating, palpitations, mood swings, irritability to seizure, coma and in severe cases, death.