Type 1 diabetes (in adults and children) and type 2 diabetes (in adults).
<4yrs: not recommended. ≥4yrs: Give SC, either by injection or by external infusion pump. Rotate injection sites. SC inj: give 15 minutes before meal or within 20 minutes after starting meal; use with an intermediate or long-acting insulin. Or, may give by IV under medical supervision. Individualize; monitor and adjust as needed.
During episodes of hypoglycemia.
Instruct patients on diet, exercise, blood or urine testing, proper administration of insulin, and management of hypoglycemia. Monitor glucose, potassium levels (esp. by IV route). May need to adjust dose during infection, illness, stress, trauma, pregnancy. May need lesser dose with renal or hepatic dysfunction. Pregnancy (Cat.C). Nursing mothers.
See literature. Potentiated by ACE inhibitors, antidiabetic agents, pramlintide, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates, sulfonamide antibiotics. Antagonized by corticosteroids, diuretics, sympathomimetics, glucagon, isoniazid, phenothiazines, somatropin, protease inhibitors, atypical antipsychotics, thyroid hormones, estrogens, progestogens. Variable effects with β-blockers, clonidine, lithium, alcohol. Do not mix with insulins other than NPH; draw insulin glulisine into syringe first, inject immediately after mixing. Do not dilute or mix with other insulins in pump.
Hypoglycemia, hypokalemia, local or systemic allergy, lipodystrophy, weight gain, peripheral edema.
Vial (10mL)—1; Cartridges (3mL)—5 (use with OptiClik); Apidra SoloStar pen (3mL)—5 (prefilled, disposable inj device)