Humalog Dosing Guide
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Insulin Therapy Considerations
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If a patient is unable to achieve his or her glycemic goals with diabetes medications, diet, and lifestyle modifications, he or she may be a candidate for insulin therapy. There are several types of insulins available to match your patients' needs. These include basal, mixture, and mealtime insulins. Assessment of fasting and postprandial glucose (PPG) levels, as well as A1C, can help guide your insulin regimen choice. In many patients with type 2 diabetes, mealtime control can be particularly challenging. However, there are insulin regimen options that can help address this issue.

Consideration also should be given to factors such as the patient's schedule, physical activity, eating patterns, personality, and age when selecting an insulin regimen.1 Young patients, for example, require different standards of care. Talking to patients is important to not only understand their individual considerations, but also to empower them with knowledge. A variety of patient education tools and programs available from Lilly can help in this effort, as can referral to a diabetes educator.

As with any guidelines, applicability to a specific patient must be determined by the physician, considering individual circumstances.

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Reference:
1. American Diabetes Association. Standards of medical care in diabetes — 2006. Diabetes Care. 2006;29(suppl 1):S4-S42.


Important Safety Information
Humalog insulins are contraindicated during episodes of hypoglycemia and in patients sensitive to Humalog or one of its excipients. The safety and effectiveness of Humalog in patients less than 3 years of age have not been established. Safety and effectiveness of Humalog Mix75/25 and Humalog Mix50/50 in patients less than 18 years of age have not been established. There are no adequate and well-controlled clinical studies of the use of Humalog in pregnant or nursing mothers.

Potential side effects associated with the use of all insulins include hypoglycemia, weight gain, hypokalemia, lipodystrophy, and hypersensitivity. Because of the difference in action of Humalog, care should be taken in patients in whom these conditions may be clinically relevant (e.g., those who are fasting, have autonomic neuropathy or renal impairment, are using potassium-lowering drugs, or taking drugs sensitive to serum potassium level). Patients should be advised not to mix Humalog Mix75/25 or Humalog Mix50/50 with another insulin. Starting or changing insulin therapy should be done cautiously and only under medical supervision.

When used in an external insulin pump, Humalog should not be diluted or mixed with any other insulin. Humalog Mix75/25 and Humalog Mix50/50 are not indicated for use in external insulin pumps.

Humalog differs from regular human insulin by its rapid onset of action, as well as a shorter duration of activity. Therefore, Humalog and Humalog Mixtures should be given within 15 minutes before a meal. Humalog can also be given immediately after a meal. The short duration of action of Humalog means that patients such as those with type 1 diabetes, whose basal insulin levels are inadequate, will also require a longer-acting insulin to give optimal glucose control (except when using an insulin pump).

Clinical studies comparing Humalog Mix75/25 with human insulin mixtures did not show a difference in the overall rate of hypoglycemia between the two treatments. The overall rate of hypoglycemia did not differ between type 1 and type 2 patients treated with Humalog, as compared with regular human insulin. The lower rate of hypoglycemia with Humalog may be related to higher nocturnal blood glucose levels, as reflected by a small increase in the mean fasting blood glucose levels.

The clinical significance of improvement in postmeal hyperglycemia has not been established. In 12-month clinical studies, A1C did not differ between patients treated with regular human insulin and those treated with Humalog.

Humalog, Humalog Mix75/25, and Humalog Mix50/50 are available by prescription only.

For other important safety information and prescribing considerations, please see Humalog, Humalog Mix75/25, and Humalog Mix50/50 Prescribing Information.

Humalog is a registered trademark of Eli Lilly and Company. Humalog Mix75/25 and Humalog Mix50/50 are trademarks of Eli Lilly and Company.

Humalog Prescribing Information | Humalog Mix75/25 Prescribing Information | Humalog Mix50/50 Prescribing Information | Important Safety Information