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Absorption Rates

9.1 Human Insulin

1 IM injection of all human
insulin should be avoided since
rapid absorption and serious
hypoglycaemia can result.
( 95,96)

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2 The thigh and buttocks are
the preferred injection sites
when using NPH (intermediate
acting) as the basal insulin,
since absorption is slowest
from these sites. (43,97

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3 The abdomen is the preferred
site for soluble human insulin,
since absorption is fastest
there. (16,44,46,98-100)

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4 The absorption of soluble
(short acting) human insulin
in the elderly can be slow and
this insulin should not be used
when a rapid effect is needed.
(14,101) icon_b.pngicon_2.png (Note: Insulin
actions may overlap)


5 For those people who require
very large doses of insulin
U-500 insulin maybe an option
instead of U-100. U-500 is
only available as soluble
insulin. However it has a
pharmacokinetic profile more
closely simulating NPH human
intermediary insulin than
soluble short acting human.
U-100. (5,6,158)

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6 Massaging the site before or
after injection may speed up
absorption and is not generally
recommended. (5,6,70)

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9.2 Premixed Insulin

1 Premixed insulin (human or
analogue) should be given in
the abdomen in the morning
to increase the speed of
absorption of the short-acting
insulin in order to cover post-breakfast
glycaemic excursions.
(12)

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2 Premixed insulin should be
given in the thigh or buttock
before evening meal as this
leads to slower absorption and
decreases the risk of nocturnal
hypoglycaemia. (93,97)

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3 Massaging the site before or
after injection may speed up
absorption and is not generally
recommended. (5,6,70)

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9.3 Insulin Analogues

1 Rapid-acting insulin analogues
may be given at any of the
injection sites, as absorption
rates do not appear to be
site-specific. (81-85)

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2 Rapid-acting analogues should
not be given intramuscularly
(IM). (82,83,86)

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3 Long-acting insulin analogues
may be given at any of the
injection sites, as absorption
rates do not appear to be
site-specific. (87,88)

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4 IM injections of long-acting
analogues must be avoided
due to the risk of severe
hypoglycaemia or erratic
control. (89,90)

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5 When injecting rapid and long
acting analogue insulin these
should be given in different
sites even if given at different
times during the day.

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6 Larger doses may cause a delay
in the peak and increase the
duration of action. (5,6)

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7 Massaging the site before or
after injection may speed up
absorption and is not generally
recommended. (5,6,70)

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9.4 GLP-1 Agonists


1 Pending further studies,
people with diabetes who
inject GLP-1 agents (e.g.
exenatide - Byetta®; liraglutide
- Victoza®) should follow the
manufacturers instructions. (72)

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