Humulin ® (human insulin)

This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information.For current prescribing information for all Lilly products, including Summaries of Product Characteristics, Patient Information Leaflets and Instructions for Use, please visit: www.medicines.org.uk (England, Scotland, Wales) or www.emcmedicines.com/en-GB/northernireland/ (Northern Ireland).

How to administer Humulin® R (insulin human) 100 units/mL intravenously?

For intravenous use, Humulin R U-100 should be used at concentrations from 0.1 to 1 unit/mL in infusion systems containing 0.9% sodium chloride.

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Intravenous administration of Humulin R 100 units/mL

Continuous intravenous (IV) infusion using Humulin R (insulin human) 100 units/mL (U-100R) is a method of insulin delivery specifically for use in hospitalized patients.1-3

For IV use, U-100R may be administered only under medical supervision with close monitoring of blood glucose (BG) and potassium levels to reduce the risk of hypoglycemia and hypokalemia.4

When administered intravenously in doses ranging from 0.1 to 0.2 units/kg, the pharmacologic effect of U-100R

  • begins approximately 10 to 15 minutes after administration, and
  • ends at a median of approximately 4 hours (range: 2-6 hours) after administration.4

Typically, IV insulin infusions are mixed to a concentration of 1 unit/mL in normal saline and infused into a dedicated IV line. If the patient requires volume restriction, a more concentrated solution may be used.2

Dosing and Stability in IV Bags

Infusion bags prepared with U-100R are stable when

  • used at concentrations from 0.1 unit/mL to 1 unit/mL containing 0.9% sodium chloride, and
  • stored in a refrigerator (2°C to 8°C) for 48 hours and then may be used at room temperature for up to an additional 48 hours.4

Priming of IV Sets

The priming of IV sets to accommodate the adsorption of insulin is included in several institutional protocols.5-7

A study designed to quantify the insulin adsorption losses to IV lines

  • added 100 units of Regular Human Insulin to each of 20 polyvinyl chloride bags containing 100 mL of 0.9% sodium chloride for injection
  • delivered the resultant solutions (1 unit/mL) through standard polypropylene infusion sets, and
  • collected samples at 10-mL intervals from 0 to 50 mL.7

The authors concluded that, for standard IV insulin infusions, a priming volume of 20 mL was sufficient to minimize the effect of insulin adsorption losses to IV lines.7

References

1American Diabetes Association Professional Practice Committee. 16. Diabetes care in the hospital: standards of medical care in diabetes2022. Diabetes Care. 2022;45(suppl 1):S244-S253. https://doi.org/10.2337/dc22-S016

2Clement S, Braithwaite SS, Magee MF, et al; Diabetes in Hospitals Writing Committee. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27(2):553-591. https://doi.org/10.2337/diacare.27.2.553

3Moghissi ES, Korytkowski MT, DiNardo M, et al. AACE/ADA Consensus Statement: American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15(4):353-369. https://doi.org/10.4158/EP09102.RA

4Data on file, Eli Lilly and Company and/or one of its subsidiaries.

5Quevedo SF, Sullivan E, Kington R, Rogers W. Improving diabetes care in the hospital using guideline-directed orders. Diabetes Spectr. 2001;14(4):226-233. http://dx.doi.org/10.2337/diaspect.14.4.226

6Goldberg PA, Roussel MG, Inzucchi SE. Clinical results of an updated insulin infusion protocol in critically ill patients. Diabetes Spectr. 2005;18(3):188-191. http://dx.doi.org/10.2337/diaspect.18.3.188

7Goldberg PA, Kedves A, Walter K, et al. “Waste not, want not”: determining the optimal priming volume for intravenous insulin infusions. Diabetes Technol Ther. 2006;8(5):598-601. http://dx.doi.org/10.1089/dia.2006.8.598

Date of Last Review: 27 October 2022


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