Diasulin R Vial 100 IU/ml

✔️ Dosage & Administration

Adult Dosage

Type 1 Diabetes Mellitus:

Initial: 0.2–0.4 units/kg/day SC divided every 8 hours or more frequently

Maintenance: 0.5–1 unit/kg/day (higher doses may be required in insulin-resistant patients)

Type 2 Diabetes Mellitus:

Initial: 0.2–0.4 units/kg/day SC divided every 8–12 hours, as adjunct to diet, exercise, or oral agents

Diabetic Ketoacidosis (IV route):

Initial loading dose: 20 units

Continuous infusion: 6 units/hour until blood glucose falls to ~10 mmol/L

Adjust: Reduce to 3 units/hour with 5% glucose infusion to avoid hypoglycemia

Continue until patient resumes oral intake

Hyperkalemia:

5–10 units IV insulin in 50 mL D50W (25 g glucose) infused over 15–30 minutes

Combination with Intermediate-acting Insulin:

Morning: ⅔ of daily insulin dose (Regular:NPH = 1:2)

Evening: ⅓ of daily insulin dose (Regular:NPH = 1:1)

Pediatric Dosage

Type 1 Diabetes Mellitus:

Initial: 0.2–0.4 units/kg/day SC

Maintenance: 0.5–1 unit/kg/day; may increase up to 1.5 units/kg/day during puberty

Prepubertal children: Usually require 0.7–1 unit/kg/day

Special Populations

Renal impairment: Dose reduction may be necessary

Hepatic impairment: Use with caution; dosage adjustment required

✔️ Administration Route

Subcutaneous (preferred): Inject into the upper arm, thigh, or abdominal wall.

Intravenous (IV): For DKA management under close monitoring.

Intramuscular (IM): In emergencies when IV access is not available.

Administer within 15 minutes before or immediately after meals.
Abdominal injections ensure faster absorption.

✔️ Side Effects

Common: Hypoglycemia, headache, blurred vision, rash, pruritus

Local: Injection site reactions, lipodystrophy, lipoatrophy

Systemic: Allergic reactions, insulin resistance, hypokalemia, flu-like symptoms, back pain, diarrhea, dyspepsia, pharyngitis

✔️ Drug Interactions

↓ Hypoglycemic effect (antagonistic):

Corticosteroids, diuretics, thyroid hormones, danazol, glucagon, sympathomimetics, oral contraceptives, atypical antipsychotics

↑ Hypoglycemic effect (synergistic):

Oral antidiabetic agents, ACE inhibitors, MAOIs, salicylates, fibrates, fluoxetine, sulfonamide antibiotics

Others:

Beta-blockers may mask hypoglycemia symptoms

Alcohol can potentiate or prolong hypoglycemia

Pioglitazone/Rosiglitazone may increase weight gain and edema risk

✔️ Contraindications

Hypoglycemia

Hypersensitivity to human insulin or formulation components

✔️ Precautions

Monitor blood glucose regularly and adjust dose accordingly

Pregnancy: Insulin needs may vary — lower in the 1st trimester, higher in 2nd & 3rd

Lactation: Safe to use; dosage adjustment may be required

Caution in conditions with decreased insulin requirement (renal/hepatic impairment, malabsorption, hypothyroidism)

Caution in conditions with increased insulin requirement (fever, infection, surgery, trauma)

Hypokalemia may occur; monitor potassium levels

✔️ Storage

Store at 2°C–8°C (refrigerated). Do not freeze.

Protect from light.

In-use vials can be kept below 25°C for up to 6 weeks.