Insulin biphasic

Biphasic insulin mixture of insulin preparations that provide for immediate and prolonged action... 

Biphasic insulins are fixed dose combinations of a short-acting and intermediate-acting insulin in various proportions. Examples are Humulin, a biosynthetic human insulin (rDNA origin) suspension with respectively 20%, 30% and 40% regular and 80%, 70% and 60% isophane insulin and Mixtard, a biphasic biosynthetic human insulin suspension with respectively 10%, 20% and 40% soluble and 90%, 80% and 60% isophane insulin. 

Glucose-induced stimulahon of insulin release from cells is biphasic. The initial rapid rise in insulin that follows a rise in glucose is termed the first phase of insulin release and is thought to reflect the release of the presynthesized insulin in the storage granules a more... 

A 45-year-old woman who had used insulin for 4 years had a biphasic hypersensitivity reaction to human insulin (or another component of the injection fluid) (135). Within 20 minutes after the injection a swelling developed and in a later phase papular lesions with lichenoid features and post-inflammatory hyperpigmentation emerged. Histologically, there was neutrophilic infiltration with erythrocyte extravasation and eosinophilic amorphous material, surrounded by neutrophilic infiltrate. Saline injection did not elicit an effect. IgE anti-insulin antibodies were not found. There was no Arthus reaction (type IV allergy). 

Aspart insulin and biphasic insulin aspart (30% soluble rapid-acting insulin and 70% protamine-bound aspart insulin) have been reviewed (4). 

The new, short-acting insulins can be bound to protamine, allowing the preparation of mixed formulations. In an open, randomized, single-dose, three-way, crossover trial biphasic insulin aspart 30 (30% aspart plus 70% protaminated aspart, BIAsp 30), biphasic insulin lispro 25 (25% lispro plus 75% protaminated lispro, Mix 25), and biphasic human insulin 30 (30% regular plus 70% isophane insulin, BHI 30) were compared in 45 patients (15). Biphasic insulin aspart improved postprandial control better. There were 23 episodes of hypoglycemia with BIAsp 30, 19 with Mix 25, and 11 with BHI 30 two episodes with BIAsp 30, five with Mix 25, and two with BHI 30 required third-party intervention. 

Hermansen K, Colombo M, Storgaard H, O Stergaard A, Kolendorf K, Madsbad S. Improved postprandial glycemic control with biphasic insulin aspart relative to biphasic insulin lispro and biphasic human insulin in patients with type 2 diabetes. Diabetes Care 2002 25(5) 883-8. 

Lindholm A, Jensen LB, Home PD, Raskin P, Boehm BO, Rastam J. Immune responses to insulin aspart and biphasic insulin aspart in people with type 1 and type 2 diabetes. Diabetes Care 2002 25(5) 876-82. 

DP was initiated on a preloaded pen, using an insulin mix (biphasic) for subcutaneous administration. She was started on a twice daily biphasic insulin regimen based on a total dose of 0.5 units/kg/day with 2/3 given in the morning before breakfast and 1/3 given before the evening meal. 

King, M. I, et al. (2002),Transdermal delivery of insulin from a novel biphasic lipid system in diabetic rats, Diabetes Technol. Ther., 4(4), 479 188. 

Q12 Insulin injections, which are intended for subcutaneous administration, are prescribed for patients suffering from type 1 diabetes, since gastric acid and enzymes destroy insulin if it is given orally. More than 30 different insulin products are available rapid-acting, intermediate, long-acting and biphasic so treatment can be tailored to the requirements of individual patients. The only difference between the products is their time of onset, peak serum levels and the duration of action, which can be 3-24 hours, depending on the preparation. 

A series of 4-oxazoleacetic acid derivatives was identified as a group of potential hypoglycaemic agents in mice via the insulin tolerance test [197]. The most potent compound, AD-4610 (33), was found to potentiate biphasic glucose-induced insulin secretion in the perfused pancreas and in normal rats in a glucose-dependent fashion. AD-4610 also lowers plasma glucose in yellow KK mice, a model of NIDDM in which tolbutamide is inactive [198]. Development of AD-4610 and/or analogues is reported to have been discontinued [167]. 

A mixture of soluble and isophane insulins, officially called biphasic insulins. The shortacting analogue insulins are now also available in mixtures. Other nrixtures are available, but infrequently used. 

Biphasic insulins are, with one exception, proprietary mixtures of soluble (neutral) insulin and isophane insulin, which provide soluble (neutral) insulin at concentrations between 10% and 50% of the total insulin concentration. Human, porcine and beef are available, but most preparations in this group are of human insulin. These preparations remove the need for patients to mix soluble and isophane insulins, without... 

Mixed insulin zinc suspension is, confusingly, the approved name for proprietary mixtures of crystalline and amorphous zinc suspension. Mixed insulins are not, therefore, the same as biphasic insulins. While the different proprietary formulations in this group do have differing time courses of action (see Fig. 35.1) depending on their (unstated) proportions of amorphous and crystalline suspension, it is not expected that doctors or patients would vary the formulation prescribed. 

Compatibility. Soluble insulin may be mixed in the syringe with insulin zinc suspensions (amorphous, crystalline) and with isophane and mixed (biphasic) insulin, and used at once but there are insulins in which protamine is used as a carrier, and spare protamine will bind some of the short-acting neutral insulin, thus blunting its effects. 

If it is decided to give the patient orrly one injection per day, then 10-14 units of an intermediate-acting isophane suspension may be given. Dose increments (4 units) may be made on alternate days. Soluble insulin (neutral) may be added, or mixed (biphasic) insulins may be used, according to the patient s response. 

When stable, patients usually receive either a biphasic insulin or a mixture of soluble, short-acting human insulin, and a longer-acting suspension of insulin with protamine or zinc. 

A biphasic or intermediate-acting insulin (see Fig. 35.1) twice a day before morning and evening meals... 

Insulin preparations BP See Insulin Zinc Suspension (Crystalline) BP, Insulin Zinc Suspension (Amorphous) BP, Biphasic Insulin Injection BP... 

Biphasic 6.6-Z.2 Acetate Insulin in solution (25%) Rhombohedral crystals (75%) -1 18-22... 

Hormones, proteins, and small peptides are not suitable for oral administration without complex modifications in the formulation. A variety of approaches for insulin delivery, as a model drug, have been attempted to improve on its bioavailability. Advances have been realized in the delivery of insulin through oral, nasal, rectal, dermatologic, and ocular routes. Proteins can also be delivered transdermally, using a lipid-based, biphasic delivery system in therapeutic quantity. 

Proteins can also be delivered transdermally using a lipid-based biphasic delivery system in therapeutic quantity. Insulin treatment (10-50 mg/g formulation) was administered by a transdermal patch adhered to the abdomen of anesthetized Sprague-Dawley rats made diabetic by a single injection of strep-tozotocin (55 mg/kg). Blood was sampled from a tail vein every 2-4 h for 48 h. Response to transdermally applied insulin was both pH and concentration dependent. Blood glucose was decreased by 55% in the treated animals with mean response duration of 15 h. Serum insulin level was 162 pg/mL. 

USA biphasic insulin lispro insulin Humalog MIX Recombinant human insulin where the B chain amino acids at 28 and 29 are inverted with different proportions of a protamine suspension Diabetes... 

USA biphasic human insulin insulin Humulin M Humulin 50/50, 70/30, Ml, M2, M3, M4, M5 A mixture of isophane and soluble recombinant human insulin obtained from an E. coli expression system Diabetes... 

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