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Insulin Glulisine is used for the treatment of blood sugar control in people with type 1 and type 2 diabetes mellitus. It is a fast-acting type of insulin that helps to lower blood sugar levels after meals and reduce the chances of developing serious complications of diabetes. Insulin Glulisine is normally prescribed along with a long-acting type of insulin or other diabetes medicines. Your doctor or nurse will teach you the correct way of injecting it under the skin. It should be taken 15 minutes before a meal or within 20 minutes after starting a meal. Do not stop taking it unless your doctor tells you to. It is only part of a treatment program that should also include a healthy diet, regular exercise, and weight reduction as advised by your doctor. Check your blood sugar levels regularly, keep track of your results and share them with your doctor. This is very important to work out the correct dose of the medicine for you. The most common side effect of this medicine is low blood sugar levels (hypoglycemia). To prevent this, it is important to always inject the correct dose of medicine only, have regular meals (do not skip), and monitor your blood sugar levels regularly. Drinking excessive alcohol can also lead to a fall in your blood sugar levels. Other side effects include allergy at the injection site like redness, swelling, or hard lumps (lipodystrophy). Some people may also gain weight while taking insulin. Do not use this medicine when you have low blood sugar levels (hypoglycemia). Tell your doctor if you have ever had kidney, liver or heart problems before starting treatment. Pregnant or breastfeeding women should consult their doctor before using it. Insulin Glulisine is fast-acting insulin which starts working within 10-20 minutes after injecting. It works similar to the insulin produced by the body. Insulin facilitates reuptake of glucose in muscle and fat cells and also blocks the release of glucose from the liver.

• Diabetes mellitus (Type 1 & Type 2)

Insulin glulisine is a rapid acting human insulin analog produced by recombinant DNA technology using a non-pathogenic laboratory strain of Escherichia coli (K12). Insulin glulisine and insulin human are equipotent on a unit-for-unit basis. Insulin glulisine has a more rapid onset and shorter duration of action compared with insulin human after subcutaneous admin.

Adult Dose: Subcutaneous Diabetes mellitus Dose should be individualised and depends on patient's needs. Usual range: 0.5-1 u/kg/day. Dosing considerations Equipotent to regular human insulin (ie, elicits same glucose lowering effects on unit per unit basis) when administered IV Insulin glulisine has a more rapid onset of action and a shorter duration of action than regular human insulin Dosage must be individualized; blood glucose monitoring is essential in all patients receiving insulin therapy Insulin requirements may be altered during stress, major illness, or with changes in exercise, meal patterns, or coadministered drugs Hepatic impairment: Dose reduction may be needed. Child Dose: Type 1 Diabetes Mellitus Indicated to improve glycemic control in adults and children with diabetes mellitus <4 years: Safety and efficacy not established 4-17 years: May require 0.8-1.2 units/kg/day SC during growth spurts; otherwise use adult dosing (0.5-1 unit/kg/day) Renal Dose: Renal impairment: Dose reduction may be needed.

Your doctor or nurse will guide you how to use this medicine.

If you have missed a dose of Insulin Glulisine, your blood sugar level may become too high (hyperglycemia). Check your blood sugar and then take the next dose accordingly.

Common: • Hypoglycemia (low blood glucose level) • Injection site allergic reaction • Itching • Rash • Lipodystrophy (skin thickening or pits at the injection site)

[CAUTION] Your ability to drive may be affected if your blood sugar is too low or too high. Do not drive if these symptoms occur. Take it 15 minutes before a meal or within 20 minutes after starting a meal. Injection sites must be rotated to prevent hard lumps from developing at one site. Injection below the skin of the abdomen results in faster absorption than other injection sites. Do not use it if the preparation is no longer clear and colorless or if it contains particles. Hypoglycemia (low blood sugar level) is a common side effect. Monitor your blood sugar level regularly. Always carry some sugary food or fruit juice with you in case you experience hypoglycemia symptoms such as cold sweats, cool pale skin, tremors, weakness, and anxiety. Opened vials/cartridges stay good at room temperature for up to 4 weeks, while unopened vials must be placed in the refrigerator (2°C–8°C).

Hypoglycaemia.Hypersensitivity to any of the components.

Possible absence of hypoglycaemic warning symptoms with beta-blockers. Decreased hypoglycaemic effect with corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetic agents, thyroid hormones, oestrogens, progestins (e.g. in oral contraceptives), protease inhibitors and atypical antipsychotics (e.g. olanzapine and clozapine). Increased hypoglycaemic effect with oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates and sulfonamide antibiotics. Decreased insulin resistance with octreotide and lanreotide. Increased risk of wt gain and peripheral oedema with pioglitazone, rosiglitazone. Decreased effect of sermorelin.

[UNSAFE] It is unsafe to consume alcohol with Insulin Glulisine.

[CONSULT YOUR DOCTOR] Insulin Glulisine may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[SAFE IF PRESCRIBED] Insulin Glulisine is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.

[CAUTION] Insulin Glulisine should be used with caution in patients with kidney disease. Dose adjustment of Insulin Glulisine may be needed. Please consult your doctor. Regular monitoring of blood glucose levels is recommended for dose adjustment. [CAUTION] Insulin Glulisine should be used with caution in patients with liver disease. Dose adjustment of Insulin Glulisine may be needed. Please consult your doctor. Frequent and regular monitoring of blood glucose levels is advised.

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