Lente Insulin

Lente Insulin Brand Name– Humulin L

What is Lente Insulin

Lente insulin was intermediate-acting insulin that is produced by adding zinc ions to regular insulin, which causes a delay in absorption and a prolongation of the duration of action after subcutaneous administration.

NOTE: Lente insulin is no longer available in the U.S.

The combination with zinc ions enhances the aggregation of insulin into dimers and hexamers when injected subcutaneously; a depot is formed after injection, and the insulin is released slowly.

Lente insulin is commonly administered twice daily in combination with quick-acting insulin (regular insulin, insulin aspart, insulin glulisine, or insulin lispro) to patients with type 2 diabetes mellitus (DM) and during the honeymoon phase of type 1 DM.

The duration of action of Lente insulin is variable; some patients may require only one injection while others require 3 or more injections daily; patients with type 1 DM will often require more than 2 injections of Lente insulin daily when used as basal insulin.

Lente insulin was not the ideal basal insulin as it has variable absorption, unwanted peaks leading to hypoglycemia including nocturnal hypoglycemia, and often an inadequate duration of action (even when administered twice daily) causing fasting hyperglycemia.

Indications

  1. type 1 diabetes mellitus
  2. type 2 diabetes mellitus

Side Effects

  1. anaphylactoid reactions
  2. antibody formation
  3. blurred vision
  4. confusion
  5. diaphoresis
  6. fatigue
  7. headache
  8. hyperinsulinemia
  9. hypertension
  10. hypoglycemia
  11. hypokalemia
  12. hypothermia
  13. injection site reaction
  14. insulin resistance
  15. irritability
  16. lipodystrophy
  17. nausea
  18. pallor
  19. palpitations
  20. peripheral edema
  21. pruritus
  22. sinus tachycardia
  23. Somogyi effect
  24. tremor
  25. urticaria
  26. vomiting
  27. weight gain
  28. yawning

Monitoring Parameters

  • blood glucose
  • glycosylated hemoglobin A1c (HbA1c)

Contraindications

  • bovine protein hypersensitivity
  • breast-feeding
  • children
  • coma
  • continuous subcutaneous insulin infusion (CSII) administration
  • diabetic ketoacidosis
  • diarrhea
  • fever
  • geriatric
  • hepatic disease
  • hyperosmolar hyperglycemic state (HHS)
  • hypoglycemia
  • hypokalemia
  • infants
  • infection
  • intravenous administration
  • porcine protein hypersensitivity
  • pregnancy
  • renal failure
  • renal impairment
  • surgery
  • thyroid disease
  • tobacco smoking
  • trauma
  • vomiting

Interactions

  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetazolamide
  • Acrivastine; Pseudoephedrine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amlodipine; Benazepril
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
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