|INSULIN ZINC SUSPENSION (LENTE)
Humulin L, Novolin L
Classifications: hormone; antidiabetic agent; insulin intermediate-acting; Therapeutic: antidiabetic; insulin intermediate-acting
Prototype: Insulin injection
Pregnancy Category: B
Intermediate-acting human insulin created by adding zinc ions to human regular insulin. It lowers blood glucose levels by
increasing peripheral glucose uptake, especially by skeletal muscle and fat tissue, and by inhibiting the liver from changing
glycogen to glucose. It is not the ideal basal insulin since its absorption is variable.
It lowers glucose level over a longer period of time than regular human insulin.
Hyperglycemia in diabetic patients allergic to other preparations of insulin. Also for patients with evidence of thrombotic
phenomena in which protamine may be a factor.
During episodes of hypoglycemia or in patients sensitive to any ingredient in the formulation; insulin pump; intravenous
administration; hyperosmolar hyperglycemic state; diabetic ketoacidosis.
In insulin resistant patients, hyperthyroidism or hypothyroidism; lactation, older adults, pregnancy (category B), renal
or hepatic impairment; children.
Route & Dosage
Adult: IM/SC Individualized doses (see INSULIN INJECTION, REGULAR)
- Give insulin zinc suspensions 30 min before breakfast. Some patients require another injection 30 min before supper time
or at bedtime.
- Note: Zinc insulin preparation (Lente) is compatible with regular insulin.
- Ensure complete dispersion by mixing thoroughly by gently rotating the vial between the palms and by inverting it end-to-end
several times. Do not shake.
- Note: Time of action of insulin zinc (Lente) approximates that of isophane insulin suspension (NPH) allowing patients usually
to be transferred directly to the latter on a unit-for-unit basis.
- Store unopened vial at 2°8° C (36°46° F). Avoid freezing and exposure to extremes in temperature
or to direct sunlight.
Adverse Effects (≥1%)
See INSULIN INJECTION, REGULAR
See INSULIN INJECTION
12 h. Peak:
812 h. Duration:
1824 h. Metabolism:
In liver and kidney. Elimination:
<2% excreted unchanged in urine. Half-Life:
Up to 13 h.
(see INSULIN INJECTION, REGULAR)
Patient & Family Education
- Be alert for S&S of hypoglycemia (see Appendix F); most apt to occur between mid-afternoon and dinner time (an early symptom
may be a sense of extreme fatigue). Immediately take soluble carbohydrate (e.g., orange juice, honey). If the time between
the midday and evening meal is prolonged, an afternoon snack may be needed.
- Do not overlook possibility of nocturnal hypoglycemia, especially during dose adjustment. Signs include restlessness or
profuse sweating during sleep.