Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergic reactions: If you notice signs of a serious allergic reaction (swelling of the face or throat, difficulty breathing, wheezing, fast heart rate, sweating, low blood pressure, or itchy skin rash), stop using the medication and seek immediate medical attention.
Appearance of insulin: The contents of the vial of insulin glulisine should be clear and colourless. Do not use this medication if your notice anything unusual about its appearance, such as cloudiness, discoloration, or clumping.
Blood glucose monitoring: It is important for anyone using insulin to monitor their blood glucose levels regularly, as recommended by their doctor or diabetes educator. It is especially important to test blood glucose more often when your insulin dose or schedule changes, or when you are ill or under stress. If blood tests consistently show high or low blood glucose levels, contact your doctor or diabetes educator.
Changes in insulin requirements: Many things can affect blood glucose levels and insulin requirements. These include:
- certain medical conditions (e.g., infections, thyroid conditions, or kidney or liver disease)
- certain medications that increase or decrease blood glucose levels
- travelling over time zones
It is important that your doctor know your current health situation and any changes that may affect the amount of insulin you need. Blood glucose should be monitored regularly, as recommended by your doctor or diabetes educator.
Diabetes identification: It is important to either wear a bracelet (or necklace) or carry a card indicating you have diabetes and are taking insulin.
Family and friends: Educate your family and friends about the signs and symptoms of hypoglycemia (low blood glucose). Keep a glucagon kit available and instruct them on its proper use in case you experience severe low blood glucose and you lose consciousness.
Insulin pumps: When used in an insulin pump, insulin glulisine should not be mixed with any other insulins or solutions.
Low blood glucose (hypoglycemia): Hypoglycemia may occur if too much insulin is used, if meals are missed, or if you exercise more than usual. Symptoms of mild to moderate hypoglycemia may occur suddenly and can include cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, anxiety, irritability, trouble concentrating, fatigue, and numbness or tingling (tongue, lips, or fingers). Mild to moderate hypoglycemia may be treated by eating foods or drinks that contain sugar. People taking insulin should always carry a quick source of sugar, such as hard candies, glucose tablets, juice, or regular soft drinks (not diet soft drinks).
Signs of severe hypoglycemia can include disorientation, loss of consciousness, and seizures. People who are unable to take sugar by mouth or who are unconscious may require an injection of glucagon or treatment with intravenous (into the vein) glucose.
Low blood sugar can impair your ability to drive or operate machinery. People who have frequent episodes of low blood sugar and people who are less aware of the warning symptoms of low blood sugar, should consider whether is it safe to drive or operate machinery. They should also monitor their blood glucose levels more frequently. Talk to your doctor or pharmacist if you are having frequent episodes of low blood glucose or are having difficulty recognizing the symptoms.
Skin reactions at injection site: Injecting insulin can cause a little depression in the skin; skin thickening; or skin redness, swelling, or itching. You can reduce the chance of getting these reactions if you change the injection site each time you inject insulin. If you experience these skin reactions, contact your doctor or diabetes educator.
Pregnancy: It is essential to maintain good blood glucose control throughout pregnancy. Insulin requirements usually decrease during the first trimester and increase during the second and third trimesters. Therefore, contact your doctor if you are pregnant or are thinking about pregnancy.
Breast-feeding: It is not known if insulin glulisine passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding .Breast-feeding mothers may require adjustments in insulin dose or diet.
Children: The safety and effectiveness of using this medication has not been established in children under 6 years of age.