Diabetes Self Care Diary
Contents
1. Blood Sugar Testing Schedule Record your planned test times by checking the time slot or by filling in the actual time of the test Testing your blood sugar before and after meals is a good way to find out how well you are controlling your diabetes Breakfast Lunch Dinner Bedtime Night Before After Before After Before After Monday Tuesday Wednesday Thursday Friday Saturday Sunday Enter the following information Write in the date of the week B Write in the time and result of your blood sugar test on the line that shows the time that it was taken Week of 1 10 1 4 05 breakfast after breakfast etc Breakfast After Dinner After Bedtime Breakfast Dinner Monday B Tuesday 7 50 151 9 50 128 1120 119 5 40 178 50 62 Wednesday 7 15 156 EZI ff 1D 5 50 168 Thursday 730 252 11 20 456 5 55 149 Friday Saturday Sunday Write in the units and Write in any other diabetes Write in any special notes you think type of insulin on the medications that you and your may be important to know such as line that shows the doctor may want to track and a big meal illness stress exercise time it was taken the time you take each dose urine ketone test result etc Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Mond2. Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type INFORMATION FOR THE PATIENT 3 ML DISPOSABLE INSULIN DELIVERY DEVICE HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN 100 Units per mL U 100 WARNINGS THIS LILLY HUMAN INSULIN ANALOG IS DIFFERENT FROM OTHER INSULINS BECAUSE IT HAS A RAPID ONSET AND SHORTER DURATION OF ACTION THE RAPID ONSET OF ACTION MEANS THAT YOU SHOULD TAKE YOUR DOSE OF HUMALOG INSULIN LISPRO INJECTION rDNA ORIGIN WITHIN 15 MINUTES BEFORE OR IMMEDIATELY AFTER EATING THE SHORT DURATION OF ACTION OF HUMALOG MEANS THAT IF YOU HAVE TYPE 1 DIABETES YOU ALSO NEED TO USE A LONGER ACTING INSULIN TO GIVE THE BEST GLUCOSE CONTROL IF YOU HAVE TYPE 2 DIABETES HUMALOG MAY BE USED WITHOUT A LONGER ACTING INSULIN WHEN USED IN COMBINATION THERAPY WITH SULFONYLUREA AGENTS ANY CHANGE OF INSULIN SHOULD BE MADE CAUTIOUSLY AND ONLY UNDER MEDICAL SUPERVISION CHANGES IN STRENGTH MANUFACTURER TYPE E G REGULAR NPH LENTE SPECIES BEEF PORK BEEF PORK HUMAN OR METHOD OF MANUFACTURE rDNA VERSUS ANIMAL SOURCE INSULIN MAY RESULT IN THE NEED FOR A CHANGE IN THE TIMING OR DOSAGE OF HUMALOG OR THE LONGER ACTING INSULIN OR BOTH HUMALOG Pen
3. Your Self EE Diabetes a Name Doctor s Name Address Telephone City Hospital State Zip Telephone Pharmacy Telephone I have diabetes In case of emergency please call Name Diabetes Educator s Name Address Telephone Telephone Staying in Control One of the best things you can do to stay in control of your diabetes is to maintain your blood sugar levels and A1C results within the target range set by you your doctor and or your diabetes educator To know whether your blood sugar levels are in range you need to check your blood sugar throughout the day and have an A1C test performed at your doctor s office at least every three to six months Talk to your doctor or diabetes educator for more information about how to check your A1C Both tests provide you and your healthcare team with important information about your blood sugar control Your home blood sugar result is like a snap shot It tells you what your blood sugar level is at the exact time you check it The A1C result tells you what your average blood sugar has been for the past two months When you meet with your doctor or diabetes educator to set your goals for these tests complete the section of this diary called Your Diabetes Plan so you will always know your target ranges Keep your diary up to date and take it when you visit your healthcare team This will help them find any p
4. Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units
5. lightheadedness abnormal behavior inability to concentrate unsteady movement headache personality changes Signs of severe hypoglycemia can include disorientation seizures unconsciousness death Therefore it is important that assistance be obtained immediately Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions such as long duration of diabetes diabetic nerve disease use of medications such as beta blockers changing insulin preparations or intensified control 3 or more injections per day of diabetes A few patients who have experienced hypoglycemic reactions after transfer from animal source insulin to human insulin have reported that the early warning symptoms of hypoglycemia were less pronounced or different from those experienced with their previous insulin Without recognition of early warning symptoms you may not be able to take steps to avoid more serious hypoglycemia Be alert for all of the various types of symptoms that may indicate hypoglycemia Patients who experience hypoglycemia without early warning symptoms should monitor their blood glucose frequently especially prior to activities such as driving If the blood glucose is below your normal fasting glucose you should consider eating or drinking sugar containing foods to treat your hypoglycemia HUMALOG Mix75 25 Pen 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORI
6. Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday U
7. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturd
8. METHOD OF MANUFACTURE rDNA VERSUS ANIMAL SOURCE INSULIN MAY RESULT IN THE NEED FOR A CHANGE IN THE TIMING OR DOSAGE OF HUMA LOG Mix75 25 PATIENTS TAKING HUMALOG Mix75 25 MAY REQUIRE A CHANGE IN DOSAGE FROM THAT USED WITH OTHER INSULINS IF AN ADJUSTMENT IS NEEDED IT MAY OCCUR WITH THE FIRST DOSE OR DURING THE FIRST SEVERAL WEEKS OR MONTHS HUMALOG Mix75 25 Pen 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN PV 3720 AMP TO OBTAIN AN ACCURATE DOSE CAREFULLY READ AND FOLLOW THE DISPOSABLE INSULIN DELIVERY DEVICE USER MANUAL AND THIS INFORMATION FOR THE PATIENT INSERT BEFORE USING THIS PRODUCT BEFORE EACH INJECTION YOU SHOULD PRIME THE PEN A NECESSARY STEP TO MAKE SURE THE PEN IS READY TO DOSE PRIMING THE PEN IS IMPORTANT TO CONFIRM THAT INSULIN COMES OUT WHEN YOU PUSH THE INJECTION BUTTON AND TO REMOVE AIR THAT MAY COLLECT IN THE INSULIN CARTRIDGE DURING NORMAL USE IF YOU DO NOT PRIME YOU MAY RECEIVE TOO MUCH OR TOO LITTLE INSULIN see also INSTRUCTIONS FOR INSULIN PEN USE section DIABETES Insulin is a hormone produced by the pancreas a large gland that lies near the stomach This hormone is necessary for the body s correct use of food especially sugar Diabetes occurs when the pancreas does not make enough insulin to meet your body s needs To control your diabetes your doctor has prescribed injections of insulin products to keep your blood glucose at a near normal level Y
9. Mix50 50 are for use in patients with diabetes to control high blood sugar Humalog should be used with a longer acting insulin except when used in combination with sulfonylureas in patients with type 2 diabetes Important Safety Information Humalog insulins are contraindicated during episodes of hypoglycemia and in patients sensitive to Humalog or one of its excipients The safety and effectiveness of Humalog in patiens less than 3 years of age have not been established Safety and effectiveness of Humalog Mix75 25 and Humalog Mix50 50 in Patients less than 18 years of age have not been established There are no clinical studies of the use of Humalog insulins in pregnacy or nursing mothers Potential side effects associated with the use of all insulins include low blood sugar weight gain low blood potassium changes in fat tissue at the site of injection and allergic reactions both general and local Humalog Mix75 25 and Humalog Mix50 50 should not be mixed with another insulin Starting or changing insulin therapy should be done cautiously and only under medical supervision T3AH3S3H SLHOIY TIY ANVdIAIOO ANY 173 7900029 LH9IHAdOO WSN NI GALNIYd 90LL ZSLEPIH Aueduuog pue Apr 13 jo 05 08XIA pue Gz G XIA Aueduuo pue Apr 3 10 pa arsiBal eje se1eqeiq Jno pue uio Jouedsqu3A ryMMM MMM uiB
10. WHEN YOU PUSH THE INJECTION BUTTON AND TO REMOVE AIR THAT MAY COLLECT IN THE INSULIN CARTRIDGE DURING NORMAL USE IF YOU DO NOT PRIME YOU MAY RECEIVE TOO MUCH OR TOO LITTLE INSULIN see a so INSTRUCTIONS FOR INSULIN PEN USE section DIABETES Insulin is a hormone produced by the pancreas a large gland that lies near the stomach This hormone is necessary for the body s correct use of food especially sugar Diabetes occurs when the pancreas does not make enough insulin to meet your body s needs To control your diabetes your doctor has prescribed injections of insulin products to keep your blood glucose at a near normal level You have been instructed to test your blood and or urine regularly for glucose Studies have shown that some chronic complications of diabetes such as eye disease kidney disease and nerve disease can be significantly reduced if the blood sugar is maintained as close to normal as possible The American Diabetes Association recommends that if your premeal glucose levels are consistently above 130 mg dL bedtime glucose levels are consistently above 160 mg dL or your hemoglobin Ai HbA1c is more than 7 consult your doctor A change in your diabetes therapy may be needed If your blood tests consistently show below targeted glucose levels you should also let your doctor know Proper control of your diabetes requires close and constant cooperation with your doctor Despite diabetes you can lead an active and healthy life if
11. dose window Following an Injection Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 AMP PREPARING FOR INJECTION 1 Wash your hands 2 To avoid tissue damage choose a site for each injection that is at least 1 2 inch from the previous injection si 3 Cleanse the skin with al e The usual sites of injection are abdomen thighs and arms cohol where the injection is to be made 4 With one hand stabilize the skin by spreading it or pinching up a large area 5 Inject the dose as instructed by your doctor Hold the needle under the skin for at least 5 seconds after in 6 After injecting a dose p jecting ull the needle out and apply gentle pressure over the injection site for several seconds Do not rub the area 7 Immediately after an in jection remove the needle from the Humalog Mix50 50 Pen Doing so will guard against contamination and prevent leakage of Humalog Mix50 50 reentry of air and needle clogs Do not reuse needles Place the used needle in a puncture resistant disposable container and properly dispose of it as directed by your Health Care Professional DOSAGE Your doctor has told you which insulin to use how much and when and how often to inject it Because eac h patient s case of diabetes is different this schedule has been individualized for you Your usual Humalog Mix50 50 dose may be affected by changes in your food activity or
12. immediately before a meal within 15 minutes In contrast mixtures containing regular human insulin should be given 30 60 minutes before a meal Identification Insulin lispro rDNA origin injection by Eli Lilly and Company has the trademark Humalog Humalog products are available in three formulations Humalog Humalog Mix75 25 and Humalog 50 50 Your doctor has prescribed the type of insulin that he she believes is best for you DO NOT USE ANY OTHER INSULIN EXCEPT ON YOUR DOCTOR S ADVICE AND DIRECTION YOU SHOULD NOT MIX HUMALOG Mix50 50 WITH ANOTHER INSULIN The Humalog 50 50 Pen is available in boxes of 5 disposable insulin delivery devices insulin Pens The Humalog 50 50 Pen is not designed to allow any other insulin to be mixed in its cartridge of Humalog Mix50 50 or for the cartridge to be removed Always examine the appearance of Humalog Mix50 50 suspension in the insulin Pen before administering a dose Roll the Pen between the palms 10 times see Figure 1 Holding the Pen by one end invert it 180 slowly 10 times to allow the glass bead to travel the full length of the cartridge with each inversion see Figure 2 Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 AMP Mee ie Figure 1 Humalog Mix50 50 should look uniformly cloudy or milky after mixing If not repeat the above steps until the contents are mixed Pens containing Humalog Mix50
13. medications you are taking with your doctor Exercise Exercise may lower your body s need for insulin products during and for some time after the physical activity Exercise may also speed up the effect of a Humalog Mix50 50 dose especially if the exercise involves the area of your injection site Discuss with your doctor how you should adjust your regimen to accommodate exercise Travel Persons traveling across more than 2 time zones should consult their doctor concerning adjustments in their insulin schedule COMMON PROBLEMS OF DIABETES Hypoglycemia Low Blood Sugar Hypoglycemia too little glucose in the blood is one of the most frequent adverse events experienced by insulin users It can be brought about by 1 Missing or delaying meals 2 Taking too much insulin 3 Exercising or working more than usual 4 An infection or illness especially with diarrhea or vomiting 5 A change in the body s need for insulin 6 Diseases of the adrenal pituitary or thyroid gland or progression of kidney or liver disease T Interactions with other drugs that lower blood glucose such as oral antidiabetic agents salicylates for example aspirin sulfa antibiotics and certain antidepressants 8 Consumption of alcoholic beverages Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 AMP Symptoms of mild to moderate hypoglycemia may occur suddenly and can include sweating drowsi
14. normal fasting glucose you should consider eating or drinking sugar containing foods to treat your hypoglycemia Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 AMP Mild to moderate hypoglycemia may be treated by eating foods or drinks that contain sugar Patients should always carry a quick source of sugar such as candy mints or glucose tablets More severe hypoglycemia may require the assistance of another person Patients who are unable to take sugar orally or who are unconscious require an injection of glucagon or should be treated with intravenous administration of glucose at a medical facility You should learn to recognize your own symptoms of hypoglycemia If you are uncertain about these symptoms you should monitor your blood glucose frequently to help you learn to recognize the symptoms that you experience with hypoglycemia If you have frequent episodes of hypoglycemia or experience difficulty in recognizing the symptoms you should consult your doctor to discuss possible changes in therapy meal plans and or exercise programs to help you avoid hypoglycemia Hyperglycemia and Diabetic Ketoacidosis DKA Hyperglycemia too much glucose in the blood may develop if your body has too little insulin Hyperglycemia can be brough about by any of the following 1 Omitting your insulin or taking less than the doctor has prescribed 2 Eating significantly more than your meal plan sugg
15. of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units T
16. sugar is maintained as close to normal as possible The American Diabetes Association recommends that if your premeal glucose levels are consistently above 130 mg dL or your hemoglobin HbAic is more than 7 consult your doctor A change in your diabetes therapy may be needed If your blood tests consistently show below normal glucose levels you should also let your doctor know Proper control of your diabetes requires close and constant cooperation with your doctor Despite diabetes you can lead an active and healthy life if you eat a balanced diet exercise regularly and take your insulin injections as prescribed HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP Always keep an extra supply of Humalog as well as a spare syringe and needle on hand Always wear diabetic identification so that appropriate treatment can be given if complications occur away from home HUMALOG Description Humalog insulin lispro rDNA origin is made by a special non disease producing laboratory strain of Escherichia coli bacteria that has been genetically altered by the addition of the gene for this human insulin analog Humalog consists of zinc insulin lispro crystals dissolved in a clear fluid Humalog is a sterile solution and is for subcutaneous injection It should not be used intramuscularly The concentration of Humalog is 100 units mL 0 100 Humalog starts lowering blood glucose more quickly and has a shorter duration of
17. work schedule Carefully follow your doctor s instructions to allow for these changes Other things that may affect your Humalog Mix50 50 dose are IIIness llIness especially with nausea and vomiting may cause your insulin requirements to change Even if you are not eating you will still require insulin You and your doctor should establish a sick day plan for you to use in case of illness When you are sick test your blood glucose urine ketones frequently and call your doctor as instructed Pregnancy Good control of diabetes is especially important for you and your unborn baby Pregnancy may make managing your diabetes more difficult If you are planning to have a baby are pregnant or are nursing a baby consult your doctor Humalog Mix50 50 has not been tested in pregnant or nursing women Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 Medication Insulin requirements may be increased if you are taking other drugs with hyperglycemic activity such as oral contraceptives corticosteroids or thyroid replacement therapy Insulin requirements may be reduced in the presence of drugs with blood glucose lowering activity such as oral antidiabetic agents salicylates for example aspirin sulfa antibiotics alcohol and certain antidepressants Your Health Care Professional is aware of these and other medications that may affect your diabetes control Therefore always discuss any
18. you eat a balanced diet exercise regularly and take your insulin injections as prescribed Always keep an extra Humalog Mix50 50 Pen as well as a spare needle on hand Always wear diabetic identification so that appropriate treatment can be given if complications occur away from home HUMALOG Mix50 50 Description Humalog insulin lispro rDNA origin is made by a special non disease producing laboratory strain of Escherichia coli bacteria that has been Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 genetically altered by the addition of the gene for this human insulin analog Humalog Mix50 50 is a mixture of 50 insulin lispro protamine suspension and 50 insulin lispro It is a longer acting insulin combined with the more rapid onset of action of Humalog The duration of activity is similar to that of Humulin 50 50 and may last up to 16 hours following injection The time course of Humalog Mix50 50 action like that of other insulins may vary in different individuals or at different times in the same individual based on dose site of injection blood supply temperature and physical activity Humalog Mix50 50 is a sterile suspension and is for subcutaneous injection It should not be used intravenously The concentration of Humalog Mix50 50 is 100 units mL U 100 Humalog Mix50 50 starts lowering blood glucose more quickly than regular human insulin allowing for convenient dosing
19. 0 AMP You should learn to recognize your own symptoms of hypoglycemia If you are uncertain about these symptoms you should monitor your blood glucose frequently to help you learn to recognize the symptoms that you experience with hypoglycemia If you have frequent episodes of hypoglycemia or experience difficulty in recognizing the symptoms you should consult your doctor to discuss possible changes in therapy meal plans and or exercise programs to help you avoid hypoglycemia Hyperglycemia and Diabetic Acidosis Hyperglycemia too much glucose in the blood may develop if your body has too little insulin Hyperglycemia can be brought about by any of the following 1 Omitting your insulin or taking less than the doctor has prescribed 2 Eating significantly more than your meal plan suggests 3 Developing a fever infection or other significant stressful situation In patients with insulin dependent diabetes prolonged hyperglycemia can result in diabetic acidosis The first symptoms of diabetic acidosis usually come on gradually over a period of hours or days and include a drowsy feeling flushed face thirst loss of appetite and fruity odor on the breath With acidosis urine tests show large amounts of glucose and acetone Heavy breathing and a rapid pulse are more severe symptoms If uncorrected prolonged hyperglycemia or diabetic acidosis can lead to nausea vomiting dehydration loss of consciousness or death Therefore it is imp
20. 50 suspension should be examined frequently Do not use if the insulin substance the white material remains visibly separated from the liquid after mixing Do not use a Humalog Mix50 50 Pen if there are clumps in the insulin after mixing Do not use a Humalog Mix50 50 Pen if solid white particles stick to the bottom or wall of the cartridge giving a frosted appearance Always check the appearance of the Humalog Mix50 50 suspension before using If you note anything unusual in its appearance or notice your insulin requirements changing markedly consult your doctor Storage Not in use unopened Humalog Mix50 50 Pens not in use should be stored in a refrigerator but not in the freezer Do not use Humalog Mix50 50 Pen if it has been frozen In use Humalog Mix50 50 Pens in use should NOT be refrigerated but should be kept at room temperature below 86 F 30 C away from direct heat and light Humalog 50 50 Pens in use must be discarded after 10 days even if they still contain Humalog Mix50 50 Do not use Humalog Mix50 50 Pens after the expiration date stamped on the label Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 AMP Figure 2 INSTRUCTIONS FOR INSULIN PEN USE It is important to read understand and follow the instructions in the Disposable Insulin Delivery Device User Manual before using Failure to follow instructions may result in getting too much or too littl
21. GIN PV 3720 AMP Mild to mot should always hypoglycemia may require erate hypog lycemia may be treated by eating foods or drinks that contain sugar Patients carry a quick source of sugar such as candy mints or glucose tablets More severe the assistance of another person Patients who are unable to take sugar orally or who are unconscious require an injection of glucagon or should be treated with intravenous administration of glucose ai You should symptoms you should m symptoms that you If you have frei you should consult your programs to help you avoii Hyperglycemia and Diabetic Ketoacidosis DKA Hyperglycemia too much glucose in the blood has too little insulin Hyperglycemia can be brought about by any of the following develop if your bot 1 Omitting your insulin learn to recognize your own symptoms of hypoglycemia If you are uncertain about experience with hypoglycemia uent episodes of hypoglycemia or experience difficulty in recognizing the symp a medical facility hese onitor your blood glucose frequently to help you learn to recognize the oms octor to discuss possible changes in therapy meal plans and or exercise hypoglycemia may or taking less than the doctor has prescribed 2 Eating significantly more than your meal plan suggests 3 Developing a fever in In patients with ection or other significant stressful situation pe 1 or insulin dependent diabetes prolon
22. INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP PATIENTS TAKING HUMALOG MAY REQUIRE A CHANGE IN DOSAGE FROM THAT USED WITH OTHER INSULINS IF AN ADJUSTMENT IS NEEDED IT MAY OCCUR WITH THE FIRST DOSE OR DURING THE FIRST SEVERAL WEEKS OR MONTHS TO OBTAIN AN ACCURATE DOSE CAREFULLY READ AND FOLLOW THE DISPOSABLE INSULIN DELIVERY DEVICE USER MANUAL AND THIS INFORMATION FOR THE PATIENT INSERT BEFORE USING THIS PRODUCT BEFORE EACH INJECTION YOU SHOULD PRIME THE PEN A NECESSARY STEP TO MAKE SURE THE PEN IS READY TO DOSE PRIMING THE PEN IS IMPORTANT TO CONFIRM THAT INSULIN COMES OUT WHEN YOU PUSH THE INJECTION BUTTON AND TO REMOVE AIR THAT MAY COLLECT IN THE INSULIN CARTRIDGE DURING NORMAL USE IF YOU DO NOT PRIME YOU MAY RECEIVE TOO MUCH OR TOO LITTLE INSULIN see also INSTRUCTIONS FOR PEN USE section DIABETES Insulin is a hormone produced by the pancreas a large gland that lies near the stomach This hormone is necessary for the body s correct use of food especially sugar Diabetes occurs when the pancreas does not make enough insulin to meet your body s needs To control your diabetes your doctor has prescribed injections of insulin products to keep your blood glucose at a near normal level You have been instructed to test your blood and or your urine regularly for glucose Studies have shown that some chronic complications of diabetes such as eye disease kidney disease and nerve disease can be significantly reduced if the blood
23. OR INJECTION 1 Inspect the appearance of Humalog solution in the Humalog Pen It should look clear and colorless Do not use Humalog if it appears cloudy thickened or slightly colored or if solid particles are visible HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP 2 Follow the instructions in the Disposable Insulin Delivery Device User Manual for needle clogs Do not reuse needles Place the used needle in a puncture resistant these steps disposable container and properly dispose of it as directed by your Health Care Preparing the Pen Professional Attaching the Needle Use a new needle for each injection DOSAGE Your doctor has told you which insulin to use how much and when and how Priming the Pen The Pen must be primed before each injection to make sure the often to inject it Because each patient s diabetes is different this schedule has been Pen is ready to dose Performing the priming step is important to confirm that individualized for you Your usual dose of Humalog may be affected by changes in your insulin comes out when you push the injection button and to remove air that may food activity or work schedule Carefully follow your doctor s instructions to allow for collect in the insulin cartridge during normal use these changes Other things that may affect your dose of Humalog are Setting a Dose IlIness lllness especially with nausea and vomiting may cause your insulin requirements Injec
24. action compared to regular human insulin This means that your dose of Humalog should be given within 15 minutes before or immediately after a meal regular insulin works best when given 30 60 minutes before a meal The short duration of action of Humalog means that if you have type 1 diabetes you need to use a longer acting insulin to give the best glucose control If you have type 2 diabetes Humalog may be used without a longer acting insulin when used in combination therapy with sulfonylurea agents The time course of Humalog action like that of other insulins may vary in different individuals or at different times in the same individual based on dose site of injection blood supply temperature and physical activity Identification lnsulin lispro injection rDNA origin manufactured by Eli Lilly and Company has the trademark Humalog Your doctor has prescribed the type of insulin that he she believes is best for you DO NOT USE ANY OTHER INSULIN EXCEPT ON YOUR DOCTOR S ADVICE AND DIRECTION The Humalog Pen is available in boxes of 5 disposable insulin delivery devices insulin Pens The Humalog Pen is not designed to allow any other insulin to be mixed in its cartridge of Humalog or for the cartridge to be removed HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP Always examine the appearance of Humalog solution in the insulin Pen before administering a dose Humalog is a clear and colorless liquid with a wat
25. activity Exercise may also speed up the effect of a Humalog Mix75 25 dose especially if involves the area of your injection site Discuss with your doctor how you should adjust your re than 2 time zones should consult their doctor concerning COMMON PROBLEMS OF DIABETES Hypoglycemia Low Blood Sugar Hypoglycemia too little glucose in the blood is one of the most brought about by 1 Missing or delaying meals 2 Taking too much insulin 3 Exercising or working more than usi 4 An infection or illness especially wi requent adverse events experienced by insulin users It can be ual h diarrhea or vomiting 5 A change in the body s need for insulin 6 Diseases of the adrenal pituitary or hyroid gland or progression of kidney or liver disease HUMALOG Mix75 25 Pen 75 INSULI 7 Interactions with other drugs that lower blood glucose such as oral antidiabetic agents salicylates for example aspirin sulfa antibiotics and certain antidepressants 8 Consumption of alcoholic beverages N LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN PV 3720 AMP Symptoms of mild to moderate hypoglycemia may occur suddenly and can include sweating drowsiness e dizziness sleep disturbances palpitation anxiety tremor blurred vision hunger slurred speech restlessness depressed mood tingling in the hands feet lips or tongue irritability
26. an Diabetes Association National Service Center 1660 Duke Street Alexandria Virginia 22314 1 800 DIABETES 1 800 342 2383 Another publication DIABETES COUNTDOWN is available from the Juvenile Diabetes Foundation International JDF 120 Wall Street 19th Floor New York New York 10005 4001 1 800 JDF CURE 1 800 533 2873 Additional information about Humalog and Humalog Pen can be obtained by calling 1 888 88 LILLY 1 888 885 4559 Literature issued November 19 2003 PV 3700 AMP Eli Lilly and Company Litt Indianapolis IN 46285 USA Copyright 1998 2003 Eli Lilly and Company All rights reserved PRINTED IN USA HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP INFORMATION FOR THE PATIENT 3 ML DISPOSABLE INSULIN DELIVERY DEVICE HUMALOG Mix75 25 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN 100 UNITS PER ML U 100 WARNINGS THIS LILLY HUMAN INSULIN ANALOG MIXTURE IS DIFFERENT FROM OTHER INSULIN MIXTURES IN THAT ITS ONSET OF ACTION IS VERY QUICK THE QUICK ONSET OF ACTION MEANS THAT YOU SHOULD TAKE YOUR DOSE OF HUMALOG Mix75 25 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN WITHIN 15 MINUTES BEFORE YOU EAT ANY CHANGE OF INSULIN SHOULD BE MADE CAUTIOUSLY AND ONLY UNDER MEDICAL SUPERVI SION CHANGES IN STRENGTH MANUFACTURER TYPE E G REGULAR NPH ANALOG SPECIES BEEF PORK BEEF PORK HUMAN OR
27. atterns such as high blood sugar levels in the morning that may require changes to your medication or meal plan to improve control By making regular daily entries in this diary you will be an active partner in maintaining the best possible control over your diabetes How to Compare Values This chart shows the average blood sugar that corresponds to the A1C test results Your doctor and or diabetes educator will help you set your goal Reference Diabetes Control and Complications Trial DCCT Results of Feasibility Trial Diabetes Care Volume 10 1 19 1987 4 MEN co 5 90 Blood A1C co o Sugar UE 15 mg dL 12 300 13 330 Meal Planning Despite what you may have heard having diabetes does not mean you have to give up the foods you enjoy However learning to eat healthy satisfying meals is an important part of your treatment Starches and sugars carbohydrates have more effect on blood sugar than protein or fat By keeping track of the carbohydrates you eat and spreading them throughout the day you can help control your blood sugar Your healthcare team can help you learn what is right for you and can list the amounts in the chart below Breakfast Lunch Dinner Snack Carbohydrates Other Health Checklist Here are some key things you need to do to stay feeling your best Be sure to list your test values and information in the chart below for your own records Keep t
28. ay Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine
29. ay Units Type E n Tuesday 4 7N sH 14N EXERCISED AFTER DINNER Units Type AND HAD LOW SUGAR Wednesday Units Type Thursday NOT FEELING WELL Units Type KETONES NEG Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner
30. e a new needle Prime to make sure the Pen is ready to dose Make sure you got your full dose NEVER SHARE INSULIN PENS CARTRIDGES OR NEEDLES PREPARING THE INSULIN PEN FOR INJECTION 1 Inspect the appearance of Humalog Mix75 25 suspension in the Humalog Mix75 25 Pen It should look uniformly cloudy or milky after mixing Once the Humalog Mix75 25 Pen is in use inspect the insulin in the Humalog Mix75 25 Pen before each injection 2 Follow the instructions in the Disposable Insulin Delivery Device User Manual for these steps Preparing the Pen Attaching the Needle Use a new needle for each injection Priming the Pen The Pen must be primed before each injection to make sure the Pen is ready to dose Performing the priming step is important to confirm that insulin comes out when you push the injection button and to remove air that may collect in the insulin cartridge during Normal use Setting a Dose Injecting a Dose To make sure you have received your full dose you must push the injection button all the way down until you see a diamond or an arrow in the center of the dose window Following an Injection HUMALOG Mix75 25 Pen 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN PV 3720 AMP PREPARING FOR INJECTION 1 Wash your hands 2 To avoid tissue damage choose a site for each injection that is at least 1 2 inch from the previous injection site The
31. e insulin The needle must be changed and the Pen must be primed before each injection to make sure the Pen is ready to dose Performing the priming step is important to confirm that insulin comes out when you push the injection button and to remove air that may collect in the insulin cartridge during normal use Every time you inject Use a new needle Prime to make sure the Pen is ready to dose Make sure you got your full dose NEVER SHARE INSULIN PENS CARTRIDGES OR NEEDLES PREPARING THE INSULIN PEN FOR INJECTION 1 Inspect the appearance of Humalog Mix50 50 suspension in the Humalog Mix50 50 Pen It should look uniformly cloudy or milky after mixing Once the Humalog Mix50 50 Pen is in use inspect the Insulin in the Humalog Mix50 50 Pen before each injection 2 Follow the instructions in the Disposable Insulin Delivery Device User Manual for these steps Preparing the Pen Attaching the Needle Use a new needle for each injection Priming the Pen The Pen must be primed before each injection to make sure the Pen is ready to dose Performing the priming step is important to confirm that insulin comes out when you push the injection button and to remove air that may collect in the insulin cartridge during normal use Setting a Dose Injecting a Dose To make sure you have received your full dose you must push the injection button all the way down until you see a diamond or an arrow 9 in the center of the
32. enetical analog Humalog Mix75 25 is a mixture of 75 insulin lispro insulin lispro It is a longer acting insulin combined with the more rapid activity is similar to that of Humulin 70 30 ly altered by the and may last up that of other insulins ased on dose site of is a sterile suspension ion of Humalog uman st mi insulin allowing lures containing ly and Company has the trademark umalog Mix75 25 Your AND DIRECTION YOU levices insulin designed to allow any other insulin to I glass bead to travel the full length of HUMALOG Mix75 25 Pen 75 INSULI SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIG N LISPRO PROTAMINE e mixed in its cartridge before adminis Holding the Pen by one end invert the cartridge with each PV 3720 AMP Figure 1 Humalog Mix75 25 should look until the contents are mixed Pens contai requently Do not use if the insul Do not use a Humalog Mix75 25 markedly consult your doctor e discarded after 10 days even i Do not use Humalog Mix75 25 HUMALOG Mix75 25 Pen 75 giving a frosted appearance Always check using If you note anything unusual in its Storage Not in use unopened Humal ut not in the freezer Do not use Humalog Mix75 25 Pen if it In use Humalog Mix75 25 Pens in use should NOT be temperature below 86 F 30 C away from direct heat and li uniformly cloudy or milky in substance
33. er like appearance and consistency Do not use if it appears cloudy thickened or slightly colored or if solid particles are visible If you note anything unusual in its appearance or notice your insulin requirements changing markedly consult your doctor Storage Not in use unopened Humalog Pens not in use should be stored in a refrigerator but not in the freezer Do not use Humalog Pen if it has been frozen In use Humalog Pens in use should NOT be refrigerated but should be kept at room temperature below 86 F 30 C away from direct heat and light Humalog Pens in use must be discarded after 28 days even if they still contain Humalog Do not use Humalog Pens after the expiration date stamped on the label INSTRUCTIONS FOR PEN USE It is important to read understand and follow the instructions in the Disposable Insulin Delivery Device User Manual before using Failure to follow instructions may result in getting too much or too little insulin The needle must be changed and the Pen must be primed before each injection to make sure the Pen is ready to dose These steps are important to confirm that insulin comes out when you push the injection button and to remove air that may collect in the insulin cartridge during normal use Every time you inject Use a new needle Prime to make sure the pen is ready to dose Make sure you got a full dose NEVER SHARE INSULIN PENS CARTRIDGES OR NEEDLES PREPARING THE INSULIN PEN F
34. ests 3 Developing a fever infection or other significant stressful situation In patients with type 1 or insulin dependent diabetes prolonged hyperglycemia can result in DKA The first symptoms of DKA usually come on gradually over a period o hours or days and include a drowsy feeling flushed face thirst loss of appetite and fruity odor on the breath With DKA urine tests show large amounts of glucose and ketones Heavy breathing and a rapid pulse are more severe symptoms If uncorrected prolonged hyperglycemia or DKA can lead to nausea vomiting stomach pains dehydration loss o consciousness or death Therefore it is important that you obtain medical assistance immediately Lipodystrophy Rarely administration of insulin subcutaneously can result in ipoatrophy depression in the skin or lipohypertrophy enlargement or thickening o issue If you notice either of these conditions consult your doctor A change in your injection technique may help alleviate the problem Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 AMP Allergy Local Allergy Patients occasionally experience redness swelling and itching at the site of injection This condition called local allergy usually clears up in a few days to a few weeks In some instances this condition may be related to factors other than insulin such as irritants in the skin cleansing agent or poor injection technique If
35. ged hyperglycemia can result in DKA The first symptoms of DKA usually come on gradually over a period of hours or days and include a drowsy feeling flushed face thirst large amounts of glucose and ketones loss of appetite and fruity odor on the breath With DKA urine tests show leavy breathing and a rapid pulse are more severe symptoms If uncorrected prolonged hyperglycemia or DKA can lead to nausea vomiting stomach pains dehydration loss of consciousness or death Therefore it is important that you obtain medical assistance immediately Lipodystrophy Rarely administration of insulin subcutaneously can result in lipoatrophy depression in the skin or lipohypertrophy enlargement or thickening of tissue If you notice either of these conditions consult your doctor A change in your injection technique may help alleviate the problem HUMALOG Mix75 25 Pen 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN PV 3720 AMP Allergy Local Alleray Patients occasionally experience redness swelling injection This condition called local allergy usually clears up in a few days instances this condition may be related to factors other than insulin such as irri agent or poor injection technique If you have local reactions contact your doc Systemic Allergy Less common but potentially more serious is generalize and itching at the site of a few weeks In so
36. his handy and refer to it often When you start a new diary write down your last test result in the new diary My Health Record Date Date Date Date Every Visit Blood Pressure Weight Visual Foot Exam Every 3 6 Months A1C A1C Normal Range Every Year Total Cholesterol HDL Cholesterol LDL Cholesterol Triglycerides Kidney Checks Comprehensive Foot Exam Dilated Eye Exam e See your doctor and or diabetes educator at least every 3 6 months Work with your health care team to set your personal goals Blood pressure check at every visit Visual foot exam every visit comprehensive foot exam at least every year e Have A1C test at least every 3 6 months Check blood fats lipids at least every year Kidney check microalbumin at least every year Dilated eye exam at least every year Yearly exams for all people with type 2 diabetes Yearly exams for people with type 1 diabetes beginning 5 years after diagnosis Your Diabetes Plan Fill out this page when you meet with your doctor or diabetes educator so you know your target ranges the dose and type of diabetes medicine you should be taking as well as your blood sugar testing schedule Diabetes Medicine Tims Type Blood Sugar Target Ranges Before Meals mg dL to mg dL 2 Hours After Meals mg dL to mg dL A1C Target Goal Less than
37. ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday
38. lan for you to use in case of illness When you are sick test your blood glucose urine glucose and ketones frequently and call your doctor as instructed Pregnancy Good control of diabetes is especially important for you and your unborn baby Pregnancy may make managing your diabetes more difficult If you are planning to have a baby are pregnant or are nursing a baby consult your doctor Humalog Mix75 25 has not been tested in pregnant or nursing women HUMALOG Mix75 25 Pen 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN PV 3720 AMP Medication Insulin requirements ma activi may be reduced in the presence of drugs agen Health Care Professional is aware of thes Therefore always discuss any medication the physical the exercise regimen to accommodate exercise Travel Persons traveling across mo adjustments in their insulin schedule y be increased if you are taking other drugs with hyperglycemic Such as oral contraceptives corticosteroids or thyroid replacement therapy Insulin requirements with blood glucose lowering activity such as oral antidiabetic s salicylates for example aspirin sulfa antibiotics alcohol and certain antidepressants Your e and other medications that may affect your diabetes control s you are taking with your doctor Exercise Exercise may lower your body s need for insulin products during and for some time after
39. ls or at di injection blood supply temperature and and is for subcutaneous injection It shoul Mix75 25 is 100 units mL U 100 Humalog Mix75 25 starts lowering blo convenient dosing immediai regular human insulin should be given 30 Identification Insulin lispro rDNA oi Humalog Humalog products are available doctor has prescribed the type of insulin DO NOT USE ANY OTHER INSULIN E 0 Pens The Humalog Mix75 25 Pen is of H it 180 slowly 10 times to allow the smal inversion see Figure 2 rain of Escherichia coli baci his human insulin 00 The duration of The time course of Humalog Mix75 25 action lik ely before SHOULD NOT MIX HUMALOG Mix75 25 WITH ANOTHER INSULIN The Humalog Mix75 25 Pen is available in boxes of 5 disposal umalog Mix75 25 or for the cartridge to be removed Always examine the appearance of Humalog Mix75 25 suspension in the insulin Pen ering a dose Roll the Pen between the palms 10 times see Figure he same individual Mix75 25 erent times in physical activity Humal od glucose more quickly than regular a meal within 15 minutes In contra 0 60 minutes before a meal rigin injection by Eli Lil le in two formulations Humalog and H hat he she believes is best for you XCEPT ON YOUR DOCTOR S ADVICE Id not be used intravenously The concentra le insulin delivery alog insulin lispro rDNA origin is made by a special non eria that has been g
40. me ants in the skin cleansing or d allergy to insulin which may cause rash over the whole body shortness of breath wheezing reduction in blood pressure fast pulse or sweating Severe cases of generalized allergy may be life threatening a generalized allergic reaction notify a doctor immediately ADDITIONAL INFORMATION Additional information about diabetes may be ob educator DIABETES FORECAST is a magazine designed especially for people with dial is available by subscription from 61054 0363 1 800 DIABETES 1 800 342 2383 Another publication COUNTDOWN is available from the Juvenile Diabel you think you are having tained from your diabetes etes and their families It he American Diabetes Association ADA 0 Box 363 Mt Morris IL es Research Foundation International JDRFI 120 Wall Street 19th Floor New York 10005 1 800 533 CURE 1 800 533 2873 Additional information about Humalog Mix75 25 and Humalog Mix75 25 calling The Lilly Answers Center at 1 800 LillyRx 1 800 545 5979 Literature revised March 3 2005 PV 3720 AMP Eli Lilly and Company Litt Indianapolis IN 46285 USA Copyright 1999 2005 Eli Lilly and Company All rights reserved HUMALOG Mix75 25 Pen 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN Pens can be obtained by PV 3720 AMP INFORMATION FOR THE PATIENT 3 ML DISPOSABLE INSULIN DELIVERY DEVICE HUMALOG Mi
41. ness dizziness sleep disturbances palpitation anxiety tremor blurred vision hunger slurred speech restlessness tingling in the hands feet lips or tongue lightheadedness inability to concentrate headache Signs of severe hypoglycemia can include disorientation unconsciousness depressed mood irritability abnormal behavior unsteady movement personality changes seizures death Therefore it is important that assistance be obtained immediately Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions such as long duration of diabetes diabetic nerve disease use of medications such as beta blockers changing insulin preparations or intensified control 3 or more injections per day of diabetes A few patients who have experienced hypoglycemic reactions after transfer from animal source insulin to human insulin have reported that the early warning symptoms of hypoglycemia were less pronounced or different from those experienced with their previous insulin Without recognition of early warning symptoms you may not be able to take steps to avoid more serious hypoglycemia Be alert for all of the various types of symptoms that may indicate hypoglycemia Patients who experience hypoglycemia without early warning symptoms should monitor their blood glucose frequently especially prior to activities such as driving If the blood glucose is below your
42. nits Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Sa
43. nsulin Reaction Hypoglycemia too little glucose in the blood is one of the most frequent adverse events experienced by insulin users It can be brought about by 1 Missing or delaying meals 2 Taking too much insulin 3 Exercising or working more than usual 4 An infection or illness especially with diarrhea or vomiting 5 A change in the body s need for insulin 6 Diseases of the adrenal pituitary or thyroid gland or progression of kidney or liver disease 7 Interactions with other drugs that lower blood glucose such as oral hypoglycemics salicylates for example aspirin sulfa antibiotics and certain antidepressants 8 Consumption of alcoholic beverages Symptoms of mild to moderate hypoglycemia may occur suddenly and can include sweating drowsiness dizziness sleep disturbances palpitation anxiety tremor blurred vision hunger slurred speech restlessness depressed mood HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP tingling in the hands feet lips or tongue lightheadedness inability to concentrate headache Signs of severe hypoglycemia can include disorientation seizures Unconsciousness death Therefore it is important that assistance be obtained immediately Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions such as long duration of diabetes diabetic nerve disease use of medications such as be
44. ortant that you obtain medical assistance immediately Lipodystrophy Rarely administration of insulin subcutaneously can result in lipoatrophy depression in the skin or lipohypertrophy enlargement or thickening of tissue If you Notice either of these conditions consult your doctor A change in your injection technique may help alleviate the problem Allergy Local Alleray Patients occasionally experience redness swelling and itching at the site of injection This condition called local allergy usually clears up in a few days HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP to a few weeks In some instances this condition may be related to factors other than insulin such as irritants in the skin cleansing agent or poor injection technique If you have local reactions contact your doctor Systemic Allergy Less common but potentially more serious is generalized allergy to insulin which may cause rash over the whole body shortness of breath wheezing reduction in blood pressure fast pulse or sweating Severe cases of generalized allergy may be life threatening If you think you are having a generalized allergic reaction notify a doctor immediately ADDITIONAL INFORMATION Additional information about diabetes may be obtained from your diabetes educator DIABETES FORECAST is a national magazine designed especially for patients with diabetes and their families and is available by subscription from the Americ
45. ou have been instructed to test your blood and or urine regularly for glucose Studies have shown that some chronic complications of diabetes such as eye disease kidney disease and nerve disease can be significantly reduced if the blood sugar is maintained as close to normal as possible The American Diabetes Association recommends that if your pre meal glucose levels are consistently above 130 mg dL bedtime glucose levels are consistently above 160 mg dL or you hemoglobin Ay is more than 7 consult your doctor A change in your diabetes therapy may be needed If your blood tests consistently show below targeted glucose levels you should also let you doctor know Proper control of your diabetes requires close and constant cooperation with your doctor Despite diabetes you can lead an active and healthy life if you eat a balanced diet exercise regularly and take your insulin injections as prescribed Always keep an extra Humalog Mix75 25 Pen as well as a spare needle on hand Always wear diabetic identification so that appropriate treatment can be given if complications occur away from home HUMALOG Mix75 25 Pen 75 INSULIN LISPRO PROTAMINE SUSPENSION AND 25 INSULIN LISPRO INJECTION rDNA ORIGIN PV 3720 AMP HUMALOG Mix75 25 Description Hum disease producing laboratory s addition of the gene for protamine suspension and 25 onset of action of Humal to 24 hours following injection may vary in different individua
46. ta blockers changing insulin preparations or intensified control 3 or more injections per day of diabetes A few patients who have experienced hypoglycemic reactions after transfer from animal source insulin to human insulin have reported that the early warning symptoms of hypoglycemia were less pronounced or different from those experienced with their previous insulin Without recognition of early warning symptoms you may not be able to take steps to avoid more serious hypoglycemia Be alert for all of the various types of symptoms that may indicate hypoglycemia Patients who experience hypoglycemia without early warning symptoms should monitor their blood glucose frequently especially prior to activities such as driving If the blood glucose is below your normal fasting glucose you should consider eating or drinking sugar containing foods to treat your hypoglycemia Mild to moderate hypoglycemia may be treated by eating foods or drinks that contain sugar Patients should always carry a quick source of sugar such as candy mints or glucose tablets More severe hypoglycemia may require the assistance of another person Patients who are unable to take sugar orally or who are unconscious require an injection of glucagon or should be treated with intravenous administration of glucose at a medical facility irritability abnormal behavior unsteady movement personality changes HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 370
47. the white mat he appearance of they still contain Humalog Pens after the expiration dat INSULIN LISPRO PROTAM SUSPENSION AND 25 INSULIN LISPRO appearance or INJECTION rDNA ORIGIN Figure 2 er mixing If not repeat the above steps ining Humalog Mix75 25 suspension should be examined remains visibly separated from the iquid after mixing Do not use a Humalog Mix75 25 Pen if there are clumps in the insulin after mixing Pen if solid white particles s ick to the bottom or wall of the cartridge e Humalog Mix75 25 suspension before ice your insulin requirements changing og Mix75 25 Pens not in use should be stored in a refrigerator as been frozen refrigerated but should be kept at room t Humalog Mix75 25 Pens in use must Mix75 25 e stamped on the label NE PV 3720 AMP INSTRUCTIONS FOR INSULIN PEN USE It is important to read understand and follow the instructions in the Disposable Insulin Delivery Device User Manual before using Failure to follow instructions may result in getting too much or too little insulin The needle must be changed and the Pen must be primed before each injection to make sure the Pen is ready to dose Performing these steps before each injection is important to confirm that insulin comes out when you push the injection button and to remove air that may collect in the insulin cartridge during normal use Every time you inject Us
48. ting a Dose To make sure you have received your dose you must push the to change Even if you are not eating you will still require insulin You and your doctor injection button all the way down until you see a diamond or an arrow gt should establish a sick day plan for you to use in case of illness When you are sick test in the center of the dose window your blood glucose urine glucose and ketones frequently and call your doctor as instructed e Following an Injection Pregnancy Good control of diabetes is especially important for you and your unborn baby Pregnancy may make managing your diabetes more difficult If you are planning to PREPARING FOR INJECTION have a baby are pregnant or are nursing a baby consult your doctor Humalog has not 1 Wash your hands been tested in pregnant or nursing women 2 To avoid tissue damage choose a site for each injection that is at least 1 2 inch from Geriatric Use Elderly patients using Humalog had HbA c values and hypoglycemia the previous injection site The usual sites of injection are abdomen thighs and rates similar to those observed in younger patients The onset of action of Humalog may arms be different in elderly patients 3 Cleanse the skin with alcohol where the injection is to be made Medication Insulin requirements may be increased if you are taking other drugs with 4 With one hand stabilize the skin by spreading it or pinching up a large area hyperglycemic activi
49. turday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week
50. ty such as oral contraceptives corticosteroids or thyroid replacement 5 Inject the dose as instructed by your doctor therapy Insulin requirements may be reduced in the presence of drugs with blood 6 After dispensing a dose pull the needle out and apply gentle pressure over the glucose lowering activity such as oral hypoglycemics salicylates for example aspirin injection site for several seconds Do not rub the area sulfa antibiotics alcohol and certain antidepressants Your health care professional is 7 Immediately after an injection remove the needle from the Humalog Pen Doing so aware of other medications that may affect your diabetes control Therefore always will guard against contamination and prevent leakage of Humalog reentry of air and discuss any medications you are taking with your doctor HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP HUMALOG Pen INSULIN LISPRO INJECTION rDNA ORIGIN PV 3700 AMP Exercise Exercise may lower your body s need for insulin products during and for some time after the physical activity Exercise may also speed up the effect of a dose of Humalog especially if the exercise involves the area of injection site Discuss with your doctor how you should adjust your regimen to accommodate exercise Travel Persons traveling across more than 2 time zones should consult their doctor concerning adjustments in their insulin schedule COMMON PROBLEMS OF DIABETES Hypoglycemia I
51. uo vq uonoefur oJdsi ujjnsui 09 uonoefur odsi 2 uoisuadsns euiuejoJd oJdsij uijnsul 9 06 uoisuedsns 020811 ulinsul 9567 uBuo uonoefui 01051 8 osos vel serere 6
52. usual sites of injection are abdomen thighs and arms 3 Cleanse the skin with alcohol where the injection is to be made 4 With one hand stabilize the skin by spreading it or pinching up a large area 5 Inject the dose as instructed by your doctor Hold the needle under the skin for at least 5 seconds after injecting 6 After injecting a dose pull the needle out and apply gentle pressure over the injection site for several seconds Do not rub the area 7 Immediately after an injection remove the needle from the Humalog Mix75 25 Pen Doing so will guard against contamination and prevent leakage of Humalog Mix75 25 reentry of air and needle clogs Do not reuse needles Place the used needle in a puncture resistant disposable container and properly dispose of it as directed by your Health Care Professional DOSAGE Your doctor has told you which insulin to use how much and when and how often to inject it Because each patient s case of diabetes is different this schedule has been individualized for you Your usual Humalog Mix75 25 dose may be affected by changes in your food activity or work schedule Carefully follow your doctor s instructions to allow for these changes Other things that may affect your Humalog Mix75 25 dose are IIIness lliness especially with nausea and vomiting may cause your insulin requirements to change Even if you are not eating you will still require insulin You and your doctor should establish a sick day p
53. x50 50 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN 100 UNITS PER ML U 100 WARNINGS THIS LILLY HUMAN INSULIN ANALOG MIXTURE IS DIFFERENT FROM OTHER INSULIN MIXTURES IN THAT ITS ONSET OF ACTION IS VERY QUICK THE QUICK ONSET OF ACTION MEANS THAT YOU SHOULD TAKE YOUR DOSE OF HUMALOG Mix90 90 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN WITHIN 15 MINUTES BEFORE YOU EAT ANY CHANGE OF INSULIN SHOULD BE MADE CAUTIOUSLY AND ONLY UNDER MEDICAL SUPERVISION CHANGES IN STRENGTH MANUFACTURER TYPE E G REGULAR NPH ANALOG SPECIES BEEF PORK BEEF PORK HUMAN OR METHOD OF MANUFACTURE rDNA VERSUS ANIMAL SOURCE INSULIN MAY RESULT IN THE NEED FOR A CHANGE IN THE TIMING OR DOSAGE OF HUMALOG Mix50 50 PATIENTS TAKING HUMALOG Mix50 50 MAY REQUIRE A CHANGE IN DOSAGE FROM THAT USED WITH OTHER INSULINS IF AN ADJUSTMENT IS NEEDED IT MAY OCCUR WITH THE FIRST DOSE OR DURING THE FIRST SEVERAL WEEKS OR MONTHS TO OBTAIN AN ACCURATE DOSE CAREFULLY READ AND FOLLOW THE DISPOSABLE INSULIN DELIVERY DEVICE USER MANUAL AND THIS INFORMATION FOR THE PATIENT INSERT BEFORE USING THIS PRODUCT BEFORE EACH INJECTION YOU SHOULD PRIME THE PEN A NECESSARY STEP TO MAKE SURE THE PEN IS READY TO DOSE PRIMING THE PEN IS IMPORTANT TO CONFIRM THAT INSULIN COMES OUT 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 AMP
54. you have local reactions contact your doctor Systemic Allergy Less common but potentially more serious is generalized allergy to insulin which may cause rash over the whole body shortness of breath wheezing reduction in blood pressure fast pulse or sweating Severe cases of generalized allergy may be life threatening If you think you are having a generalized allergic reaction notify a doctor immediately ADDITIONAL INFORMATION Additional information about diabetes may be obtained from your diabetes educator DIABETES FORECAST is a magazine designed especially for people with diabetes and their families It is available by subscription from the American Diabetes Association ADA P O Box 363 Mt Morris IL 61054 0363 1 800 DIABETES 1 800 342 2383 Another publication COUNTDOWN is available from the Juvenile Diabetes Research Foundation International JDRFI 120 Wall Street 19th Floor New York NY 10005 1 800 533 CURE 1 800 533 2873 Additional information about Humalog Mix50 50 and Humalog Mix50 50 Pens can be obtained by calling The Lilly Answers Center at 1 800 LillyRx 1 800 545 5979 Literature revised January 23 2006 PV 4511 AMP Eli Lilly and Company Indianapolis IN 46285 USA Copyright 2005 2006 Eli Lilly and Company All rights reserved PRINTED IN USA Pen 50 INSULIN LISPRO PROTAMINE SUSPENSION AND 50 INSULIN LISPRO INJECTION rDNA ORIGIN PV 4511 AMP Humalog Humalog Mix75 25 and Humalog
55. ype Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday Insulin Morning Evening Bedtime Oral Comments illness reactions Agent s urine ketones activities Monday Units Type Tuesday Units Type Wednesday Units Type Thursday Units Type Friday Units Type Saturday Units Type Sunday Units Type Week of Blood Breakfast After Lunch After Dinner After Bedtime Night Sugar Breakfast Lunch Dinner Monday Tuesday Wednesday Thursday Friday Saturday Sunday
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