Pharmacology · MU Sofia

63. Insulins and insulin analogues.

Explains how insulin lowers blood glucose and sets out the rapid-acting, intermediate-acting and long-acting types with their onset and duration, followed by pharmacodynamic effects on glycogenesis, gluconeogenesis and lipolysis. It also covers pharmacokinetics by type, common and rare side effects, drug interactions that raise or lower insulin's effect, therapeutic uses, and use in pregnancy and lactation, ending with recap questions.

Inside: 9 sections · 3 labelled pictures · 5 tables · 10 flashcards · 2 min

Topic 62 of 93 in the MU Sofia syllabus for Pharmacology (Dental Medicine, Year 3). The free AceMed note covers it in 9 sections, about 184 words (2 min of reading), with 10 flashcards.

In this note

  1. Insulins and Insulin Analogs
  2. Classification / Examples
  3. Pharmacodynamics
  4. Pharmacokinetics
  5. Side Effects
  6. Drug Interactions
  7. Therapeutic Uses
  8. Pregnancy & Milk
  9. Recap Questions

Insulins and Insulin Analogs

Insulin is a hormone produced by the pancreas that lowers blood glucose by facilitating glucose uptake into cells, especially in muscle and adipose tissue.

Pharmacodynamics

  • Increases glucose uptake via GLUT4 transporters in muscle/adipose tissue.
  • Promotes:
  • Glycogenesis (glucose → glycogen in liver and muscles)
  • Protein synthesis
  • Lipogenesis
  • Inhibits:
  • Gluconeogenesis (new glucose production)
  • Glycogenolysis (breakdown of glycogen)
  • Lipolysis and ketogenesis

Pharmacokinetics

  • Half-life:
  • Endogenous insulin: few minutes
  • Long-acting analogs: several hours

Therapeutic Uses

  • Type 1 Diabetes Mellitus (lifelong insulin dependence)
  • Type 2 Diabetes Mellitus (when oral drugs/lifestyle fail)
  • Gestational diabetes
  • Diabetic ketoacidosis (DKA)
  • Hyperkalemia (insulin shifts K⁺ into cells, usually given with glucose)
  • Perioperative glycemic control

Pregnancy & Milk

  • Insulin is the preferred treatment during pregnancy (Type 1, Type 2, or GDM).
  • Does not cross placenta → safe for fetus.
  • Excreted in low amounts in breast milk, but generally safe during lactation.

Recap Questions

  1. 1. What is the main difference between insulin lispro and insulin glargine?
  2. 2. Why is insulin the first-line treatment in pregnancy?
  3. 3. Which insulin has the longest duration of action?
  4. 4. Name a drug that can increase the risk of insulin -induced hypoglycemia.
  5. 5. What are the signs of insulin -induced lipodystrophy?

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