25.9 : 胰岛素：给药方案和不良反应

Insulin dosage regimens generally include a mixture of analogs given as daily injections. Typically, most patients are prescribed long and short-acting analogs.

Long-acting formulations account for 40-50% of the total daily dose, and pre-meal short-acting insulin covers the remaining.

Examples include a single daily injection of long-acting glargine and three premeal short-acting insulin injections. At times, a less intensive regimen with twice-daily intermediate-acting NPH insulin for basal coverage and regular short-acting insulin before three meals are prescribed.

Glucose self-monitoring and regular A1c tests are essential to avoid undesirable insulin effects.

The most common adverse effect is hypoglycemia or abnormally low blood sugar. Such low glucose levels may cause brain damage or cardiac arrest.

Some rare effects, such as allergic reactions to recombinant human insulin, are seen in some cases.

Repeated injections at the same site significantly enlarge subcutaneous fat depots due to insulin's lipogenic action.