Must not be administered IV, as it may result in severe hypoglycemia. IM administration should also be avoided. Not to be used in insulin infusion pumps. Seek physician's advice before travelling to different time zones. Inadequate dosing or discontinuation of treatment, especially in type 1 diabetes, may lead to hyperglycemia & diabetic ketoacidosis. Omission of meal or unplanned strenuous physical exercise may lead to hypoglycemia, or if the dose is too high. Intensified insulin therapy may change the usual warning symptoms of hypoglycemia, & long-standing diabetes may reduce these warning symptoms. Transferring from other types of insulin should be done under strict medical supervision. Rapid onset of action should be considered in patients w/ delayed food absorption. Concomitant illness, especially infections & feverish conditions, usually increases the patient's insulin requirement. Concomitant diseases in the kidney, liver or affecting the adrenal, pituitary or thyroid gland may require changes in the insulin dose. Rotate inj site continuously. Cases of CHF were reported when thiazolidinediones were used in combination w/ insulin, especially in patients w/ risk factors for development of CHF. Insulin antibodies may form & require dose adjustment. Renal or hepatic impairment may reduce the patient's insulin requirements. Hypoglycemia may impair ability to drive or operate machinery. Limited clinical experience in pregnancy & may require dose adjustment in lactation. Limited clinical data exists for childn 6-9 yr. There is limited experience in combination w/ OADs in patients >75 yr.
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