For SC use only. Inadequate dosing or discontinuation of treatment, especially in type 1 diabetes, may lead to hyperglycemia & diabetic ketoacidosis. Concomitant illness, especially infections, usually increases the patient's insulin requirement. Omission of meal or unplanned strenuous physical exercise may lead to hypoglycemia. Intensified insulin therapy may change the usual warning symptoms of hypoglycemia. Shifting from other types of insulin should be done under strict medical supervision. Concomitant diseases in the kidney, liver or those affecting the adrenal, pituitary or thyroid gland may require changes in the insulin dose. Cases of cardiac failure have been reported when thiazolidinediones were used in combination w/ insulin, especially in patients w/ risk factors for development of cardiac failure. Abrupt improvement in glycemic control may be associated w/ temporary worsening of diabetic retinopathy. In elderly patients & patients w/ renal or hepatic impairment, glucose monitoring should be intensified & the dosage should be adjusted on an individual basis. Insulin administration may cause insulin antibodies to form which may necessitate dose adjustment. May impair ability to drive or operate machinery (as a result of hypoglycemia). Pregnancy & lactation. Childn <18 yr.
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