Humulin R Side Effects

Generic Name: insulin regular

Note: This page contains information about the side effects of insulin regular. Some of the dosage forms included on this document may not apply to the brand name Humulin R.

Not all side effects for Humulin R may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to insulin regular: injection solution

In addition to its needed effects, some unwanted effects may be caused by insulin regular (the active ingredient contained in Humulin R). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking insulin regular:

Incidence not known
  • Anxiety
  • blurred vision
  • chills
  • cold sweats
  • coma
  • confusion
  • convulsions
  • cool, pale skin
  • cough
  • decreased urine
  • depression
  • difficulty swallowing
  • dizziness
  • dry mouth
  • fast heartbeat
  • flushing or redness of the skin
  • headache
  • hives
  • increased hunger
  • increased thirst
  • irregular heartbeat
  • itching
  • loss of appetite
  • muscle pain or cramps
  • nausea
  • nightmares
  • numbness or tingling in the hands, feet, or lips
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • shakiness
  • shortness of breath
  • skin rash
  • slurred speech
  • sweating
  • swelling
  • tightness in the chest
  • unusual tiredness or weakness
  • unusually warm skin
  • wheezing

Some of the side effects that can occur with insulin regular may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known
  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  • redistribution or accumulation of body fat

For Healthcare Professionals

Applies to insulin regular: injectable solution, subcutaneous solution

Endocrine

Permanent neuropsychological impairment has been associated with recurrent episodes of severe hypoglycemia.

In one retrospective study of 600 randomly selected patients with insulin-treated diabetes mellitus, the only reliable predictors of severe hypoglycemia were a history of hypoglycemia, a history of hypoglycemia-related injury or convulsion, and the duration of insulin therapy. Those with a history of hypoglycemia had been treated with insulin for 17.4 years, which was significantly longer than the 14.3 years in the insulin-treated patients without a history of hypoglycemia.

Human insulin does not appear to be associated with hypoglycemic episodes more often than animal insulin. Caution is recommended when switching from animal (either bovine or pork) to purified porcine insulin or biosynthetic human insulin, however, because of increased potency or bioavailability.[Ref]

Endocrine side effects have included hypoglycemia, which has been the most common and serious side effect of insulin, occurring in approximately 16% of type 1 and 10% of type II diabetic patients (the incidence varies greatly depending on the populations studied, types of insulin therapy, etc). Although there are counterregulatory endocrinologic responses to hypoglycemia, some responses are decreased, inefficient, or absent in some patients. Severe hypoglycemia usually presents first as confusion, sweating, or tachycardia, and can result in coma, seizures, cardiac arrhythmias, neurological deficits, and death. Blood or urine glucose monitoring is recommended in patients who are at risk of hypoglycemia or who do not recognize the signs and symptoms of hypoglycemia. The risk for developing hypoglycemia is higher in patients receiving intensive or continuous infusion insulin therapy. The association between insulin and dyslipidemia is currently being evaluated.[Ref]

Ocular

Ocular side effects have included reports bilateral presbyopia (blurry vision) during the beginning of therapy. This was thought to be due to changes in the osmotic equilibrium between the lens and the ocular fluids, and was usually self-limited.[Ref]

Dermatologic

Dermatologic side effects have included lipohypertrophy (insulin is lipogenic) and lipoatrophy (probably immunologically-mediated). The incidence of lipoatrophy is markedly decreased with the use of purer forms of pork insulin or biosynthetic human insulin and when injection sites are alternated. Without proper hygiene, subcutaneous insulin injections may be complicated by infection.[Ref]

Hypersensitivity

Hypersensitivity side effects have included both local and systemic reactions. These reactions are becoming rare (less than 1% of patients) due to the use of purer forms of pork insulin or biosynthetic human insulin. Local reactions have presented as erythema, swelling, heat, or subcutaneous nodules. They usually occurred within the first two weeks of therapy, then disappeared. True allergy to insulin has been rare, and sensitization was usually associated with specific animal proteins in bovine and less pure forms of porcine insulins.[Ref]

A diabetic patient with true allergy to insulin can undergo desensitization. Desensitization kits and protocols are available from some insulin manufacturers.[Ref]

Immunologic

Immunologic side effects have included the formation of anti-insulin antibodies, particularly when animal insulin formulations were used. The presence of these antibodies caused the elimination half-life of insulin to increase.[Ref]

Immunologic analysis of anaphylaxis to some insulin preparations in some cases has revealed markedly elevated serum levels of lgE and lgG to protamine, but not to regular insulin.[Ref]

Cardiovascular

Cardiovascular side effects have included hyperinsulinemia. Given the high frequency of both microvascular and macrovascular diseases in patients with diabetes, some experts are evaluating insulin as a possible atherogenic agent. Controversy and continued study surround the role of hyperinsulinemia as the precursor of hypertension.[Ref]

Other cardiovascular risk factors that are accentuated in persons with carbohydrate intolerance and hypertension include abnormalities in platelet function, clotting factors, the fibrinolytic system, and dyslipidemia. The relationship between diabetes, insulin, and these disorders is currently under investigation.

Insulin may contribute to the pathogenesis of hypertension by stimulating the sympathetic nervous system, promoting renal sodium retention, and/or stimulating vascular smooth muscle hypertrophy. It may induce dyslipidemia by promoting hepatic synthesis of very low density lipoproteins (VLDLs).

Insulin may stimulate heart rate in the absence of hypoglycemia.[Ref]

General

General side effects have included weight gain, sometimes presenting as edema associated with abrupt restoration of glucose control in a patient whose control was previously poor. Weight gain may be due to more efficient use of calories during insulin therapy, suggesting additional benefits of dietary and exercise modifications. Patients on intensive insulin therapy may be more likely to experience weight gain.[Ref]

Intensive insulin therapy causes an increase in body fat as a result of the elimination of glycosuria and reduction in 24-hour energy expenditure. The reduction in 24-h energy expenditure is the result of an insulin-associated decrease in triglyceride/free fatty acid cycling and nonoxidative glucose and protein metabolism.[Ref]

Metabolic

Rare cases of hypophosphatemia have been associated with the use of glucose, insulin, and potassium infusions during the treatment of myocardial infarction.[Ref]

Metabolic side effects have included reports of hypokalemia and hypomagnesemia, particularly in patients treated for diabetic ketoacidosis (DKA). Insulin increases the intracellular transport of phosphate, which often results in hypophosphatemia during treatment of DKA.[Ref]

Renal

Renal effects have included reports of significantly decreased renal plasma flow and glomerular filtration rate, and significantly increased urinary albumin excretion rate from insulin-induced hypoglycemia. These changes were usually reversible upon resolution of hypoglycemia.[Ref]

Hypoglycemia is associated with increased plasma dopamine, epinephrine, and plasma renin activity. Acute changes in renal function during insulin-induced hypoglycemia, therefore, may result from direct stimulation of the efferent sympathetic nerves to the kidney and hormonal counterregulatory mechanisms.[Ref]

Hematologic

Hematologic side effects have included an increase in the concentration of von Willebrand factor due to insulin-induced hypoglycemia. Increased von Willebrand factor, combined with hypoglycemia-associated decreased plasma volume and increased plasma viscosity, may predispose patients to reduced peripheral perfusion or embolic phenomenon. A single case of insulin-induced hemolytic anemia has been reported.[Ref]

The effects of insulin-induced hypoglycemia on hemostasis may explain some of the clinical observations of embolic phenomenon during treatment of diabetic ketoacidosis.

Limited data show that diabetics have a significantly lower basal concentration of tissue plasminogen activator.[Ref]

Gastrointestinal

Gastrointestinal side effects have been reported rarely. GI distress tends to resolve with dose reduction.[Ref]

References

1. Coscelli C, Lostia S, Lunetta M, Nosari I, Coronel GA "Safety, efficacy, acceptability of a pre-filled insulin pen in diabetic patients over 60 years old." Diabetes Res Clin Pract 28 (1995): 173-7

2. Yoo J, Peter S, Kleinfeld M "Transient hypoglycemic hemiparesis in an elderly patient." J Am Geriatr Soc 34 (1986): 479-81

3. Skyler JS "Human insulin after 10 years." Diabetes Care 16 Suppl 3 (1993): 1-3

4. Caprio S, Amiel S, Tamborlane WV, et al "Defective free-fatty acid and oxidative glucose metabolism in IDDM during hypoglycemia." Diabetes 39 (1990): 134-41

5. Kidson W "The Somogyi effect. Has it ever existed and what harm has it caused?" Med J Aust 159 (1993): 480-2

6. Teuscher A, Reinli K "Severe hypoglycaemia in Diabetes Control and Complications Trial." Lancet 343 (1994): 1097-8

7. Santiago JV "Intensive management of insulin dependent diabetes: risks, benefits, and unanswered questions." J Clin Endocrinol Metab 75 (1992): 977-82

8. Boden G, Reichard GA, Hoeldtke RD, et al "Severe insulin-induced hypoglycemia associated with deficiencies in the release of counterregulatory hormones." N Engl J Med 305 (1981): 1200-5

9. Steel JM, Masterton G, Patrick AW, McGuire R "Hyperventilation or hypoglycaemia?" Diabetic Med 6 (1989): 820-1

10. Hepburn DA, MacLeod KM, Pell AC, Scougal IJ, Frier BM "Frequency and symptoms of hypoglycaemia experienced by patients with type 2 diabetes treated with insulin." Diabet Med 10 (1993): 231-7

11. Mann SJ, Krakoff LR "Hypertensive crisis caused by hypoglycemia and propranolol." Arch Intern Med 144 (1984): 2427-8

12. Reichard P, Britz A, Rosenqvist U "Intensified conventional insulin treatment and neuropsychological impairment." Br Med J 303 (1991): 1439-42

13. von Kriegstein E "Hypoglycaemia with human and porcine insulins." BMJ 306 (1993): 720

14. Daniel DG, Rabin PL "Disguises of delirium." South Med J 78 (1985): 666-72

15. Lingenfelser T, Renn W, Sommerwerck U, Jung MF, Buettner UW, Zaiser-Kaschel H, Kaschel R, Eggstein M, Jakober B "Compromised hormonal counterregulation neurophysiological function after recurrent short-term episodes of insulin-induced hypoglycemia in IDDM patients." Diabetes 42 (1993): 610-8

16. Brodows RG, Williams C, Amatruda JM "Treatment of insulin reactions in diabetics." JAMA 252 (1984): 3378-81

17. Kalimo H, Olsson Y "Effects of severe hypoglycemia on the human brain." Acta Neurol Scand 62 (1980): 345-56

18. Wolf JP, Massol J, Nguyen NU, Berthelay S "Arginine vasopressin response to insulin-induced hypoglycemia in insulin-dependent diabetics with asymptomatic hypoglycemia." Horm Metab Res 22 (1990): 232-6

19. Borch-Johnsen K, Helweg-Larsen K "Sudden death and human insulin: is there a link?" Diabet Med 10 (1993): 255-9

20. Shimada R, Nakashima T, Nunoi K, et al "Arrhythmia during insulin-induced hypoglycemia in a diabetic patient." Arch Intern Med 144 (1984): 1068-9

21. Stangenberg M, Persson B, Stange L, Carlstrom K "Insulin-induced hypoglycemia in pregnant diabetics." Acta Obstet Gynecol Scand 62 (1983): 249-52

22. Scoppola A, Testa G, Frontoni S, Maddaloni E, Gambardella S, Menzinger G, Lala A "Effects of insulin on cholesterol synthesis in type II diabetes patients." Diabetes Care 18 (1995): 1362-9

23. Kerr D, Reza M, Smith N, Leatherdale BA "Importance of insulin in subjective, cognitive, and hormonal responses to hypoglycemia in patients with IDDM." Diabetes 40 (1991): 1057-62

24. Bressler R, Galloway JA "The insulins." Ration Drug Ther 5 (1971): 1-6

25. Block MB, Rubenstein AH "Spontaneous hypoglycemia in diabetic patients with renal insufficiency." JAMA 213 (1970): 1863-6

26. Egger M, Smith GD, Teuscher A "Hypoglycaemia with human and porcine insulins." BMJ 306 (1993): 719-20

27. Urdl W, Desoye G, Schmon B, et al "Interactions between insulin and insulin-like growth factor I in the pathogenesis of polycystic ovarian disease." Ann N Y Acad Sci 626 (1991): 177-83

28. Pladziewicz DS, Nesto RW "Hypoglycemia-induced silent myocardial ischemia." Am J Cardiol 63 (1989): 1531-2

29. Collier A, Matthews DM, Young RJ, Clarke BF "Transient atrial fibrillation precipitated by hypoglycaemia: two case reports." Postgrad Med J 63 (1987): 895-7

30. Kiser D "The somogyi effect." Am J Nurs Feb (1980): 236-8

31. Berger W, Honegger B, Keller U, Jaeggi E "Warning symptoms of hypoglycaemia during treatment with human and porcine insulin in diabetes mellitus." Lancet 05/13/89 (1989): 1041-4

32. Lingenfelser T, Renn W, Plonz C, et al "Catecholamine response during human and pork insulin-induced hypoglycemia in IDDM patients." Diabetes Care 15 (1992): 261-4

33. Garre M, Boles JM, Garo B, Mabin D "Cerebral oedema in diabetic ketoacidosis: do we use too much insulin?" Lancet 1 (1986): 220

34. Karam J, Brink S, Clements R, et al "Evaluation of efficacy and safety of human insulin (novo) in the treatment of insulin-dependent diabetes mellitus: a double-blind, multicenter clinical trial." Diabetes Care 6 (1983): 56-60

35. Walker JD, Viberti G "Recurrent nocturnal hypoglycemia in an insulin-dependent diabetic patient receiving a small daily dose of insulin." Am J Med 88 (1990): 537-9

36. Hilsted J, Bonde-Petersen F, Norgaard M-B, et al "Haemodynamic changes in insulin-induced hypoglycaemia in normal man." Diabetologia 26 (1984): 328-32

37. Patrick AW, Campbell IW "Fatal hypoglycaemia in insulin-treated diabetes mellitus: clinical features and neuropathological changes." Diabetic Med 7 (1990): 349-54

38. Kopman EA, Ramirez-Inawat RC "Persistent electromechanical cardiac arrest following administration of cardioplegic and glucose-insulin-potassium solutions." Anesth Analg 59 (1980): 69-71

39. Wredling R, Levander S, Adamson U, Lins PE "Permanent neuropsychological impairment after recurrent episodes of severe hypoglycaemia in man." Diabetologia 33 (1990): 152-7

40. MacLeod KM, Hepburn DA, Frier BM "Frequency and morbidity of severe hypoglycaemia in insulin-treated diabetic patients." Diabet Med 10 (1993): 238-45

41. Tzamaloukas AH, Avasthi PS "Hypoglycemia during hemodialysis in diabetics treated with insulin." Nephron 61 (1992): 470-1

42. Johansen K, Ellegaard S, Wex S "Detection of nocturnal hypoglycemia in insulin-treated diabetics by a skin temperature-skin conductance meter." Acta Med Scand 220 (1986): 213-7

43. Krahn DD, Mackenzie TB "Organic personality syndrome caused by insulin-related nocturnal hypoglycemia." Psychosomatics 25 (1984): 711-2

44. Orchard TJ, Maser RE, Becker DJ, et al "Human insulin use and hypoglycaemia: insights from the pittsburgh epidemiology of diabetes complications study." Diabetic Med 8 (1991): 469-74

45. Tattersall RB, Gill GV "Unexplained deaths of type 1 diabetic patients." Diabetic Med 8 (1991): 49-58

46. Bhatia V, Wolfsdorf JI "Severe hypoglycemia in youth with insulin-dependent diabetes mellitus: frequency and causative factors." Pediatrics 88 (1991): 1187-93

47. Moses RG, Hubert PA, Lewis-Driver DJ "Severe hypoglycaemia: a one-year prospective survey in wollongong." Med J Aust 142 (1985): 294-6

48. Fish HR, Chernow B, O'Brian JT "Endocrine and neurophysiologic responses of the pituitary to insulin-induced hypoglycemia: a review." Metabolism 35 (1986): 763-80

49. Ziegler D, Hubinger A, Gries FA "Changes in brainstem auditory evoked potentials during insulin-induced hypoglycaemia in type 1 diabetic patients." Diabetic Med 8 (1991): 805-11

50. Bernstein RK "The somogyi phenomenon." Arch Intern Med 145 (1985): 575

51. Frier BM, Corrall RJ, Davidson NM, et al "Peripheral blood cell changes in response to acute hypoglycaemia in man." Eur J Clin Invest 13 (1983): 33-9

52. Vettor R, Mazzonetto P, Macor C, Scandellari C, Federspil G "Effect of endogenous organic hyperinsulinaemia on blood pressure and serum triglycerides." Eur J Clin Invest 24 (1994): 350-4

53. Arnqvist HJ, Halban PA, Mathiesen UL, Zahnd G, von Schenck H "Hypoglycaemia caused by atypical insulin antibodies in a patient with benign monoclonal gammopathy." J Intern Med 234 (1993): 421-7

54. Langan SJ, Deary IJ, Hepburn DA, Frier BM "Cumulative cognitive impairment following recurrent severe hypoglycaemia in adult patients with insulin-treated diabetes mellitus." Diabetologia 34 (1991): 337-44

55. Sjolie AK "Ocular complications in insulin treated diabetes mellitus." Acta Ophthalmol (Copenh) S172 (1985): 1-77

56. Frier BM, Hepburn DA, Fisher BM, Barrie T "Fall in intraocular pressure during acute hypoglycaemia in patients with insulin dependent diabetes." Br Med J 294 (1987): 610-1

57. Berman BA, Ross RN "Conversations on allergy and immunology: insulin hypersensitivity." Cutis 32 (1983): 320,28,30,32

58. Valenta LJ, Elias AN "Insulin-induced lipodystrophy in diabetic patients resolved by treatment with human insulin." Ann Intern Med 102 (1985): 790-1

59. Pietri A, Raskin P "Cutaneous complications of chronic continuous subcutaneous insulin infusion therapy." Diabetes Care 4 (1981): 624-6

60. Goldman JM, Wheeler MF "Lipodystrophy from recombinant DNA human insulin." Am J Med 83 (1987): 195-6

61. Schernthaner G "Immunogenicity and allergenic potential of animal and human insulins." Diabetes Care 16 Suppl 3 (1993): 155-65

62. MacDonald MJ "Conventional and human insulin: complications of insulin therapy in children." Prim Care 10 (1983): 691-706

63. Jordaan HF, Sandler M "Zinc-induced granuloma: a unique complication of insulin therapy." Clin Exp Dermatol 14 (1989): 227-9

64. Elte JW, van der Schroeff JG, van Leeuwen AW, Radder JK "Sclerosing granuloma after short-term administration of depot-insulin hoechst." Klin Wochenschr 60 (1982): 1461-4

65. Fleming MG, Simon SI "Cutaneous insulin reaction resembling acanthosis nigricans." Arch Dermatol 122 (1986): 1054-6

66. Brogden RN, Heel RC "Human insulin. A review of its biological activity, pharmacokinetics and therapeutic use." Drugs 34 (1987): 350-71

67. Chin RL, Martinez R, Garmel G "Gas gangrene from subcutaneous insulin administration." Am J Emerg Med 11 (1993): 622-5

68. Reeves WG, Allen BR, Tattersall RB "Insulin-induced lipoatrophy: evidence for an immune pathogenesis." Br Med J 06/21/80 (1980): 1500-3

69. Ross JM, Murali MR, DeLara TC, Cheron RG "Anaphylaxis and immunologic insulin resistance in a diabetic woman with ketoacidosis." Diabetes Care 7 (1984): 276-9

70. Lyngsoe J, Vestermark S "The efficacy and safety of human insulin (novo) in insulin-dependent diabetic patients." Diabetes Care 6 (1983): 53-5

71. Naparstek Y, Ben-Chetrit E, Okon E, Estrov Z, Eliakim M "Angioimmunoblastic lymphadenopathy in a patient with allergy to insulin: a case report." Cancer 47 (1981): 545-7

72. Stewart WJ, McSweeney SM, Kellett MA, et al "Increased risk of severe protamine reactions in NPH insulin-dependent diabetics undergoing cardiac catheterization." Circulation 70 (1984): 788-92

73. Small P, Lerman S "Human insulin allergy." Ann Allergy 53 (1984): 39-41

74. Wurzburger MI, Prelevic GM, Despotovic N, et al "Delayed-type allergy against various insulin preparations including human semisynthetic insulin." Ann Allergy 59 (1987): 44-7

75. Chideckel EW, Mullin CJ, Michael BE "Cimetidine in insulin allergy." Diabetes Care 4 (1981): 503-4

76. Simmonds JP, Russell GI, Cowley AJ, et al "Generalised allergy to porcine and bovine monocomponent insulins." Br Med J 08/02/80 (1980): 355-6

77. Burcelin RG, Eddouks M, Beylot M, Normand S, Boitard C, Feutren G, Landais P, Riou JP, Girard JR, Bach JF, et al "Hypersensitivity to insulin during remissions in cyclosporin-treated IDDM patients." Diabetes Care 16 (1993): 881-8

78. Carveth-Johnson AO, Mylvaganam K, Child DF "Generalised allergic reaction with synthetic human insulin." Lancet 12/04/82 (1982): 1287

79. Goldman JM, Brynildsen HC "Generalised allergy to porcine and bovine monocomponent insulins." Br Med J 281 (1980): 1494

80. Diem P, Spengler H, De Weck AL "Lymphocyte transformation by insulin and insulin-zinc suspensions." Clin Exp Immunol 50 (1982): 155-62

81. Gossain VV, Rovner DR, Mohan K "Systemic allergy to human (recombinant DNA) insulin." Ann Allergy 55 (1985): 116-8

82. Thompson DM, Ronco JJ "Prolonged desensitization required for treatment of generalized allergy to human insulin." Diabetes Care 16 (1993): 957-8

83. Altman JJ, Pehuet M, Slama G, Tchobroutsky C "Three cases of allergic reaction to human insulin." Lancet 2 (1983): 524

84. Silverstone P "Generalised allergic reaction to human insulin." Br Med J 292 (1986): 933-4

85. Dykewicz MS, Kim HW, Orfan N, Yoo TJ, Lieberman P "Immunologic analysis of anaphylaxis to protamine component in neutral protamine Hagedorn human insulin." J Allergy Clin Immunol 93 (1994): 117-25

86. Bell DS "Insulin resistance. An often unrecognized problem accompanying chronic medical disorders." Postgrad Med 93 (1993): 99-103,

87. Kahn CR, Mann D, Rosenthal AS, et al "The immune response to insulin in man: interaction of HLA alloantigens and the development of the immune response." Diabetes 31 (1982): 716-23

88. Micic D, Brkic S, Kendereski A, Popovic V, Zoric S, Nikolic JA, Igrutinovic L, Ivanoska D, Manojlovic D, Micic J "Immunological resistance to human biosynthetic insulin--effects of immunosuppression and plasmapheresis." Diabetes Res Clin Pract 19 (1993): 83-9

89. Jovanovic-Peterson L, Sparks S, Palmer JP, Peterson CM "Jet-injected insulin is associated with decreased antibody production and postprandial glucose variability when compared with needle- injected insulin in gestational diabetic women." Diabetes Care 16 (1993): 1479-84

90. Tenkanen L, Manttari M, Manninen V "Some coronary risk factors related to the insulin resistance syndrome and treatment with gemfibrozil: experience from the helsinki heart study." Circulation 92 (1995): 1779-85

91. Stout RW "Overview of the association between insulin and atherosclerosis." Metabolism 34 (1985): 7-12

92. Slater EE "Insulin resistance and hypertension." Hypertension 18 (1991): I108-14

93. Wingard DL, Barrettconnor EL, Ferrara A "Is insulin really a heart disease risk factor?" Diabetes Care 18 (1995): 1299-304

94. Wieczorek I, Pell AC, McIver B, MacGregor IR, Ludlam CA, Frier BM "Coagulation and fibrinolytic systems in type I diabetes: effects of venous occlusion and insulin-induced hypoglycaemia." Clin Sci (Colch) 84 (1993): 79-86

95. Genuth S "Exogenous insulin administration and cardiovascular risk in non-insulin-dependent and insulin-dependent diabetes mellitus." Ann Intern Med 124(1 Pt 2) (1966): 104-9

96. Brown RT, Polinsky RJ, Baucom CE "Euglycemic insulin-induced hypotension in autonomic failure." Clin Neuropharmacol 12 (1989): 227-31

97. Wheatley T, Edwards OM "Insulin oedema and its clinical significance: metabolic studies in three cases." Diabetic Med 2 (1985): 400-4

98. Shinozaki K, Suzuki M, Ikebuchi M, Takaki H, Hara Y, Tsushima M, Harano Y "Insulin resistance associated with compensatory hyperinsulinemia as an independent risk factor for vasospastic angina." Circulation 92 (1995): 1749-57

99. Standl E "Hyperinsulinemia and atherosclerosis." Clin Invest Med 18 (1995): 261-6

100. Evans DJ, Pritchard-Jones K, Trotman-Dickenson B "Insulin oedema." Postgrad Med J 62 (1986): 665-8

101. Siani A, Strazzullo P, Giorgione N, et al "Insulin-induced increase in heart rate and its prevention by propranolol." Eur J Clin Pharmacol 38 (1990): 393-5

102. Mantle JA, Rogers WJ, Smith LR, et al "Clinical effects of glucose-insulin-potassium on left ventricular function in acute myocardial infarction: results from a randomized clinical trial." Am Heart J 102 (1981): 313-24

103. Koh H, Nambu S, Tsushima M, et al "The effects of insulin on the cardiovascular system in patients with coronary heart disease." Arzneimittelforschung 34 (1984): 185-90

104. Sowers JR, Standley PR, Ram JL, Jacober S, Simpson L, Rose K "Hyperinsulinemia factors in the pathogenesis of hypertension and atherosclerosis." Am J Hypertens 6 (1993): s260-70

105. Stern MP "Do non-insulin-dependent diabetes mellitus and cardiovascular disease share common antecedents?" Ann Intern Med 124(1 Pt 2) (1996): 110-6

106. Takata S, Yamamoto M, Yagi S, et al "Peripheral circulatory effects of insulin in diabetes." Angiology Feb (1985): 110-5

107. Jarrett RJ "Is insulin atherogenic?" Diabetologia 31 (1988): 71-5

108. Bohrer H, Fleischer F, Krier C "Hyperkalemic cardiac arrest after cardiac surgery following high-dose glucose-insulin-potassium infusion for inotropic support." Anesthesiology 69 (1988): 949-53

109. Savage PJ, Soad MF "Insulin and atherosclerosis: villain bystander?" Br Heart J 69 (1993): 473-5

110. Jarrett RJ "Insulin and atheroma." Lancet 05/30/87 (1987): 1272

111. Swislocki A "Insulin resistance and hypertension." Am J Med Sci 300 (1990): 104-15

112. Carlson MG, Campbell PJ "Intensive insulin therapy and weight gain in IDDM." Diabetes 42 (1993): 1700-7

113. Marwick TH, Woodhouse SP "Severe hypophosphataemia induced by glucose-insulin-potassium therapy. A case report and proposal for altered protocol." Int J Cardiol 18 (1988): 327-30

114. Patrick AW, Hepburn DA, Swainson CP, Frier BM "Changes in renal function during acute insulin-induced hypoglycaemia in patients with type 1 diabetes." Diabetic Med 9 (1992): 150-5

115. Christensen CK, Christiansen JS, Christensen T, et al "The effect of six months continuous subcutaneous insulin infusion on kidney function and size in insulin-dependent diabetics." Diabetic Med 3 (1986): 29-32

116. Fisher BM, Smith JG, McCruden DC, Frier BM "Responses of peripheral blood cells and lymphocyte subpopulations to insulin-induced hypoglycaemia in human insulin-dependent (type 1) diabetes." Eur J Clin Invest 17 (1987): 208-13

117. Yamreudeewong W, Cavell RM, Henann NE "Possible hemolytic anemia associated with human insulin therapy." DICP 24 (1990): 887

118. Fisher BM, Quin JD, Rumley A, et al "Effects of acute insulin-induced hypoglycaemia on haemostasis, fibrinolysis and haemorheology in insulin-dependent diabetic patients and control subjects." Clin Sci 80 (1991): 525-31

119. Riddle MC "Relief of gastrointestinal symptoms by correcting insulin excess." Diabetes Care 4 (1981): 296-8

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