Diasulin N 100 IU/10 ml SC Injection

Diasulin N 100IU – Isophane (NPH) Human Insulin 100 IU/ml Intermediate-Acting Injection

What is Diasulin N 100IU?

Diasulin N 100IU is an intermediate-acting NPH (isophane) human insulin in a 10 ml vial, manufactured by Opsonin Pharma Ltd., Bangladesh — the same company behind the Diasulin range of human insulins. The "N" designation stands for NPH (Neutral Protamine Hagedorn), the classic intermediate-acting insulin formulation in which protamine delays absorption, extending duration to 16–24 hours with a pronounced peak at 4–12 hours. Diasulin N provides overnight and inter-meal basal glucose control and is also used as the NPH component in custom-mixed insulin regimens. As a locally manufactured product, it offers an affordable alternative to imported NPH insulins such as Humulin N (Eli Lilly) or Insulatard (Novo Nordisk).

Generic Name and Composition

Each ml contains: 100 IU isophane human insulin (rDNA). NPH insulin is formed by combining human insulin with protamine (a positively charged protein) and zinc in precise ratios, creating a crystalline suspension that dissolves slowly after SC injection. Unlike long-acting analogues (glargine, detemir), NPH has a pronounced action peak at 4–12 hours — providing stronger overnight coverage but with greater hypoglycaemia risk during the peak window.

Indications

• Type 1 diabetes — intermediate basal component, typically combined with rapid/short-acting insulin
• Type 2 diabetes — once- or twice-daily basal insulin to control fasting glucose
• Manual mixing: combined in the same syringe with soluble (R) insulin for a custom premix ratio
• Patients requiring a cost-effective intermediate-acting insulin

How It Works — Mechanism of Action

After SC injection, the NPH suspension dissolves gradually. Protamine is slowly cleaved by tissue enzymes, releasing human insulin into the bloodstream. Peak plasma insulin levels at 4–12 hours provide strongest overnight glucose-lowering action. The extended duration of 16–24 hours covers inter-meal and fasting glucose. When mixed with soluble (R) insulin, the combined preparation provides both rapid post-meal control and intermediate overnight coverage in a single injection.

Dosage and Administration

Once or twice daily SC injection, typically at bedtime (for overnight coverage) or before breakfast. Mix NPH with soluble insulin: draw soluble insulin first into syringe, then NPH — never inject directly into the NPH vial with a contaminated needle. Resuspend before use: roll vial gently 10 times. The suspension should appear uniformly cloudy white — discard if clumped. Inject SC into abdomen, thigh, or upper arm. Rotate sites.

Side Effects

Very common: Hypoglycaemia — particularly nocturnal (4–12 hr peak coincides with sleeping hours). Common: Injection site reactions, lipohypertrophy, weight gain. Uncommon: Lipoatrophy, peripheral oedema. Rare: Hypersensitivity, anaphylaxis.

Drug Interactions

Enhance hypoglycaemia: OADs, GLP-1 agonists, SGLT-2 inhibitors, ACE inhibitors, MAO inhibitors, salicylates, alcohol. Reduce effect: Corticosteroids, glucagon, thyroid hormones, sympathomimetics, thiazide diuretics, oral contraceptives. Mask hypoglycaemia symptoms: Beta-blockers, clonidine.

Contraindications

• Active hypoglycaemia
• Hypersensitivity to human insulin or protamine
• Intravenous administration (NPH suspension — SC injection only)

Pregnancy and Lactation

Pregnancy: NPH (isophane) human insulin is considered the standard of care for basal insulin in pregnancy — preferred over insulin analogues by many guidelines. Monitor closely. Lactation: No clinically significant passage into breast milk.

Precautions and Warnings

• Resuspend before each injection — gently roll vial 10 times. Never shake. Inspect for uniformly cloudy white suspension.
• Nocturnal hypoglycaemia risk: The 4–12 hr peak is most dangerous during sleep. Bedtime snack may be needed, especially at higher doses.
• Manual mixing order: Always draw soluble (clear) insulin into syringe first, then NPH (cloudy) — prevents contaminating the soluble insulin vial with protamine.
• Do not freeze. Protect from direct light and heat.

Overdose

Hypoglycaemia. Mild: oral glucose or carbohydrate. Severe: IV dextrose 20–50% or IM glucagon 1 mg. NPH duration (16–24 hrs) means prolonged monitoring is required — hypoglycaemia may recur for many hours after treatment, particularly with large overdoses.

Storage Instructions

• Unopened vial: 2–8 degrees C. Do not freeze.
• In-use vial: Below 25 degrees C. Protect from light.
• Discard 28 days after first use.

Frequently Asked Questions

Q1: What is the difference between Diasulin N and Diasulin R?
Diasulin N is NPH (isophane) human insulin — intermediate-acting with onset 1–2 hrs, peak 4–12 hrs, duration 16–24 hrs. Diasulin R is regular (soluble) human insulin — short-acting with onset 30 min, peak 2–4 hrs, duration 6–8 hrs. Diasulin N is used for basal/overnight coverage; Diasulin R is used as a mealtime bolus. They can be mixed in the same syringe for a custom premix.

Q2: What is the difference between Diasulin N and long-acting insulin analogues (glargine, detemir)?
NPH (Diasulin N) has a pronounced peak at 4–12 hrs and duration of 16–24 hrs — requiring twice-daily dosing in many patients and carrying higher nocturnal hypoglycaemia risk. Insulin glargine (e.g., Larsulin, Glarine) is peakless with a flat 24-hour profile — once-daily, lower nocturnal hypoglycaemia risk, but more expensive. NPH is preferred in pregnancy; glargine may be preferred for convenience and hypoglycaemia risk reduction.

Q3: Who manufactures Diasulin N?
Diasulin N is manufactured by Opsonin Pharma Ltd., Bangladesh — a leading domestic pharmaceutical manufacturer. The Diasulin range covers the full spectrum of human insulin formulations: Diasulin R (soluble), Diasulin N (NPH), and Diasulin 30/70 (premixed), all at 100 IU/ml.

Q4: Can Diasulin N be mixed with Diasulin R in the same syringe?
Yes — NPH and regular human insulin can be mixed in the same syringe. Draw the soluble (Diasulin R, clear) insulin first, then add NPH (Diasulin N, cloudy). This technique is used to create a custom premix ratio, avoiding the need for two separate injections. Do not mix NPH with insulin analogues (aspart, lispro, glargine) as compatibility and stability are not guaranteed.

Medical Disclaimer: For educational purposes only. Diasulin N 100IU is Rx-only. Consult your diabetologist before starting or changing insulin therapy. DiabetesStore.com.bd is a licensed online pharmacy in Bangladesh.