Explanation

Biphasic isophane insulin (also called Mixtard 30) is a man-made version of natural insulin. It helps to balance your body's sugar levels if you have diabetes.

What does it do?

If you have diabetes, you can use biphasic isophane insulin to top up your own insulin levels and help to balance your blood glucose levels.

What does it look like?

Biphasic isophane insulin is a cloudy white liquid that comes in a glass vial, a glass cartridge or a prefilled pen for injection.

When do I have to take it?

You should have a biphasic isophane insulin injection 30 minutes before having a meal or snack with carbohydrates in it. You will have to inject it just under your skin (don't worry, it doesn't hurt), usually in your thigh or tummy, but you could also do it in your bum or the top of your arm.

Remember that it's to go into your skin , so it's important that you don't accidentally put the needle in your muscle. To make it easier, you could pinch your skin out and inject the skin you are holding. Instead of injecting in the same part of your body all the time, you should use a different area of skin to inject each time. You could ask your parents or the adult looking after you to help you, if you want.

But what if I don't feel like taking it?

It's very important that you keep having the injections, even if you don't want to. If you stop, you may get hyperglycaemia, which can be dangerous. If you get hyperglycaemiayou may:

Feel very thirsty

need to wee all the time

feel sick

vomit

feel drowsy

lose your appetite (don't feel hungry)

If you keep missing your injections, hyperglycaemia could turn into diabetic ketoacidosis.

What should I do if I forget to take it?

If you miss an injection of biphasic isophane insulin you may get high blood glucoseand start to feel the signs of hyperglycaemia. You should test your blood sugar level straightaway, and tell the person looking after you so that you or they can then call your doctor for advice.

Your doctor will be able to tell you exactly what to do if you forget to take biphasic isophane insulin.

How much should I use?

Everyone needs different amounts of biphasic isophane insulin. Your doctor will be able to tell you exactly how much you should take.

What are the most likely side effects I might get if I take biphasic isophane?

The side effect you are most likely to get is irritation of the skin where you have had your injection. The types of things you may notice are redness, pain, itching, hives and/or swelling.

To make it less likely you get these remember to have your injection in different places on your body, not the same place every time.

Don't forget to let your doctor know if you notice any of these side effects while you are on biphasic isophane insulin.

What other side effects might I get?

There are other side effects that you may get with biphasic isophane insulin but they are very unlikely. It's important that you look out for them though, and make sure you tell your doctor if you notice any of these:

pain, especially in your hands or feet (peripheral neuropathy)

trouble focusing when looking at objects

skin rash

itching, sweating, sore tummy, trouble breathing or fainting

Is it safe for me to be taking it?

Before you start taking biphasic isophane insulin you need to tell your doctor if you know you are allergic to any medicines or are sensitive to man-made insulin. Biphasic isophane insulin contains metacresol, which may cause allergic reactions, so it is important to let him or her know if you are allergic to it.

If you are changing from another type of insulin take special care to look out for the signs of hypoglycaemia and hyperglycaemia. You may need to change the amount you used to take if you are swapping to biphasic isophane insulin from another type of insulin, so make sure that you tell your doctor if you notice anything strange.

You or the adult looking after you should call your doctor if you are going on holiday to a different country, because you might need to take your biphasic isophane insulin and meals at different times.

Is it okay for me to take it if I am already taking other medicines?

Before you start taking biphasic isophane insulin, it's important to tell your doctor if you're taking any other medicines. This is important because other medicines, including any herbal medicines or anything you got from a pharmacist without a prescription, may affect the amount of biphasic isophane insulin you will need. If you are taking some medicines you may need MORE, and if you are taking other medicines, you may need LESS. Your doctor will be able to tell you how much to take.

Medicines called beta-blockers may make it harder to notice signs of hypoglycaemia, and it may take longer for you to feel better if you actually get hypoglycaemia so make sure you tell your doctor if you are taking beta blockers.

Is there anything else I need to know about it?

You should keep biphasic isophane insulin in the box it came in to make sure no light can get to it. You should make sure you store it at room temperature, but don't keep it in the fridge.

Also, remember that biphasic isophane insulin is for injection only so you can't use it in infusion pumps.

What if I have any more questions?

If you have any other questions, you can ask your doctor, or chat to other people with diabetes in the Medikidz forums and virtual world, Mediland.