human insulin (prb) human insulin (prb)

30% soluble insulin 70% isophane insulin 30% soluble insulin 70% isophane insulin

A GUIDE TO STARTING
HUMULIN® M3

If you experience side effects talk to your doctor or other healthcare

professional. This includes any possible side effects not listed in the
package leaflet. To report a side effect or product complaint with a Lilly
product please call Lilly on +44 (0) 1256 315000 (UK) or
+353 (0)1 664 0446 (ROI).

Additionally reporting forms and further information can be found

at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in
the Google Play or Apple App Store (UK) or www.hpra.ie (ROI). By
reporting side effects you can help provide more information on the
safety of medicines.

This booklet has been developed and printed

by Lilly as a service to patients.

Eli Lilly & Company Ltd

Priestley Road
Basingstoke
RG24 9NL

Lilly and Humulin® are registered trademarks

of Eli Lilly and Company.

Humulin® M3 KwikPen® and Lilly are registered

trademarks of Eli Lilly and Company. This booklet is intended only for those
who have been prescribed Humulin® M3.
PP-HM-GB-0015 September 2018 It is intended to be used in addition to
the Patient Information Leaflet (PIL)
© 2018 Eli Lilly and Company. which is included in your medicine and
All rights reserved. should also be read.
Why have I been given
Your details
this booklet?

You have been prescribed Humulin® M3 by your Name

Healthcare Professional to help manage your
diabetes. This booklet summarises useful points Diabetes Nurse Specialist
about taking Humulin® M3 and will help answer any
questions you may have about your new insulin.
Hospital Doctor

This booklet is not intended to replace the Patient

Information Leaflet found in your medicine GP
pack, which should also be read thoroughly and
understood before you start taking this insulin. Who to call in an emergency

Your Healthcare Professional will provide you

Telephone number of contact
with your Humulin® M3 ID card. This card will help
you identify what the insulin should look like.
Dose of Humulin® M3 to be taken: (Healthcare
Keep this card with you at all times as a reminder Professional to complete)
of what type of insulin you have been prescribed Time Dose
and show this to the pharmacist to ensure you Before breakfast
receive the correct insulin when you collect Before evening meal
your prescription. Other

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Why have I been prescribed
How does Humulin® M3 work?
Humulin® M3?

You have been prescribed Humulin® M3, Humulin® M3 copies the way the body’s own insulin
a mixed insulin, to help provide your daily works in people without diabetes, which means
insulin requirements. that it provides glucose control between and after
meals.
Putting together a short acting insulin and an
intermediate acting insulin produces a quick rise
in insulin activity after injection, which gradually
subsides over time. Humulin® M3 should be injected
30-40 minutes before a meal.

How Humulin® M3 works

This diagram shows theoretical
representations of insulin activity
in people without diabetes
and in people with diabetes in
Breakfast Lunch Dinner Midnight whom Humulin® M3 has been
given twice daily. It is based on

Insulin Activity
information from different clinical
This booklet will allow you to learn more about studies and is not intended to
show direct comparisons.
your insulin and help you make the
right decisions about adjusting your insulin
and taking control of your diabetes.
Humulin® M3 gives you mealtime cover
Expected insulin changes in people without diabetes
Time of injecton of Humulin® M3

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How do I take my Humulin® M3?

Your Humulin® M3 will come in a 3ml cartridge, Humulin® M3 KwikPen®

or a pre-filled device, the Humulin® M3 KwikPen®
Your insulin should be (please tick)
3ml Humulin® M3 cartridge for use in the
durable pen device, the HumaPen® Savvio™
Cartridge
3ml Humulin® M3 KwikPen®

Please review this in detail, alongside the

Patient Information Leaflet found within the
medicine pack, before using this insulin.

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When do I take my Humulin® M3?

Humulin® M3 is usually taken twice daily about I forgot to take my Humulin® M3, what should I do?
30 minutes before breakfast and about 30 Don’t panic, forgetting your Humulin® M3 is rarely
minutes before your evening meal. an emergency situation. However, you may notice
When starting Humulin® M3, you should take the that your blood glucose levels are higher and you
number of injections your Healthcare Professional may feel tired, thirsty or pass more urine than
has advised you to, as your insulin regimen has usual. You should seek advice from your Healthcare
been tailored for your needs. Professional. The advice will vary depending on
when you realised you have forgotten to take your
Make sure you/your healthcare provider write down Humulin® M3.
when you should take your injection. You can make
a note in your insulin diary and at the front of this
booklet.
When do I check my blood glucose levels?
It is likely that you will need to check your blood
glucose levels first thing in the morning before
breakfast (fasting blood glucose).
Your Healthcare Professional will discuss with you
how often and when to test.
You should record your blood glucose levels in your
Humulin® M3 diary.

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Instruction for self-adjustment
of my insulin

When testing your blood glucose, if you have a

Twice daily Humulin® M3
consistently high reading for more than three days
at any testing point, then you will need to adjust Fasting (before Before evening
your insulin. Twice daily breakfast) mmol/l meal mmol/l
Humulin® M3 Above Below Above Below
Your Healthcare Professional will explain to you
how to adjust your insulin and will complete the
following table for your needs. Adjust units of insulin

adjust evening adjust morning

dose dose

Dose reduction is recommended if

any results are consistently less than
4mmol/l (‘hypo’) at any time.

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Where do I inject my Humulin® M3?

Your Healthcare Professional will explain

how to inject your insulin.
We recommend that you also fully review
the Patient Information Leaflet found within your
medicine pack, for specific details on
how to inject this insulin.
Where do I inject it?
Humulin® M3 can be injected into any of the places
shown below. The site of injection should be rotated
within an area to avoid irritation and aid absorption.

HUMULIN® M3 KWIKPEN® (insulin human) REPUBLIC OF IRELAND

SUMMARY OF PRODUCT CHARACTERISTICS Available at: https://
backend-lb.medicines.ie/uploads/files/HUMULIN-M3-KwikPen_SPC_IE_
Aug18_HU83M_1535636971.pdf [Accessed September 2018]
HUMULIN® M3 (Mixture 3) 100IU/ml suspension for injection in vial.
Available from: https://www.medicines.org.uk/emc/product/8193/smpc
[Accessed August 2018]

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What is hypoglycaemia? What do I do If I have a ‘hypo’?

Humulin® M3 may cause hypoglycaemia if you Stop: it is important that you stop
take too much. It is very important that you what you are doing and immediately
understand what hypoglycaemia is, what the deal with the ‘hypo’, if hypoglycaemia
symptoms are, and how to manage it if it isn’t corrected it can lead to more serious
occurs. If untreated, hypoglycaemia can be conditions such as unconsciousness
life-threatening. and convulsions.
What is a ‘hypo’? Treat: if you experience a ‘hypo’, you
Hypoglycaemia (or ‘hypos’) occurs when your should eat or drink approximately 15g of
blood glucose levels drop below what the body sugary quick-acting carbohydrate, such
needs to function normally (below 4mmol/l). as: A small carton (200 ml) of pure fruit
‘Hypos’ begin quickly, but there are usually juice, 3 glucose or dextrose tablets or a
warning signs. Symptoms can vary from person tube of glucose gel (Speak to your HCP
to person, but may include the following: as specific quantities may vary.).
• Trembling and feeling • Lips feeling tingly Recover: if you start to feel better after
shaky • Blurred sight 10–15 minutes, have some longer-acting
• Sweating carbohydrates, such as a sandwich or a
• Being hungry
• Being anxious or
bowl of cereal. This will help prevent your
• Feeling tearful blood glucose from going down again.
irritable
• Tiredness
• Going pale If you feel you aren’t getting better,
• Having a headache
• Palpitations (fast heart contact your Healthcare Professional.
• Lack of concentration
beat) and a fast pulse Diabetes UK. Having a Hypo. Available from:
https://www.diabetes.org.uk/Guide-to-diabetes/
Complications/Hypos/Having-a-hypo.
Diabetes UK. What is a hypo? Available from: https://www.diabetes.org. [Accessed June 2018]
uk/Guide-to-diabetes/Complications/Hypos. [Accessed June 2018]

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What should I do if I fall ill?

A number of common illnesses can cause your If high blood glucose and ketones lead to
blood glucose to rise. When you are unwell vomiting and dehydration, you may require
you may not want to eat or take your insulin hospital admission. You must contact your
treatment as normal, but it is important to Healthcare Professional.
follow these basic rules in case of sickness:
Take carbohydrates in liquid form
Keep on taking your insulin Take unsweetened fluids if your blood glucose
During illness your insulin requirements may is high. If you still do not feel like eating as
go up. Ask your Healthcare Professional for your blood glucose returns to normal then
specific advice on what action to take when substitute food with sweetened fruit juices
you are ill. or drinks that contain glucose.
Monitor your blood glucose and check
for ketones
Monitor your blood glucose. Test 2–4 hourly
as your blood sugar will indicate whether
you require extra insulin doses. Always check
your urine or blood for ketones. If you have
moderate or high ketones and high blood
glucose levels, this is a good indication that
you may need more insulin and should consult
your Healthcare Professional.

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What considerations should I take
when exercising?

Physical exercise is beneficial for people with How much and what sort of exercise should
diabetes. That’s because exercise lowers your I be doing?
blood glucose levels. However, it is important It is currently recommended that you aim to do
to understand how exercise may affect the 150 minutes of moderate-to-vigorous exercise
amount of insulin that you need to take. a week (i.e. 30 minutes on five days a week).
When is it best to exercise? However, it’s OK to start slow and build up
If you do exercise within 1–2 hours after to this target. Aiming to do a small amount of
injecting Humulin® M3, the fall in blood light exercise a day (e.g. a short walk) would be
glucose will be greater than if you did not a great start!
exercise. This is because exercising uses
All physical activity counts, so try to be more
energy and therefore helps to reduce your
active during your day-to-day life. For example,
blood glucose levels.
take the stairs instead of the lift.
Due to this, you may need to reduce your
dose of Humulin® M3. Check with your
Healthcare Professional for advice if
you are unsure.
Global Strategy on Diet, Physical Activity
By monitoring your blood glucose (together and Health Available from: http://www.
who.int/ dietphysicalactivity/factsheet_
with advice from Healthcare Professionals) adults/en/ [Accessed August 2018]
you will learn the best way to combine exercise
and Humulin® M3.

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What considerations are there If you are currently living in the
for driving? United Kingdom

If you are taking insulin, in most cases this You can be fined up to £1,000 if you don’t tell DVLA about a medical
condition that affects your driving. You may be prosecuted if you’re
should not affect your ability to drive. However, involved in an accident as a result.
there are extra rules and considerations. Check with your nurse or doctor if you don’t know what type of
medication you’re on.
What are the risks? Read leaflet INF188/2 for more information about driving a car or
The major risk of driving whilst taking insulin is motorbike with diabetes.
the possibility of having a ‘hypo’. To understand Insulin treated diabetes
more about ‘hypos’ please turn to page 14. You need to tell DVLA if:
• your insulin treatment lasts (or will last) over 3 months
If you are experiencing frequent ‘hypos’, or • you had gestational diabetes (diabetes associated with pregnancy)
you find it difficult to spot when you are going and your insulin treatment lasts over 3 months after the birth
into a ‘hypo’, you will have to stop driving until • you get disabling hypoglycaemia (low blood sugar) - or a medical
professional has told you that you’re at risk of developing it
you and your Healthcare Professional get your You can report your condition online, or fill in form DIAB1 and send it to
blood glucose levels under control. DVLA.

What do I do if I have a ‘hypo’ whilst driving? Bus, coach or lorry licence.

You must tell DVLA if your diabetes is treated with insulin.
You should pull over, park safely and follow
Fill in form VDIAB1I and send it to DVLA.
the normal procedure for dealing with ‘hypos’ Read leaflet INS186 if you want to apply for vocational entitlement to
(see page 15). You should then wait at least drive larger vehicles (C1, C1E, D1, DIE, C, CE, D or DE).
45 minutes after you feel better before driving.
The DVLA leaflets and forms listed
above can be found at: GOV.UK.
Diabetes and driving. Available from:
https://www.gov.uk/diabetes-driving.
[Accessed June 2018].

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If you are currently living in the What considerations are there
Republic of Ireland when travelling?

Informing the NDLS (National Driving Licence Service) Taking insulin should not affect your ability to travel abroad
Group 1 - Driving a car, motor cycle or Tractor
but you need to plan ahead to ensure you:
You must inform NDLS if: Take enough Humulin® M3 for the duration of your trip
• you suffer more than one episode of severe hypoglycaemia You should carry spare Humulin® I KwikPens® and other
within the last 12 months.
equipment (needles, insulin etc.) in the event of unforeseen
Group 2 - Driving a bus or truck circumstances.
You must inform NDLS if:
Carry your diabetes equipment in your hand luggage, not
• you suffer one episode of severe hypoglycaemia
your main luggage
• you are at high risk of developing hypoglycaemia;
Your diabetes equipment should always be accessible. ‘In
• you begin to have difficulty in recognising warning symptoms of
use’ pens may be kept at room temperature (up to 30°C) for
low blood sugar
up to 28 days. In very hot climates, or for long hot journeys,
• you suffer severe hypoglycaemia while driving; an existing
medical condition gets worse, or you develop any other condition
it is advisable to keep your Humulin® M3 in a cool bag. Do
that may affect safe driving. not allow your insulin to freeze.

If you are a Group 1 or Group 2 driver you must inform NDLS if: If you are carrying insulin, it is also advisable to carry your
• you are treated by insulin, or if your diabetes is additionally diabetes ID and a letter from your GP stating you have
managed by tablets which carry a risk of inducing hypoglycaemia diabetes and the medication you need to treat it.
• you develop any problems with your circulation or sensation in
Plan ahead for changing time zones
your legs or feet which makes it necessary for you to drive certain
types of vehicles only You may need to speak to your diabetes Healthcare
Professional about this.
If, following consultation with your GP, your medical condition is
one that needs to be notified to the NDLS, you need to complete a
Driver Licence Application Form and a Medical Report Form (D501)
completed by your Doctor and return in person to any NDLS centre.
The NDLS forms listed above can be found at: NDLS. Form &
Reports. Available from: https://www.ndls.ie/forms-reports.html
[Accessed August 2018].
NDLS. Diabetes and Driving. Available from: https://www.ndls.ie/images/
Documents/Forms/Diabetes-and-Driving.pdf. [Accessed August 2018]
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 How do I store my Humulin® M3?

Carry your diabetes information, a letter from your Storing unused Humulin® M3
GP and identity card Store in a refrigerator (2-8°C).
It is important you carry this at all times. Do not freeze.
Have travel insurance
After first use
Make sure you are covered for existing medical
Store at room temperature (15-30°C) for up to
conditions and any diabetes-related emergency
28 days. The pen should not be stored with
which might occur.
the needle attached and a new needle should
Carry extra food for snacks be used before every injection.
Sometimes travel can be unpredictable and you
should be prepared in case of delays or for when If you have any further
food is not readily accessible or even if you don’t questions about Humulin® M3
like the food on the plane! Don’t forget your usual or about your diabetes in
Refrigerator
glucose for ‘hypos’. general, ask your Healthcare
Professional.

HUMULIN® M3 (Mixture 3) 100IU/ml

suspension for injection in vial. Available
from: https://www.medicines.org.uk/
emc/product/8193/smpc [Accessed
2-8°C
August 2018]
HUMULIN® M3 KWIKPEN® (insulin human)
REPUBLIC OF IRELAND SUMMARY OF
PRODUCT CHARACTERISTICS Available
at: https://backend-lb.medicines.ie/
uploads/files/HUMULIN-M3-KwikPen_
SPC_IE_Aug18_HU83M_1535636971.pdf
24|25 A guide to starting Humulin® M3 [Accessed September 2018]
Notes Notes

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