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"Ultralente insulin was a long-acting form of insulin. It has an onset of 4 to 6 hours, a peak of 14 to 24 hours, and a duration of 28 to 36 hours.Gomella LG, Haist SA. Chapter 22. Commonly Used Medications. In: Gomella LG, Haist SA, eds. Clinician's Pocket Reference: The Scut Monkey. 11th ed. New York: McGraw- Hill; 2007. http://www.accessmedicine.com/content.aspx?aID=2696124. Accessed February 4, 2012 Ultralente insulin, along with lente insulin, were discontinued in the US by manufacturers in the mid-2000s. One of the reasons for discontinuation was declining use in favor of NPH insulin and other newer insulin products. The FDA withdrew approval for ultralente insulin products by 2011. History Insulin which was extracted from animal sources was used as a medicine as early as 1922. These early insulin preparations required multiple daily injections due to the short duration of action and quick degradation of the insulin protein. For this reason, researchers began studying how to prolong the effects of injected insulin. In 1952, a team at Novo Terapeutisk led by K. Hallas-Møller discovered that crystals of various sizes would form when zinc was added to insulin suspensions. Larger insulin crystals take longer to dissolve into the bloodstream when injected into the body, and as such have a much longer duration of action than amorphous or small insulin crystals. Ultralente insulin was considered to be a "long- acting" insulin that could be used once per day to provide a basal level of insulin, similar to some protamine-containing preparations. While originally isolated from bovine or porcine sources, the advent of recombinant DNA technology in the 1980s allowed human insulin to be mass produced in yeast or bacteria. By the mid 1990s, ultralente insulin was being prepared from recombinant human insulin, instead of insulin extracted from animals. The advent of insulin analogues and continued use of NPH insulin led to the discontinuation of ultralente insulin products in the mid-2000s, and FDA approval to be marketed in the US was withdrawn by 2011.Federal Register Doc. E9-2901Federal Register Doc. 2011-14164 Lente insulin was a combination of ultralente insulin and amorphous, or plain, insulin in a fixed percentage combination. Ultralente insulin comprises 65% of the lente insulin preparation Vetsulin®/Caninsulin® which is produced by Merck Animal Health for veterinary use. Adverse effects = Hypoglycemia = The primary adverse effect of any insulin product is hypoglycemia, or low blood sugar. Hypoglycemia can manifest as dizziness, disorientation, trouble speaking, and changes in mental status. In severe cases, hypoglycemia can lead to loss of consciousness if not treated. As lente insulin continues to be absorbed in the body for hours after use, these signs and symptoms may be delayed from the time of administration and begin with little or no warning. = Hypersensitivity = Lente insulin is a combination of porcine and bovine insulin products which are filtered and combined with zinc to form the suspension. Even product that is filtered very well is still of animal origin, and there is a chance the body may recognize the foreign protein as such and form antibodies against it. These reactions are slightly more likely with lente insulin than with insulin derived from a single source as lente insulin contains bovine insulin which is more immunogenic than porcine insulin. Society and culture Historical brand names of ultralente insulin, all of which are now discontinued, included Ultratard HM, Humulin U, and Novolin U. References Category:Insulin therapies "
"Rachel Cuschieri (born 26 April 1992) is a Maltese football midfielder, currently playing for Lazio in the Italian Serie B. She first played in the Champions League in 2010. Early life Rachel began playing football at the age of five with San Gwann Football Nursery. She trained up to the age of 13 with the boys' team being the only girl within such age group. San Gwann Football Nursery does not have a ladies football team and her development could not progress any further due to restrictions in place within the Maltese footballing authorities that, although she was still a minor she could not play competitive games. Birkirkara became aware of her potential and signed her. Playing career = Club = Within a few months of joining B'kara Football Club, Rachel was playing with the Birkirkara first team at the age of 13. During the summer of 2014, she became the first Maltese female professional footballer to play outside Malta, when she signed for Cypriot side Apollon Limassol. =International= Cuschieri was selected for the Malta women's national football team and made her debut against Switzerland at the age of 14, which at the time was a record. During the 2013 European Championship qualifying's preliminary stage, Cuschieri scored against Armenia.Profile in UEFA's website She is currently the leading all-time scorer for and the youngest-ever goal scorer. References External links * Category:1992 births Category:Living people Category:Maltese women's footballers Category:Malta women's international footballers Category:RSC Anderlecht (women) players Category:Apollon Ladies F.C. players Category:PSV (women) players Category:S.S. Lazio Women 2015 players Category:Expatriate women's footballers in Cyprus Category:Expatriate women's footballers in Belgium Category:Maltese expatriate sportspeople in Belgium Category:Maltese expatriate sportspeople in Cyprus Category:Maltese expatriate sportspeople in Italy Category:Maltese expatriate footballers Category:Maltese footballers Category:Women's association football midfielders Category:Super League Vrouwenvoetbal players Category:Eredivisie (women) players Category:Expatriate women's footballers in the Netherlands Category:Expatriate women's footballers in Italy "