FORMS OF INSULIN
RAPID-ACTING:
ONSET
PEAK
DURATION
15 mins
1 to 2 hours
3 to 4 hours
30 to 60 mins
2 to 4 hours
5 to 7 hours
2 to 4 hours
4 to 10 hours
10 to 16 hours
3 to 4 hours
NONE
24 hours
Lispro
Aspart
Glulisine
SHORT-ACTING:
Regular (can give IV)
INTERMEDIATE:
NPH (cloudy solution)
LONG-ACTING:
Glargine
Detemir
PRECAUTIONS/INTERACTIONS
1.
2.
3.
4.
When mixing regular insulin with NPH insulin, draw up regular insulin first
Do not mix other insulins with lispro, glargine or combination 70/30
Only regular insulin is given IV (only in normal saline)
Administer glargine at bedtime
NURSING INTERVENTIONS AND CLIENT EDUCATION
1. Monitor serum glucose levels before meals and at bedtime or patterned schedulespecific to client
2. Roll vial to rotate injection sites to prevent lipodystrophy (variable loss of adipose
tissue)
3. Teach signs and management for hypoglycemia and hyperglycemia
4. Encourage diet and exercise to follow ADA recommendations
Mnemonics to remember insulin onset, peak, duration times
Rapid-acting insulin:
Insulin Lispro (Humalog)
Insulin Aspart (Novolog)
Insulin Glulisine (Apdira)
“15 minutes feels like an hour during 3 rapid responses.”
(onset- 15 mins, peak- 1 to 2 hour, duration- 3 to 4 hours)
Short-acting:
Regular Insulin
“Short-staffed nurses went from 30 patients to(2) 5 patients.” (mnemonic for SUBQ route)
(onset- 30 to 60 mins, peak- 2 to 4 hours, duration 5 to 7 hours)
Intermediate-acting:
NPH

NOTE: solutions will be CLOUDY
“Nurses Play Heroes to(2) 4 16-year-olds.”
(onset- 2 to 4 hours, peak- 4 to 10 hours, duration- 10 to 16 hours)
Long-acting:
Lantus (Glargine)
Levemir (Detemir)
“The 3 long nursing shifts never peak but lasted 24 hours.”
(onset- 3 to 4 hours, peak-none, duration- 24 hours)