ALL ABOUT INSULIN
SHORT-ACTING
RAPID-ACTING
1. Aspart
THINK: “Move your
Ass” Ass-part
2. Lispro
THINK: “Let’s go!!”
Lispro
3. Glulisine
THINK: Glue dries fast
Onset: 15 MIN!
Peak: 30-90 minutes
Duration: 3-5 hours
INTERMEDIATE-ACTING
LONG-ACTING
AKA: Regular Insulin
AKA: NPH
KEY: This is the ONLY
insulin type given IV
route
KEY: If given with
regular insulin, draw up:
clear-to-cloudy
KEY: NO PEAK
• CAN’T BE MIXED
WITH OTHER
INSULIN!
• Can be given with NPH
at the same time in the
same syringe
• Can be given with
long-acting at the same
time in a different
syringe
THINK: R-N Regular
before NPH (clear before
cloudy)
1. Detrimir
THINK: “Lasts all year”
lasts a long time
• Given 2x/day
2. Lantus
THINK: “Lantern”
lanterns burn for a long
time
Onset: 30-60 minutes
Peak: 2-4 hours
Duration: 5-8 hours
WHEN DO YOU EAT?
Onset: 60-120 minutes
Peak: 4-12 hours
Duration: 14 hours
(hence, given 2x/day)
1. Rapid-acting: Covers insulin needs for meals eaten at the same time
of injection
2. Short-acting (Regular): Covers insulin needs for meals eaten within
30-60 minutes of injection
3. Intermediate-acting (NPH): Covers insulin needs for half the day
or overnight; typically given morning and night
4. Long-acting: Covers insulin needs for the full day; can be combined
with other insulin but never mixed
RULES OF INSULIN
• Watch for signs and symptoms of hypoglycemia
shaky, clammy,
pale, sweaty
o THINK: “Cool and clammy, give me candy”
o IF AWAKE: Ask the patient to eat (candy, juice, low fat milk)
o IF UNCONSCIOUS: Stab with IV D50
• Regular insulin: ONLY insulin given IV
• NPH: If mixed, clear-to-cloudy (NPH is cloudy)
• Long-acting: Do not mix; NO PEAK
• Rotate injection sites do not aspirate/massage
• Always increase insulin with: (glucose with any type of stress)
o Stress
o Sepsis
o Sickness
o Steroids
3. Glargine
THINK: “Large” lasts
for a large amount of
time
Onset: 60-120 minutes
Peak: NO PEAK
Duration: 24 hours
REMEMBER
TYPE 1: YOU HAVE
NONE
• NO insulin being produced
• Patients will need insulin!
TYPE 2: THE PROBLEM
IS YOU
• Encourage healthy diet and
exercise
• Potential oral medication
use
• Insulin (last resort)
INSULIN PUMP
• Give a steady dose of insulin for
Type 1 DM
• Check BG 4x/day
• Push bolus at meals