Insulin Types and Thyroid Medications: Key Concepts for Diabetes and Thyroid Management

Term

Definition

Regular insulin (Humulin R) - Short-acting insulin

promotes glucose uptake and glycogen storage → Treats high blood glucose, IV for DKA; Key SEs: hypoglycemia, lipodystrophy; Contraindications: hypoglycemia, insulin allergy; Nursing teaching: monitor glucose, rotate injection sites, carry fast-acting sugar

NPH insulin (Humulin N) - Intermediate-acting insulin

promotes glucose uptake over longer period → Basal glucose control; Key SEs: hypoglycemia at peak, lipodystrophy; Contraindications: hypoglycemia, insulin allergy; Nursing teaching: monitor glucose, rotate injection sites, give 30 min before meals

Insulin glargine (Lantus) - Long-acting insulin

steady glucose lowering for ~24 hrs → Basal insulin control; Key SEs: hypoglycemia, injection site reactions; Contraindications: hypoglycemia, insulin allergy; Nursing teaching: same time daily, do not mix with other insulins, monitor glucose

Insulin lispro (Humalog) - Rapid-acting insulin

quickly promotes glucose uptake → Rapid post-meal glucose control; Key SEs: hypoglycemia, lipodystrophy; Contraindications: hypoglycemia, insulin allergy; Nursing teaching: give immediately before meals, monitor glucose, rotate sites

Insulin aspart (Novolog) - Rapid-acting insulin

promotes postprandial glucose uptake → Rapid post-meal glucose control; Key SEs: hypoglycemia, injection site reactions; Contraindications: hypoglycemia, insulin allergy; Nursing teaching: administer within 5-10 min of meal, monitor glucose, rotate sites

Metformin (Glucophage) - Biguanide

decreases hepatic glucose production, increases insulin sensitivity → Type 2 diabetes first-line; Key SEs: lactic acidosis (rare), GI upset; Contraindications: renal impairment, acidosis; Nursing teaching: take with food, monitor renal function, report GI distress or fatigue

Pioglitazone (Actos) - Thiazolidinedione (TZD)

activates PPAR-γ, improves glucose uptake → Type 2 diabetes, insulin sensitization; Key SEs: heart failure exacerbation, edema, weight gain; Contraindications: heart failure, liver disease; Nursing teaching: monitor weight and liver function, report swelling or dyspnea

Glyburide (DiaBeta) - Sulfonylurea

stimulates pancreatic insulin release → Type 2 diabetes, lowers fasting glucose; Key SEs: hypoglycemia, weight gain; Contraindications: type 1 diabetes, severe liver/kidney disease; Nursing teaching: monitor glucose, avoid alcohol, teach hypoglycemia signs

Prednisone (Deltasone) - Glucocorticoid

suppresses inflammation, alters immune response → Adrenocortical insufficiency, inflammation; Key SEs: immunosuppression, hyperglycemia, osteoporosis; Contraindications: systemic infection; Nursing teaching: take in AM, monitor glucose/BP, report infection or GI pain

Hydrocortisone (Solu-Cortef) - Glucocorticoid

mimics cortisol effects → Adrenocortical insufficiency, inflammation; Key SEs: immunosuppression, hyperglycemia, edema; Contraindications: systemic infection; Nursing teaching: monitor BP/glucose, do not stop abruptly, report infection

50% Dextrose (D50) - Carbohydrate

rapidly increases blood glucose → Severe hypoglycemia; Key SEs: hyperglycemia, phlebitis at IV site; Contraindications: hyperglycemia; Nursing teaching: monitor glucose, use large vein, assess IV site

Glucagon - Hyperglycemia agent

stimulates hepatic glycogenolysis → Severe hypoglycemia if unable to take oral glucose; Key SEs: nausea, vomiting; Contraindications: pheochromocytoma; Nursing teaching: administer IM/SQ, turn patient on side if vomiting, monitor glucose

Semaglutide (Wegovy) - GLP-1 receptor agonist

increases insulin, slows gastric emptying → Type 2 diabetes, weight management; Key SEs: pancreatitis, GI upset; Contraindications: personal/family medullary thyroid cancer; Nursing teaching: monitor GI symptoms, report severe abdominal pain, teach injection technique

Empagliflozin (Jardiance) - SGLT2 inhibitor

increases renal glucose excretion → Type 2 diabetes, reduces cardiovascular risk; Key SEs: UTI, genital infections, dehydration; Contraindications: severe renal impairment; Nursing teaching: monitor renal function, hydration status, report signs of infection

Levothyroxine (Synthroid) - Thyroid hormone (T4)

replaces thyroid hormone → Hypothyroidism; Key SEs: hyperthyroidism if overdosed; Contraindications: untreated thyrotoxicosis, acute MI; Nursing teaching: take AM on empty stomach, monitor TSH, report palpitations or chest pain

Armour Thyroid - Thyroid hormone (T3/T4)

natural replacement → Hypothyroidism; Key SEs: hyperthyroidism if overdosed; Contraindications: untreated thyrotoxicosis, adrenal insufficiency; Nursing teaching: monitor TSH, take consistently, report palpitations or nervousness

Radioactive Iodine - Antithyroid (radioactive therapy)

destroys overactive thyroid tissue → Hyperthyroidism, thyroid cancer; Key SEs: hypothyroidism, radiation thyroiditis; Contraindications: pregnancy, lactation; Nursing teaching: avoid close contact with others, monitor thyroid function, follow radiation safety instructions

PTU (Propylthiouracil) - Antithyroid (thionamide)

inhibits thyroid hormone synthesis and T4 to T3 conversion → Hyperthyroidism, thyroid storm; Key SEs: agranulocytosis, liver toxicity; Contraindications: pregnancy (1st trimester caution), liver disease; Nursing teaching: monitor CBC/liver function, report fever/sore throat/jaundice, take with food