Insulin (BGA)

Drug Names

Regular (fast-acting), NPH (long-acting), inhaled insulin, lispro, aspart, glargine, glulisine, detemir

Therapeutic Actions

promotes the storage of body’s fuels, facilitates the transport of various metabolites and ions across the cell membranes, stimulates the synthesis of glycogen from glucose, reacts with specific receptor sites on the cells

Indications

treatment of type 1 diabetes mellitus and type 2 diabetes mellitus in patients who cannot control their diabetes through diet or other medications, or those experiencing extreme stress.

Contraindications & Cautions

Insulin has no contraindications except for episodes of hypoglycemia. It should be used with caution in pregnancy and lactation.

Drug-Drug Interactions

any medication that decreases glucose levels, beta blockers (which can mask s/s of hypoglycemia), thiazide diuretics, and glucocorticoids.

Common Adverse Effects

hypoglycemia, ketoacidosis, local site infection, and decreased blood potassium levels.

What is the nursing intervention related to onset?

the patient need to have food in front of them during this time (have food on hand before giving meds, becuase you can’t count on food trays getting delivered at a set time)

What is the nursing intervention related to peak?

During this time is when the patient is most likely to experience s/s of hypoglycemia, therefore as the nurse we need to do an assessment of the patient and we can take action if needed.

Duration =

how long the insulin lasts/works in the body

What does the ratio of combination insulin mean?

short acting/long acting (ex: Humalog 75/25)

Regular

onest = 30-60 min

peak = 2-4 hrs

duration = 6-12 hrs

NPH

onest = 1-1.5 hrs

peak = 4-12 hrs

duration = 24 hrs

Inhaled Insulin

onest = 12-15 min

peak = 60 min

duration = 2.5-3 hrs

lispro

onest = less than 15 min

peak = 30-90 min

duration = 2-5 hrs

aspart

onest = 10-20 min

peak = 1-3 hrs

duration = 3-5 hrs

glargine

onest = 60-70 min

peak = NONE

duration = 24 hrs

glulisine

onest = 2-5 min

peak = 30-90 min

duration = 2 hrs

detemir

onest = 1-2 hrs

peak = 3-6 hrs

duration = 5.7-23.3 hrs

Do combination insulins have a set peak, time, and duration?

No, they vary.