Insulin Flashcards
What is the onset of action for insulin?
The point at which insulin first starts to lower glucose level
For insulin, what is considered the peak?
The point at which glucose is the lowest
What is the definition of duration of action?
The period of time insulin is lowering the glucose
What are examples of rapid acting insulin?
Lispro (humalog) aspart (novolog) glulisine (Apidra) and insulin human (Afrezza)
What is the onset of rapid acting insulin?
5-15 minutes
What is the peak is rapid acting insulin?
30-90 minutes
What is the duration of rapid acting insulin?
< 5 hours
What are examples of short acting insulin?
Regular insulin (Humulin-R, Novolin-R)
What is the onset for short acting insulin?
30-60 minutes
What is the peak of short acting insulin?
2-3 hours
What is the duration of short acting insulin?
5-8 hours
What are examples of intermediate acting insulin?
NPH human (Humulin-N, Novolin-N)
What is the onset of intermediate acting insulin?
2-4 hours
What is the peak of intermediate acting insulin?
4-10 hours
What is the duration of intermediate acting insulin?
10-16 hours
What are examples of long acting insulin?
Glargine (Lantus, basaglar, toujeo), Determir (Levemir), Degludec (Tresiba)
What is the onset of glargine?
2-4 hours
What is the peak of glargine?
No peak
What is the duration of glargine?
20-24 hours
What is the onset of determir?
3-8 hours
What is the peak of determir?
Nearly peakless
What is the duration of determir?
5.7-23.2 hours
What is the onset of degludec?
1 hour
What is the peak of degludec?
No peak
What is the duration of degludec?
25-42 hours
How is insulin measured in the US?
In units. For example, U-100 means there are 100 units of insulin in each mL of liquid
If someone takes an insulin that peaks, when should a meal be eaten?
During the peak time
If kept refrigerated, how long can unopened vials of insulin be kept?
Until the expiration date
36-46 degrees, protected from light
If kept at room temp, how long can insulin be kept?
Discard after 1 month
Not to exceed 86 degrees
Exceptions are novolog 70/30 flexpen (14 days) and Levemir (42 days)
How should opened vials or insulin pens that are in use be kept?
At room temp, not to exceed 86 degrees
It is ok to keep vial or pen in refrigerator, but cold injection may be uncomfortable (can roll between palms to warm up)
What color is rapid acting insulin?
Clear
When should a meal be eaten with rapid acting insulin?
Within 15 mins
*rapid acting insulin typically prescribed to be taken before meals
Of snack eaten that contains more than 15 g CHO, rapid acting may be needed
What color is regular insulin
Clear
When should regular insulin be taken?
30-45 mins before a meal
How long is food actively raising blood sugar?
1-2 hours after eating
What color is
Intermediate acting insulin?
Cloudy white (cloudy bc a substance has been added to slow down its action)
Must be mixed gently and thoroughly before injection is prepared—roll between palms, do not shake
How is NPH typically prescribed to be taken?
Once or twice a day
In what situation would
NPH be beneficial taken at bedtime?
Would peak during early morning hours when liver is releasing too much glucose
What color is long acting insulin?
Clear
When is long acting insulin usually prescribed to be taken?
Once daily often at bedtime. Can be taken any time day or night as long as timing is consistent
What are the strength of premixed NPH insulins?
Intermediate and short acting combined. First number in name indicates amount of intermediate insulin, second number amount of short acting
(Ex: 70/30, 75/25, 50/50)
What type of insulin is afrezza?
Inhaled, rapid acting.
Comes in cartridges of 4,8, and 12 units
*lung function should be monitored
What type of DM are disposable insulin pumps approved for?
DM2
Must be replaced q 24
Limits: only available in specific preset basal rates, no programmable features
What color is pramlintide?
Clear
When should pramlinitide be injected?
Before major meals (at least 250 cals and 30 G protein)
How do needle gauges work?
The thicker the needle, the smaller the gauge number (and visa versa)
Can long acting insulin’s
Be mixed?
No
When should first follow up be for reaching on patients taking insulin or injection therapy?
< 2 weeks; f/u at 3-6 month intervals thereafter
