Types of Insulin Flashcards
Rapid acting
Lispro
Aspart
Glulisine
Onset of rapid acting
10-15 mins
Peak of rapid acting
1-2 hours
Duration of rapid acting
3-5 hours
Short acting- Regular
Humulin or Novolin
Onset of Short acting
30-60 min
Peak of short acting
2-4 hr
Duration of short acting
4-8 hours
Intermediate acting insulin
NPH- neural protamin Hagedorn
Onset of NPH
1-3 hours
Peak of NPH
4-10 hours
Duration of NPH
10-18 hours
Long acting insulin
lantus, Touheo, Levemir, Tresiba
All have different onset, with no peak
All last longer than 24 hours with Tresiba being longer than 42 hours
Basal regimen- T2DM
Once daily of levemir/Lantus
start at 10u and tirate every 2-3 days based on FBG goal
Cont oral meds but make sure to reduce dose of SU by 50%
What if BG before lunch and dinner with basal regimen
Not sufficient enough, progress to twice daily mixed insulin or basal bolus regime
Split Mixed Insulin Regimen
2-3 injections a day with a combo of long or intermediate acting insulin AND short/rapid acting insulin
Using premixed insulin
AM dose- 2/3 of dose
Before dinner dose- 1/3 of daily dose
Carb intake must on consistent
Patient mixing own insulin
Am dose: 2/3 NPH and 1/3 rapid/regular
Dinner dose: 1/2 NPH and 1/2 regular/rapid
Titration split mixed insulin- Elevation pre Breakfast
increase evening dose of NPH
Titration split mixed insulin- Elevated pre lunch
increase AM dose of regular/rapid dose
Titration split mixed insulin- pre dinner glucose
increase AM dose of NPH
Titration split mixed insulin- Bedtime glucose
increase evening dose of regular/rapid
Split Mixed insulin with oral meds
cont metformin or TZD but stop SU
Basal Bolus Insulin regime
combines basal insulin wiht pre-meal insulin
