Endocrine Disorders

Previous Topic
Next Topic

Insulins: Onset, Peak, and Duration

Rapid-Acting: Lispro and Aspart

  • Onset: 15 minutes
  • Peak: 60 to 90 minutes
  • Duration: 3 to 4 hours
  • SC or IV

Short-Acting: Regular

  • Onset: 30 minutes to 1 hour
  • Peak: 2 to 3 hours
  • Duration: 3 to 6 hours
  • Give SC, IV or IM
  • Give 30 minutes before meals.
  • May be given with long acting insulin
  • Use sliding Scale

Intermediate-Acting: NPH

  • Onset 2 to 4 hours
  • Peak 4 to 10 hours
  • Duration: 10 to 16 hours
  • Only give SC
  • May be mixed with Regular Insulin
  • Hypoglycemia occurs mid to late afternoon

Long-Acting: Glargine and Determir

  • Onset: 1 to 2 hours
  • Peak: None
  • Duration: 24 hours
  • Never mix with other insulins
  • Given once a day at bedtime, but BID ok
  • Give only SC.

Insulin Rules and Nursing Implications

  • Only  insulins you can mix are: Regular and NPH
  • Never mix others
  • Always draw clear before cloudy. Regular before NPH.
  • Abdomen is faster absorptioin
  • Always inject 1 inch apart from previous injection
  • Never freeze insulin.
  • Administer insulin at the same time each day.
  • Once you open a vial, it is good for 30 days.