Table of Contents
Types of Insulin and Mixing
Rapid Acting Insulin
Begins to work 5 -15 minutes after injection, peaks in about 1 hour and continue to work for 2-4 hours
Used to control blood sugar levels during meals and snacks and correct high blood sugar
Mix Humalog or Novolog with other insulin types, but mix Apidra only with NPH insulin, if needed. Administer immediately after mixing
While mixing rapid-acting insulin with a longer-acting insulin, always draw rapid-acting insulin first into the syringe to avoid dosage error
Eg:- Humalog(Insulin lispro), Novolog(insulin aspart), Apidra(Insulin glulisine)
Regular or Short-Acting Insulin
Reaches the bloodstream about 30 minutes after the injection, peaks anywhere from 2 – 3 hours after the injection and is effective for approximately 3 – 6 hours
Used to control blood sugar levels during meals and snacks and correct high blood sugar levels
Administer SubQ, IM or IV, as prescribed
Eg:- Regular insulin(Humulin R, Novolin R)
Intermediate-Acting Insulin
Reaches the bloodstream about 2 -4 hours after injection, peaks 4 -12 hours and is effective for about 12 – 18 hours
Absorbed more slowly and lasts longer, which is why it is used to control blood sugar levels overnight while fasting and between meals
Eg:- NPH insulin(Novolin NPH, Humulin N)
Long-Acting Insulin
Reaches the bloodstream several hours after injection and tends to lower glucose levels fairly evenly over a 24-hour period
Absorbed slowly, has a minimal peak effect and then a stable plateau effect that lasts most of the day used to control blood sugar overnight while fasting between meals
Administer SubQ route only
Eg:- Lantus(Insulin glargine), Levemir(insulin detemir), Humulin U
Mixing of Insulin
Administer 12 units of regular insulin and 30 units of NPH insulin
The mneomonic is RN
Always Withdraw regular insulin first then NPH
Step 1
Inject 30 units of air into NPH Insulin vial
Step 2
Inject 12 units of air into regular insulin
Step 3
Withdraw 12 units of regular insulin first
Step 4
Withdraw 30 units of NPH insulin
Special Precaution:-
- Do not mix Lantus or Levemir with another insulin or solution
- Administer a combination insulin subQ route only eg:- Humulin 70/30, Novolin 70/30
- Do not use insulin if it contains precipitate that is clumped or granular or that clings to the sides of the vial
- Roll the vial gently between your palms to mix, do not shake it
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