Insulin Drug tips.....

Insulins are used to manage diabetes mellitus, a chronic illness that results from an absolute or relative deficiency of insulin. There are various types of insulins available to help manage diabetes. For each type of insulin, you will need to know the onset, peak, and duration. NCLEX questions may focus on when clients need to be assessed after insulin administration. Assessment should occur frequently, but especially during the PEAK of insulin action, as this is when hypoglycemia is most likely to occur. Signs and symptoms of abrupt-onset hypoglycemia include tachycardia, palpations, diaphoresis, and shakiness. Gradual onset hypoglycemia may manifest with headache, tremors, or weakness.

We’ll CLIMB TO THE PEAK…starting FAST and ending SLOW.

FASTEST: Rapid acting insulins: Lispro (Humalog). 

• ONSET: Less than 15 minutes
• PEAK: 30 minutes to 1 hour
• DURATION: 3 to 4 hours

FAST: Short acting insulins: Regular (Humulin R).

• ONSET: 30 minutes to 1 hour
• PEAK: 2 to 3 hours
• DURATION: 5 to 7 hours

SLOW: Intermediate-acting insulins: NPH insulin (Humulin N).

• ONSET: 1 to 2 hours
• PEAK: 4 to 12 hours
• DURATION: 18 to 24 hours

SLOWEST: Long-acting insulins: Insulin glargine (Lantus).

• ONSET: 1 hour
• PEAK: None
• DURATION: 10.4 to 24 hours

Many students look for ways to more easily remember all of the ranges associated with insulin. It is helpful to think generally rather than trying to recall all exact numbers when memorizing this information. Also, if you can only remember one thing about each type of insulin remember, CLIMB TO THE PEAK.

Pick one number from each timeframe (onset, peak, duration) to help reduce the values that you’re trying to memorize. Remember that onset, peak, and duration build sequentially as you move from one type of insulin to another, so it may be helpful to remember, for example, that onset times go from 15 minutes, to 30 minutes, to 1 hour (trend: all onsets are less than an hour). Peak times go from 30 minutes, to 2 hours, to 4 hours (trend: even numbers). Finally, duration goes from 3 hours, to 5 hours, to 24 hours.

If you always organize your thoughts by O.P.D. (onset, peak, and duration), starting FAST (rapid acting) and ending SLOW (long acting) when studying the different types of insulin, these tips will be helpful. The key is consistency…looking at values in the same order every time.