Diabetes meds driving me crazy!

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by dayanara
  2,790 Views   11 Comments

  1. I always get mixed up with the onset and peak of the insulins and cannot see the bigger picture regarding oral meds.
    Any suggestions on how to learn these better? Thanks:-)
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  2. 11 Comments

    Comment
  3. by MendedHeart
    Mar 25, '13
    I always have a hard time remembering too..lantus is the eadiest to remember. .24hours..try and relate each one to when you have to give it in relationship to the patient eating
  4. by SherluckyRN
    Mar 25, '13
    Remember RN regular before NPH. Regular is short acting I believe and NPH long acting then take it from there
  5. by dayanara
    Mar 25, '13
    Yeah Lantus is the easiest:-)

    I believe NPH is intermediate acting:-) I don't have a problem knowing the rapid, short, intermediate and long. It's just the onset and peak that troubles me cuz I find different times on different sources.

    Thank you both!
  6. by Esme12
    Mar 26, '13
    Action of Commonly Prescribed Insulin......IOH types of insulin; chart of duration and action of insulin
    Name
    Type
    Onset(1)
    Peak(1)
    Duration(1)
    Humalog (Lispro)
    Rapid
    5-15 minutes
    30-75 minutes
    2-3 hours
    Apidra (glulisine)
    Rapid
    5-15 minutes
    30-75 minutes
    2-4 hours
    Novolog (Aspart)
    Rapid
    10-20 minutes
    1-3 hours
    3-5 hours
    Regular (R)
    Short-Acting
    30 minutes
    2-5 hours
    5-8 hours
    NPH (N)
    Intermediate
    1-3 hours
    6-12 hours
    16-24 hours
    Lente (L)
    Intermediate
    1-3 hours
    6-12 hours
    16-24 hours
    Ultralente (U)
    Long-Acting
    3-5 hours
    8-14 hours
    18 hours
    Glargine Lantus
    Very Long-Acting
    1 hour
    Evenly for 24 hours
    24-28 hours
    NPH & Regular Mixed in either
    50/50 mix, or
    70/30 mix
    Premixed
    30-60 minutes
    2-12 hours
    up to 18 hours
  7. by dayanara
    Mar 26, '13
    Thank you Esme! Very helpful chart. Some sources say long-acting has no peak, and others like this one say it does...I'm just gonna go with what the book says:-)
  8. by Esme12
    Mar 26, '13
    If you click on the link it takes you to the page......where it breaks the individual insulin down. Great information!
  9. by AndrewCraigRN
    Mar 26, '13
    In my experience, I commited to memory 3-5 of the most common insulins. For instance, humalog, novolog, regular, nph, and lantus. These five are very common. If you come acrossed another type in your studies or clinicals, look em up (as usual).

    However, I too have had issues remembering insulin onset, peak, and duration. You can draw a graph for each one. Or, the main three. Novolog, regular, and lantus. That is what I did and I'm able to reproduce it to this day and not having drawn it in months. Try it.
  10. by dayanara
    Mar 26, '13
    I did Esme! Thanks. Great info:-)

    Thank you Floridatrail! That's a good one! I'll try it for sure.
  11. by eva123
    Mar 26, '13
    Now that you have some good advice on the insulins here's some info on oral antidiabetics:
    *Alpha-Glucosidase Inhibitors (Acarbose, Miglitol) act locally in GI tract to inhibit Alpha-glucosidase which is responsible for carb breakdown, because of it's mechanism of action it does not cause hypoglycemia.

    *Biguanides (Metformin) works by multiple mechanisms. It reduces gluconeogenesis, decreases intestinal reabsorption of glucose, increases cellular uptake of glucose, and increases excretion of glucose. It also does not cause hypoglycemia.

    *Incretin enhancers (Sitagliptan/Januvia) Inhibits DPP-4 from breaking down incretins, increased levels of incretins lowers blood glucose because incretins respond to glucose load and are responsible for 60% of insulin release. These can cause hypoglycemia.

    *Meglitinides (Prandin) Stimulate insulin release from pancreatic beta-cells. These can cause hypoglycemia.

    *Sulfonylureas (Glyburide, Glipizide) stimulate release of insulin from pancreatic beta cells and increase sensitivity of peripheral tissues to insulin. These can cause hypoglycemia.

    *Thiazolidinedione aka TZDs (Avandia, Actose) increase cellular sensitivity to insulin and decrease gluconeogenesis by liver. These can cause hypoglycemia.

    *Antihypoglycemic Agent (Glucogon/Gluca Gen) increases glycogenolysis, stimulates uptake of amino acids, increases gluconeogenesis, and promotes lipolysis.

    You can find all of this in your drug book and much more information, but this should provide a brief overview. I pulled this information from Davis's Drug Guide and my teachers. Hope it helps.
  12. by eva123
    Mar 26, '13
    Oh and the bigger picture on oral medications are that they are used when Type 2 diabetes cannot be controlled with diet and exercise.
  13. by dayanara
    Mar 28, '13
    Thank you very much eva123!!!

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