Insulin Question

[luv2shopp85]

I have a question about insulin...

I always get so confused with onset, peak, and duration of the different types. But now Im getting ready to take the NCLEX so I want to make sure I have the concept down.

Ultra Short Acting -Humalog & Novolog

Onset 15 min, Peak 30-90, Duration 5 hrs or less

Short acting -Regular

Onset 1/2-1 hr, Peak, 2-3 Hrs, Duration 4-6 hrs

Intermediate Acting -NPH & Lente

Onset 2-4 hrs, Peak 4-12 hrs, Duration 10-18 hours

Long Acting -Lantus

Onset 1-2 hrs, Duration 24 + hrs

I'm assuming all of that is right becaues I got it out of my textbook.

But anyways... what I'm confused with is when to look for hypoglycemic or hyperglycemic reaction. Is it after the peak or after the duration?

When its peaking you would be looking for a hypoglycemic reaction right? Because the insulin would be at its highest point then. So if the patient were on NPH.. I would look for a hypoglycemic reaction between 4 and 12 hours? And then I would look for a hyperglycemic reaction between 10-18 hours which is the duration?

I'm soo confused!!

[garnetbeauty82]

hey I found this site...It pretty much confirmed what you asked, good luck!

http://faculty.dbcc.cc.fl.us/martin/prndiabetesnote.htm

HUGS

Tisha

[Bonny619]

Some of those numbers are off from what we learned. I wouldn't get sooo hung up on being exact, just be in the ballpark.

[RN28MD]

I wonder if you post this in the DM educators site that maybe you would get a more acurate response. Since they educate in Diabetes. Good luck

[ericka07]

You would look for the hypoglycemic reaction when the peak occurs. The reason being this: you just gave insulin to someone and the peak of the medicine effect is when it is most potent, therefore that would be the most likely time for someone to became hypoglycemic (the insulin allowed all the blood sugar in the blood to be taken into the cells and now there is not enough).

The duration is how long the insulin is at measurable levels in the body, therefore you would look for hyperglycemia around this time (the end of the duration period), as the levels of insulin are dropping and the glucose levels naturally go up.

[luv2shopp85]

Okay so if I'm giving regular insulin at 8 am...

I would look for the hypoglycemic reaction between 10 and 11. This is because the insulin is at teh highest amount in the body.

The hyperglycemic reaction would occur between 12 and 2?

[ericka07]

That is how I would do it. We had a million and one questions like this in Critical Care nursing along with HHNKS and DKA. It got so old.