Understanding Insulin in Diabetes Management

Aug 7, 2024

Endocrine System Medications: Insulin

Introduction

  • Focus on endocrine system medications, specifically insulin.
  • Insulin is used by both type 1 and type 2 diabetic patients.
  • Oral antidiabetic medications are for type 2 diabetic patients only.
  • Four types of insulin: rapid-acting, short-acting, intermediate-acting, long-acting.

Types of Insulin

Rapid-Acting Insulin

  • Examples: Insulin lispro (Humalog), Insulin aspart (Novolog).
  • Onset: 15 minutes.
  • Peak: 1 hour.
  • Duration: 2-4 hours.
  • Mnemonic: Think of a log rolling rapidly down a hill.
  • Administration Tip: Ensure the meal tray is in front of the patient to prevent hypoglycemia.

Short-Acting Insulin

  • Examples: Regular insulin (Humulin R, Novolin R).
  • Onset: 30 minutes.
  • Peak: 2-3 hours.
  • Duration: 3-6 hours.
  • Administration Tip: Ensure meal trays are on the floor for the patient.

Intermediate-Acting Insulin

  • Example: NPH.
  • Onset: 2-4 hours.
  • Peak: 4-12 hours.
  • Duration: 12-18 hours.
  • Mnemonic: Neil Patrick Harris (NPH) is of intermediate height and hardworking (2-4 hours onset, stays up to 18 hours).

Long-Acting Insulin

  • Examples: Insulin glargine (Lantus), Insulin detemir (Levemir).
  • Onset: 3-4 hours.
  • Peak: None.
  • Duration: 24 hours.
  • Mnemonic: Comfy jeans (glargine) worn for 24 hours.

Key Points for Insulin Administration

  • Rotate injection sites to prevent lipohypertrophy.
  • Monitor for hypoglycemia: symptoms include tachycardia, diaphoresis, shakiness, headache, and weakness.
  • Inform patients of hypoglycemia symptoms upon discharge.
  • Extra insulin doses may be needed during illness or stress.
  • Do not skip insulin during sickness; higher doses might be necessary.
  • For hypoglycemia in conscious patients: provide orange juice or milk (15 grams glucose).
  • For unconscious patients: administer glucagon.

Mixing Insulins

  • When mixing short-acting with intermediate-acting (NPH), draw up clear (short-acting) before cloudy (NPH).
  • Inject air into cloudy insulin first, then clear, draw clear insulin, then draw cloudy insulin.
  • Mnemonic: RN (Regular before NPH).
  • Gently rotate vial before administration.
  • Dispose of short-acting insulin if cloudy or discolored.

Conclusion

  • Covered insulin information; next lecture will cover oral antidiabetic medications.
  • Thank you for watching!