Endocrine Lecture

Day 2b

Insulin History Lesson

• Instituted in 1923– Beef– Pork

• 1979 – human insulin• Can not be taken by

mouth (digested)

Onset – Peak - Duration

• Onset– The time period from

injection to when it begins to take effect

• Peak– When insulin is

working its hardest and therefore blood glucose levels are at their lowest

Onset – Peak - Duration

• Duration– Length of time the

insulin works or lasts

Types of Insulin –Very short acting/ rapid acting

• Lispro (Humalog)• Aspart (Novolog)

• Insulin pumps• Rapid reduction of glucose level

Appearance

Onset Peak Duration

Clear ¼ hour 1 hour 3 hours

Types of Insulin –Short-acting / regular

Appearance

Onset Peak Duration

Clear ½ - 1 hr(1 hour)

2-3 hrs(3 hour)

4-6 hrs(5 hours)

• Humalog R; Novolin R; Iletin II Regular

• Administered 20-30 minutes before meals• IV• Usually given 4 x a day• May to taken alone or in combination

Types of Insulin –Intermediate-acting

Appearance

Onset Peak Duration

Cloudy 2-4 hrs(2 hrs)

6-12 hrs(12 hrs)

16-20 hrs

(24 hrs)

• NPH; Humulin N; Lente: Novolin L; Novolin N

• Administer after meals• Usually given 2x a day• Eat at onset!

Types of Insulin –Long-acting

• Ultra Lente (UL)

• To control fasting glucose levels• Cannot be mixed!

Appearance

Onset Peak Duration

Cloudy 4-8hour(6 hrs)

10-30 hrs

(24 hrs)

36+ hours(36 hrs)

Learning Tip: Even and Odd

• Short-acting think odd – (1-3-5)

• Intermediate-acting think even – (2-12-24)

When should insulin be administered

• Short-acting / regular– 30 minutes before meals– Do not allow more than 30 minutes to pass by without

eating • hypoglycemia

• Intermediate acting– After meals

• If mixed (regular & intermediate)– 30 minutes before meals

What route is insulin administered

• Sub-cutaneous• IV– Regular

• Pump

Small Group Question

Mrs. Evans is 60 year old women with type 2 DM. She is on Novolin L (Lente) insulin every morning. She normally eats her meals at 8:00 AM, 12:00 PM, and 6:00 PM.

1. What time should she take her morning insulin?2. When should she be alert for S&S of

hypoglycemia?3. What should Mrs. Evans be told to do at this time.

(see question #2)

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Mrs. Sweet Peas takes 13 units of Humalog R q ac. Her meals are B-8:00 AM, L-12:00 PM, D-7:00PM

• What time should Mrs. Peas take her mid-day (lunch)dose of insulin?

• When will Mrs. peas blood sugar be at its lowest?

• What should she do, or not do at this time?

Miss Sweet Peas

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Mrs. Gumdrop takes 6 units of NPH at HS (10PM). She eats her meals at: B-7AM, L-11AM, D-5PM.

• When is she most at risk for hypoglycemia?• What can she do to prevent this?

Mrs. Gumdrop

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Mr. Chocolate Chip Cookie takes 10 units of Novolin R q AM. His meals are at : B-7AM, L-11AM, D-5PM.

• When should he take his morning does of insulin?

• When will Mr. Cookie’s blood sugar levels be at their lowest?

• What should he do, or not do at this time?

Mr. Chip

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Ms. Eng Ewe takes 10 units of Iletin II Lente q AM. Her meals are B-8AM, L-12PM, D-

7PM• When will her blood sugar levels be at their

lowest?• What should she do or not do at this time?• What can she do to prevent this?

Ms. Ewe

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