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INSULINRapid-ActingShort-ActingIntermediate-ActingLong-ActingType Insulin glulisine (Apidra)Insulin lispro (HumALOG)Insulin aspart (NovOLOG)Insulin injection SQ (NovoLIN R,HumULIN R U-500, HumULIN R) Insulin IV (regular insulin only) Isophane insulin suspension (NovoLIN NPH, HumULIN N) Insulin glargine (Lantus)Insulin detemir (Levemir) Onset (hr)Within 15 minWithin 15 min10 – 20 min30 min – 1hr10-30 min1- 2 hr3 - 4 hr3-4 hrPeak effect (hr)1 hr1 - 1.5 hr1 – 3 hr2 – 4 hr15-30 min4 – 12 hrPlateau3-14 hrDuration (hr)2-4 hr6-8 hr3-5 hr5-7 hr30 min -1 hr18-24 hr24 hr6-24 hrAppearanceClearClearClearClear ClearCloudyClearClearWhen given -meals should occur when insulin is at peak effect15 min before or within 20 after start of mealWithin 15 min before or immediately after a meal5-10 min before meals15-30 minutes prior to a meal 30 minutes prior to a mealWithin 30-60 min before a mealOne daily at the same time every day.Once daily with evening meal or bedtimeCompatibilityNPHNPHNPHNPHRegular, HumALOG, NovOLG, ApidraNoneNoneSpecial Considerations Best mimics the body’s release of pre-meal insulin when given at right time.Hypoglycemia less likely than with Regular due to timing of insulin administrationMore likely to occlude continuous subcutaneous insulin infusion CSII cannula than Regular InsulinCan be used for CS II (insulin pump)*Regular (concentrated) insulin U-500 should not be given IV(think even 2,12,24)MUST NOT BE MIXED WITH ANY OTHER INSULIN OR SOLUTIONInjection site pain more likely since Lantus is made to precipitate in the SQ tissue.With 2 daily Detemir, with evening meal, bedtime or 12 hrs after morning binations – None have CompatibilityTypeIsophane human insulin (70%) & regular human insulin (30%) (HumULIN 70/30, NovOLIN 70/30)Insulin lispro protamine/insulin lispro (HumALOG Mix 75/25) Insulin aspart protamine/insulin aspart (NovOLOG Mix 70/30))Onset 30 min15 min15 minPeak effect (hr)2-12 hr2.8 hr1-4 hrDuration (hr)24 hr24 hr18-24 hrAppearanceCloudyWhen givenOnce or Twice DailyGive within 15 minutes of mealsWithin 15 minutes of mealsHypoglycemia: anxiety, restlessness, tingling in hands, feet, lips, tongue, chills, cold sweats, confusion, cool pale skin, difficulty concentrating, drowsiness, nightmares or trouble sleeping, excessive hunger, headache, irritability, nausea, nervousness, tachycardia, tremor, weakness, unsteady gait.Hyperglycemia: confusion, drowsiness, flushed dry skin, fruit like breath odor, rapid deep breathing, polyuria, loss of appetite, nausea, vomiting, and unusual thirst. ................
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