Insulin Types and Their Uses

Types of Insulin

• Rapid-acting insulin examples include insulin lispro (Humalog), insulin aspart (NovoLog), and insulin glulisine (Apidra).
• Rapid-acting insulin has an onset of 10-15 minutes, peaks in 1-2 hours, and lasts for 3-5 hours; it should be taken before meals and requires monitoring for hypoglycemia.
• Short-acting insulin like regular insulin (Humulin R, Novolin R) starts working in 30-60 minutes, peaks in 2-4 hours, and lasts 5-8 hours; it can be administered intravenously or subcutaneously 30 minutes before meals.
• Intermediate-acting insulin, such as NPH insulin (Humulin N, Novolin N), has an onset of 1-2 hours, peaks in 4-12 hours, and lasts 12-18 hours; this cloudy insulin should be rolled to mix and is often taken twice daily (BID).
• Long-acting insulin like insulin glargine (Lantus) and insulin detemir (Levemir) starts working in 1-2 hours, has a minimal peak, and lasts approximately 24 hours; it should not be mixed and should be taken at the same time daily.

Types of Diabetes

• Type 1 Diabetes (T1DM) is caused by autoimmune beta-cell destruction and requires lifelong insulin, carbohydrate counting, and blood glucose monitoring.
• Type 2 Diabetes (T2DM) results from insulin resistance and beta-cell dysfunction, with risk factors including obesity, sedentary lifestyle, and family history; treatment involves lifestyle changes, oral medications, and insulin as needed.
• Gestational Diabetes (GDM) is due to hormonal insulin resistance during pregnancy and is managed with diet, exercise, and insulin if needed.
• Other specific types of diabetes include MODY, LADA, and forms caused by secondary factors like steroids or pancreatitis.

Nursing Care for Diabetes

• Assessment includes monitoring blood glucose, assessing symptoms, and reviewing adherence to treatment plans.
• Nursing interventions involve educating patients on proper medication use and side effects, nutrition (carb counting, balanced diet), encouraging exercise, and monitoring blood glucose.
• Hypoglycemia should be treated with 15g of carbohydrates, with a recheck in 15 minutes.
• Monitor hydration and administer insulin/fluids for DKA/HHS.
• Education is crucial for monitoring, understanding sick day rules, and practicing foot care.

Patient Teaching

• Daily foot inspections, understanding sick day insulin use, and recognizing warning signs are important.
• Potential complications include eye, kidney, nerve, and cardiovascular diseases.