Podcast
Questions and Answers
What is the primary purpose of rapid- or short-acting insulins?
What is the primary purpose of rapid- or short-acting insulins?
When is regular insulin typically injected?
When is regular insulin typically injected?
What is the characteristic of NPH insulin that allows it to have a delayed absorption and longer duration of action?
What is the characteristic of NPH insulin that allows it to have a delayed absorption and longer duration of action?
What is the primary use of NPH insulin?
What is the primary use of NPH insulin?
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What is the mechanism by which insulin detemir has a long-acting effect?
What is the mechanism by which insulin detemir has a long-acting effect?
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What is the characteristic of insulin glargine that allows it to have a flat, prolonged hypoglycemic effect?
What is the characteristic of insulin glargine that allows it to have a flat, prolonged hypoglycemic effect?
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Which of the following insulins is NOT suitable for IV administration?
Which of the following insulins is NOT suitable for IV administration?
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What is the primary advantage of using rapid-acting insulins in external insulin pumps?
What is the primary advantage of using rapid-acting insulins in external insulin pumps?
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Study Notes
Rapid- or Short-Acting Insulins
- Administered to mimic prandial (mealtime) release of insulin and control postprandial glucose
- Used in cases where swift correction of elevated glucose is needed
- Usually used in conjunction with a longer-acting basal insulin to control fasting glucose
- Regular insulin should be injected subcutaneously 30 minutes before a meal
- Rapid-acting insulins administered 15 minutes before a meal or within 15-20 minutes after starting a meal
- Commonly used in external insulin pumps and suitable for IV administration
Intermediate-Acting Insulin
- Neutral protamine Hagedorn (NPH) (isophane) insulin is an intermediate-acting insulin
- Formed by adding zinc and protamine to regular insulin, resulting in delayed absorption and longer duration of action
- Used for basal (fasting) control in type 1 or 2 diabetes, usually given with rapid- or short-acting insulin for mealtime control
- Should be given only subcutaneously (never IV) and not used when rapid glucose lowering is needed (e.g., diabetic ketoacidosis)
Long-Acting Insulin Preparations
- Insulin glargine has a lower isoelectric point than human insulin, forming a precipitate at the injection site that releases insulin over an extended period
- Has a slower onset than NPH insulin and a flat, prolonged hypoglycemic effect with no peak
- Insulin detemir has a fatty acid side chain that enhances association to albumin, resulting in slow dissociation and long-acting properties
- Both insulin glargine and insulin detemir are used for basal control and should only be administered subcutaneously
- Neither long-acting insulin should be mixed with other insulins in the same syringe, as it may alter the pharmacodynamic profile
Insulin Combinations
- Various premixed combinations of human insulins are available, such as 70% NPH insulin plus 30% regular insulin
- Use of premixed combinations decreases the number of daily injections but makes it more difficult to adjust individual components of the insulin regimen
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Description
Learn about the administration and benefits of rapid-acting insulins in controlling postprandial glucose levels and managing diabetes.