8 Questions
What is the primary purpose of rapid- or short-acting insulins?
To mimic the prandial release of insulin and control postprandial glucose
When is regular insulin typically injected?
30 minutes before a meal
What is the characteristic of NPH insulin that allows it to have a delayed absorption and longer duration of action?
The combination with protamine to form a complex
What is the primary use of NPH insulin?
Basal control of glucose levels
What is the mechanism by which insulin detemir has a long-acting effect?
The association with albumin and slow dissociation
What is the characteristic of insulin glargine that allows it to have a flat, prolonged hypoglycemic effect?
The lower isoelectric point than human insulin
Which of the following insulins is NOT suitable for IV administration?
NPH insulin
What is the primary advantage of using rapid-acting insulins in external insulin pumps?
They can be used for rapid correction of elevated glucose levels
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
Learn about the administration and benefits of rapid-acting insulins in controlling postprandial glucose levels and managing diabetes.
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