Insulins (Rapid, Short, Intermediate, Long)

Endocrine & Metabolic

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Examples

lispro, aspart (rapid)regular (short)NPH (intermediate)glargine, detemir (long)

Prefix / Suffix: No consistent suffix

Physiology

Insulin from pancreatic beta cells lowers blood glucose by promoting glucose uptake into cells, glycogen storage, and inhibiting gluconeogenesis. In diabetes, insulin is deficient or ineffective.

Mechanism of Action

Replaces or supplements endogenous insulin, binding insulin receptors to promote glucose uptake into muscle and fat, and suppress hepatic glucose production.

Indications

Type 1 diabetes mellitus
Type 2 diabetes (when oral agents inadequate)
Diabetic ketoacidosis (regular insulin IV)
Hyperkalemia (with dextrose)
Gestational diabetes

Side Effects / Adverse Effects

Hypoglycemia (most serious — sweating, tremor, confusion, seizure)
Weight gain
Lipodystrophy at injection sites
Hypokalemia
Allergic reactions (rare)

Contraindications

Hypoglycemia
Hypersensitivity

Nursing Considerations

Know onset, peak, and duration for each insulin type — peak is highest hypoglycemia risk
Rapid: onset 15 min, peak 1 h; Regular: onset 30 min, peak 2–3 h; NPH: onset 1–2 h, peak 6–10 h; Long-acting: no peak
Rotate injection sites within same area (prevents lipodystrophy)
Roll NPH between palms — do not shake (cloudy insulin)
When mixing: clear (regular) before cloudy (NPH)
Glargine and detemir: never mix with other insulins
Teach signs of hypo/hyperglycemia and how to respond
Always have a fast-acting carb available (15 g rule)
Monitor blood glucose regularly

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.