Insulins

Insulins by comparative action

• RAPID ACTING:

  • Insulin lispro: Onset: 15 min to 30 min. Peak: 30 min to 2h. Duration: 5 hr or less.

  • Insulin aspart, glulisine: Onset: 5 - 15 min. Peak: 1 - 2 h. Duration: 3 - 4 h.

• SHORT ACTING:

  • Regular (sol): Onset: 30 min to 1 h. Peak: 2 - 4 h. Duration: 6 - 8 h.

• INTERMEDIATE ACTING:

  • NPH: Onset: 1 - 3 h. Peak: 5 - 7 h. Duration: 13 - 17 h.

  • Lente: Onset: 3 - 4 h. Peak: 4 - 8 h. Duration: 12 - 18 h.

• LONG ACTING:

  • Ultralente: Onset: 6 - 10 h. Peak: 10 - 16 h. Duration: 18 - 20 h.

  • Insulin glargine: Onset: 2 - 4 h. Peakless. Duration: 24 h.

  • Detemir: Onset: 2 - 4 h. Peak: 6 - 10 h. Duration: 12 - 20 h.

• COMBINATIONS:

  • 50% NPH, 50% regular: Onset: 30 min - 1 h. Dual peak. Duration: 10 - 16 h.

  • 70% NPH, 30% regular: Onset: 30 min - 1 h. Dual peak. Duration: 10 - 16 h.

  • 75% NPL, 25% lispro: Onset: less than 15 min. Dual peak. Duration: 10 - 16 h.

Insulin dosing and monitoring in Non-ICU patients