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Rapid-Acting Type Insulin glulisine (Apidra) Within 15 min 1 hr 2-4 hr Clear 15 min before or within 20 after start of meal NPH Insulin lispro (HumALOG) Insulin aspart (NovOLOG) Short-Acting Insulin injection SQ (NovoLIN R, HumULIN R U500, HumULIN R) 30 min 1hr 2 4 hr 5-7 hr Clear 15-30 minutes prior to a meal Insulin IV (regular insulin only) 10-30 min 15-30 min 30 min -1 hr Clear 30 minutes prior to a meal IntermediateActing Isophane insulin suspension (NovoLIN NPH, HumULIN N) 1- 2 hr 4 12 hr 18-24 hr Cloudy Within 30-60 min before a meal Long-Acting Insulin glargine (Lantus) Insulin detemir (Levemir)

Onset (hr) Peak effect (hr) Duration (hr) Appearance When given meals should occur when insulin is at peak effect Compatibility Special Considerations

Within 15 min 1 - 1.5 hr 6-8 hr Clear Within 15 min before or immediately after a meal NPH

10 20 min 1 3 hr 3-5 hr Clear 5-10 min before meals

3 - 4 hr Plateau 24 hr Clear One daily at the same time every day.

3-4 hr 3-14 hr 6-24 hr Clear Once daily with evening meal or bedtime None With 2 daily Detemir, with evening meal, bedtime or 12 hrs after morning dose.


NPH *Regular (concentrate d) insulin U500 should not be given IV

Regular, HumALOG, NovOLG, Apidra

None MUST NOT BE MIXED WITH ANY OTHER INSULIN OR SOLUTION Injection site pain more likely since Lantus is made to precipitate in the SQ tissue.

Best mimics the bodys release of pre-meal insulin when given at right time. Hypoglycemia less likely than with Regular due to timing of insulin administration More likely to occlude continuous subcutaneous insulin infusion CSII cannula than Regular Insulin Can be used for CS II (insulin pump)

(think even 2,12,24)


Onset Peak effect (hr) Duration (hr) Appearance When given

Combinations None have Compatibility Isophane human insulin (70%) & regular Insulin lispro protamine/insulin lispro human insulin (30%) (HumULIN 70/30, (HumALOG Mix 75/25) NovOLIN 70/30) 30 min 15 min 2-12 hr 2.8 hr 24 hr Once or Twice Daily 24 hr Cloudy Give within 15 minutes of meals

Insulin aspart protamine/insulin aspart (NovOLOG Mix 70/30)) 15 min 1-4 hr 18-24 hr Within 15 minutes of meals

Hypoglycemia: anxiety, restlessness, tingling in hands, feet, lips, tongue, chills, cold sweats, confusion, cool pale skin, difficulty concentrating, drowsiness, nightmares or trouble sleeping, excessive hunger, headache, irritability, nausea, nervousness, tachycardia, tremor, weakness, unsteady gait. Hyperglycemia: confusion, drowsiness, flushed dry skin, fruit like breath odor, rapid deep breathing, polyuria, loss of appetite, nausea, vomiting, and unusual thirst.