Insulin Types

An insulin dose has a schedule embedded in it. Its onset tells the nurse when glucose-lowering begins, its peak identifies the period of greatest hypoglycemia risk, and its duration shows how long glucose may continue to fall after the meal is over. - Onset is when a clinically meaningful glucose-lowering effect begins. - Peak is when the insulin effect is strongest. A pronounced peak matters because carbohydrate intake, illness, activity, or a missed snack may not match that strongest effect. - Duration is how long the insulin continues to lower blood glucose. The same dose can be safe or dangerous depending on timing. Rapid insulin given when a meal is delayed can cause early hypoglycemia. NPH given at bedtime may produce hypoglycemia several hours later, when the patient is asleep. A basal analogue has little or no pronounced peak, but it can still cause hypoglycemia if the dose exceeds the patient’s background insulin requirement. Action times are approximate. Match the expected curve with the patient’s glucose pattern, meal intake, symptoms, and recent doses rather than treating a timing chart as...