1. Insulin Pancreatic hormone that stimulates glucose metabolism Low or no insulin production –leads to insulin-dependent diabetes; –necessitates routine injections of insulin.

2. Insulin – TYPES Beef and pork Human insulin Insulin Lispro – synthetic

3. Insulin – TIMING OF ACTION Mealtime Insulin –Rapid-acting Has quick onset; short duration Must be administered within 15 minutes of meal –Shorter-acting Starts slower but works longer than above Must be administered 30 to 60 minutes before meals

4. Insulin – TIMING OF ACTION (cont.) Basal Insulin – Slower onset, longer duration – Intermediate-acting – Longer-acting Mixed insulin – Both mealtime and basal insulins

5. Insulin – TIMING OF ACTION (cont.) Onset – time when insulin begins to lower blood glucose Peak – time when insulin’s effect is the greatest Duration –Length of time the effect of insulin lasts –Measured from the time of onset

6. Regular insulin injection administered at 0700 Onset – 30 minutes, 0730 Peak – 2.5 to 5 hours post administration, between 0930 and 1200 Duration – 8 h, until 1530 Insulin – TIMING OF ACTION (cont.) Example

7. TypeOnsetPeakDuration Mealtime insulin Rapid-acting 15 – 20 min1 – 3 hours3 – 5 hours Shorter-acting 30 min1 – 3 hours6 – 8 hrs Basal insulin Intermediate- acting 2 – 5 hours4 – 8 hours18 – 26 hours Long-acting 4-8 hours* 10 – 30 hours 24 to greater than 30 hours Insulin – TIMING OF ACTION (cont.) *Insulin glargine – onset 70 – 90 minutes

8. Insulin – LABELS (cont.) Same information as other drug labels Concentration –Usually listed twice as 100 units/mL U-100

9. Insulin – LABELS Expiration date & lot # Manufacturer ConcentrationBrand name Origin Storage information Type

10. Patient Education: MEASURING A SINGLE INSULIN DOSE 1.Always wash hands before handling insulin and syringes. 2.If you are using a basal or mixed insulin, roll the vial between your palms to mix the insulin until all of the insulin looks cloudy.

11. Patient Education: MEASURING A SINGLE INSULIN DOSE (cont.) 3.Cleanse the rubber stopper of the vial with an alcohol wipe, using a circular motion. Start at the center of the circle and work outward.

12. Patient Education: MEASURING A SINGLE INSULIN DOSE (cont.) 4.Draw up an amount of air equal to your insulin dose in the syringe. Pull back the plunger until the leading ring is aligned with the correct marking on the syringe.

13. Patient Education: MEASURING A SINGLE INSULIN DOSE (cont.) 5.Inject the air into the insulin vial. 6.Keep the needle inserted through the stopper and turn the vial upside down. Draw up your ordered dose of insulin.

14. Patient Education: MEASURING A SINGLE INSULIN DOSE (cont.) 7.Avoid touching the needle during the procedure. 14

15. Practice True/False Onset is the time when insulin begins to lower the glucose level. Duration is measured from the time the insulin dose was administered. When mixing insulins, draw up the cloudy before the clear. Insulin is administered using special syringes marked in units. F F T T From the time of onset Clear then cloudy

16. Apply Your Knowledge Match insulin type with correct label. Mealtime shorter-acting Mealtime rapid-acting Basal intermediate-acting

17. Apply Your Knowledge The time at which the insulin’s effect is strongest is called: a. Onset b. Peak c. Duration