Insulin: Difference between revisions
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==See Also== | ==See Also== | ||
*[[Diabetes (Main)]] | *[[Diabetes (Main)]] | ||
==References== | |||
<references/> | |||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
Latest revision as of 09:11, 22 March 2026
Types
| Type | Onset of action (h) | Peak action | Effective duration | Max duration |
| RAPID ACTING | ||||
|
Lispro (humalog) |
0.25-0.5 |
0.5-1.25 | 3-4 | 4-6 |
|
Aspart (novolog) |
0.25-0.5 |
0.5-1.25 | 3-4 | 4-6 |
|
Glulisine (apidra) |
0.25-0.5 | 0.25-1.25 |
3-4 | 4-6 |
| SHORT ACTING | ||||
| Regular | 0.5-1 | 2-3 | 3-6 | 6-8 |
| INTERMEDIATE ACTING | ||||
| NPH | 2-4 | 6-10 | 10-16 | 14-18 |
| LONG ACTING | ||||
|
glargine (Lantus) |
3-4 | 8-16 | 18-20 | 20-24 |
|
detemir (Levemir) |
3-4 | 6-8 | 14 | ~20 |
Common Anti-hyperglycemic Drugs and Pharmacology
| Drug | Pharmacology | ||
|---|---|---|---|
| Onset | Peak | Duration | |
Rapid-acting insulin
|
15-30min | 1-2h | 3-5h |
Short-acting insulin
|
30-60min | 2-4h | 6-10h |
Intermediate-acting insulin
|
1-3h | 4-12h | 18-24h |
Long-acting insulin
|
2-4h | None | 24h |
Sulfonylurea
|
– | 2-6h | 12-24h |
See also GLP-1 agonists
Insulin Sliding Scale
- Dosing depends on the patient's level of insulin resistance.
- The example sliding scales are for regular insulin with blood glucose (BG) measured in mg/dL
Low Dose (Renal Insufficiency)
- BG 150-199: 1 unit bolus Insulin
- BG 200-249: 2 units bolus Insulin
- BG 250-299: 3 units bolus Insulin
- BG 300-349: 4 units bolus Insulin
- BG Over 350: 5 units bolus Insulin
Medium Dose (Standard)
- BG 150-199: 1 unit bolus Insulin
- BG 200-249: 3 units bolus Insulin
- BG 250-299: 5 units bolus Insulin
- BG 300-349: 7 units bolus Insulin
- BG Over 350: 8 units bolus Insulin
High Dose (Severely Insulin Resistant)
- BG 150-199: 2 unit bolus Insulin
- BG 200-249: 4 units bolus Insulin
- BG 250-299: 7 units bolus Insulin
- BG 300-349: 10 units bolus Insulin
- BG Over 350: 12 units bolus Insulin
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Beta-blocker toxicity | 1 unit/kg IV bolus with D50, then 0.5-1 unit/kg/hr drip | High-dose insulin euglycemic therapy | IV/IV drip | Adult |
| Calcium channel blocker toxicity | 1 unit/kg IV bolus with D50, then 0.5-1 unit/kg/hr drip (max 2 units/kg/hr) | High-dose insulin euglycemic therapy (best evidence) | IV/IV drip | Adult |
| Diabetic ketoacidosis | 0.1 units/kg/hr IV infusion (no bolus); reduce to 0.02-0.05 units/kg/hr when BG <250 | IV insulin for moderate-severe DKA | IV drip | Adult |
| Diabetic ketoacidosis | 0.3 units/kg SC initial, then 0.1-0.2 units/kg SC q1-2h | SC insulin for mild DKA only | SC | Adult |
| Diabetic ketoacidosis (peds) | 0.1 units/kg/hr IV drip | DKA management | IV drip | Pediatric |