Insulin
Subcutaneous |
Onset (hr) |
Peak (max.effect) (hr) |
Duration (hr) |
Regular |
1 |
2-3 |
4-5 |
NPH |
2 |
8 |
24 |
- Regular Insulin Half-Lives
-
- Intravenous regular insulin: 5 minute half-life
- Intramuscular regular insulin: 2 hour half-life
- Subcutaneous regular insulin: 4 hour half-life
- If the desired level of blood sugar is not reached by diet, insulin should be added
- Almost always use NPH and regular insulin in AM and PM
- Usually need twice as much in AM than PM
- Alternative regimen the evening dose is to administer regular insulin before dinner and NPH at bed time to avoid nocturnal hypoglycemia.
Some give regular insulin before meals and NPA at bedtime.
- Some patients may require additional regular insulin before lunch to reach the goal of euglycemia state
- 2 weekly mild attacks of hypoglycemia are acceptable
Danish Recommendation:
- 4.0-6.0 mmol fasting
- (3-6 before meals)
- 3-8 after meals
- 3,5-6 middle of the night
- 6-8 before bedtime
6-8 before bedtime
3.5-6 middle of the night
Outcome such as birthweight, correlates better with postprandial than preprandial glucose levels and correlates better to the level of HbA1C.
Sliding Scale Checking BSS every 2 hours, and give regular s.c. insulin, as below:
Blood sugar mmol/l |
Action |
6,6-8,0 |
02 IU Insulin Regular |
8,1-10 |
04 IU Insulin Regular |
10,1-12 |
06 IU Insulin Regular |
12,1-14 |
08 IU Insulin Regular |
14,1-15 |
10 IU Insulin Regular |
>15 |
Call Physician especially if also ++ or +++ ketonuria |
Steroids and Insulin: Insulin requirement is increased. The above algoritm can be used.
Feel free to mail me the webmaster Dr Lars Krag Moeller if you have corrections that could improve the manual.
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