Drugs Affecting Blood Glucose Levels
Hyperglycemic States
-Type I Diabetes (insulin-dependent diabetes mellitus)
-Type II Diabetes (non-insulin-dependent diabetes mellitus)
-Gestational Diabetes
Insulins
-Manage hyperglycemia by promoting cellular glucose uptake and metabolism
-Vary by peak, onset, and duration of action
-Recombinant DNA (human) is now the standard source:
-Animal sources are still available.
-Mandatory for type 1 diabetes and may be needed in type 2 diabetes
-Administered SC
-Absorption is greater in the deltoid & abdominal areas than thigh & buttocks
-Injection sites should be rotated to prevent lipodystrophy
-American Diabetic Association suggests insulin to be injected at chosen site for 1 wk. Injections shld be 1.5 inches apart. Separate site for am & pm dose. Record site & date of injection.
-Insulin should NOT be withheld during stress or illness to prevent hyperglycemia
Lispro (Humalog)
-Onset: 15 – 30 min
-Peak: 0.5- 2.5 hours
-Duration: 3- 6.5 hours
Used in continuous subcutaneous insulin infusion pumps
Patient titrates dose delivered depending on their glucose level
Regular (Short-Acting) Insulin
-Onset: 30-60 minutes
-Peak: 1-5 hours
-Duration: 6-10 hours
Used for intravenous insulin infusions
Check your institution policy – insulin adheres to PVC tubing
Used for sliding scale coverage
NPH (Intermediate-Acting) Insulin
-Onset: 1 - 2 hours
-Peak: 6 - 14 hours
-Duration: 16 – 24+ hours
Available as combination with regular insulin 70/30 (70% NPH and 30% regular)
-Onset: 30-60 min
-Peak: 1.5 – 16 hours
-Duration: up to 24 hours
Lente (Intermediate-Acting) Insulin
Ultralente (Long-Acting) Insulin
-Lente insulin: time course similar to NPH
Ultralente
-Onset: 4-6 hours
-Peak: 8-20 hours
-Duration: 24-28 hours
Lantus (Long-Acting) Insulin
-Onset: 70 minutes
-Peak: none
-Duration: 24 hours
Do NOT confuse with Lente Insulin
Lantus insulin should not be...