Insulin pharmacokinetics — onset / peak / duration
Knowing the kinetic profile is essential for predicting hypoglycemia and timing meals.
• Rapid-acting (lispro, aspart, glulisine): onset 5-15 min, peak 30-90 min, duration 3-5 h. Inject just before/with meal.
• Short-acting (regular): onset 30 min, peak 2-3 h, duration 5-8 h. Inject 30 min before meal.
• Intermediate-acting (NPH): onset 1-2 h, peak 4-12 h, duration 14-24 h. Cloudy — must be rolled (not shaken). The peak is the highest hypoglycemia-risk window — meals/snacks must cover it.
• Long-acting (glargine, detemir, degludec): glargine onset 2-4 h, no real peak, duration ~24 h; detemir 1-2 h, slight peak 6-8 h, 12-24 h; degludec 1 h onset, no peak, ≥42 h.
• Ultra-long basal like degludec: very flat, low hypo risk overnight.
For a 0700 NPH dose, peak occurs 1100-1900 — that is when the nurse should monitor BG, ensure midmorning, lunch, afternoon snacks, watch for hypoglycemia. Options 1, 3, 4 misstate the kinetic profile.
In-depth explanation
Clinical reasoning summary
Insulin pharmacokinetics — onset / peak / duration
Knowing the kinetic profile is essential for predicting hypoglycemia and timing meals.
• Rapid-acting (lispro, aspart, glulisine): onset 5-15 min, peak 30-90 min, duration 3-5 h. Inject just before/with meal.
• Short-acting (regular): onset 30 min, peak 2-3 h, duration 5-8 h. Inject 30 min before meal.
• Intermediate-acting (NPH): onset 1-2 h, peak 4-12 h, duration 14-24 h. Cloudy — must be rolled (not shaken). The peak is the highest hypoglycemia-risk window — meals/snacks must cover it.
• Long-acting (glargine, detemir, degludec): glargine onset 2-4 h, no real peak, duration ~24 h; detemir 1-2 h, slight peak 6-8 h, 12-24 h; degludec 1 h onset, no peak, ≥42 h.
• Ultra-long basal like degludec: very flat, low hypo risk overnight.
For a 0700 NPH dose, peak occurs 1100-1900 — that is when the nurse should monitor BG, ensure midmorning, lunch, afternoon snacks, watch for hypoglycemia. Options 1, 3, 4 misstate the kinetic profile.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.