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Outline
Insulin is classified into three categories:
- How quickly they start to act
- When they have maximal effect
- How long they start to act
These three characteristics are called
- Onset
- Onset refers to the length of time before the insulin gets into the bloodstream and starts the process of lowering blood sugar.
- Peak
- This refers to a time period in which the insulin in the blood is at its optimum when lowering blood sugar.
- Duration
- Duration refers to the length of the time from the onset where the insulin you inject into a patient lowers their blood sugar.
Mnemonic For Onset Times
- READY
- SET
- INJECT
- LOVE
1. Ready- Rapid Acting Insulin
Regular or rapid-acting insulin will start lowering your patient’s blood sugar fifteen minutes after the injection.
Rapid-acting insulin usually peaks in an hour but has a duration that lasts a few hours after the injection.
2. Set- Short-Acting Insulin
This type of insulin will reach your patient’s bloodstream 30 minutes after injection.
It will reach its peak within 2-3 hours and stays effective for a duration of about 3-6 hours.
3. Inject- Intermediate Acting Insulin
Intermediate insulin has an onset of about 1-2 hours, a peak of about 4-6 hours, and a duration of about 12 hours.
4. Love- Long-Acting Insulin
Long-acting insulin has an onset of 1-2 hours.
It has a duration of about 24 hours and a gradual peak throughout the 24 hours due to its slow absorption.
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View a suggested lesson09.04 Insulin
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09.04 Insulin
Mnemonic Duration, Onset, and Peak
1. READY- RAPID-ACTING MNEMONIC
“15 year old wanted to grow up fast, 60-90-year-old grandparents misses his childhood days when he was 3-4 years old.”
- Onset- 15 minutes
- Peak- 60-90 minutes
- Duration-3-4 hours
2. SET- SHORT-ACTING INSULIN MNEMONIC
One of the most heartwarming stories of the last decade occurred in the twenty-fourth state to be admitted in the Union (Missouri), where 36 already short-staffed nurses became pregnant at the same time in one hospital.
Besides being heartwarming, this story from Missouri serves to help you remember 24 (Missouri) and thirty-six, which play a significant role in the short-acting insulin mnemonic.
“Within half a year, one short-staffed hospital in the twenty-fourth state lost and gained thirty-six nurses, Congratulations.”
- Onset- 30 minutes to 1 hour
- Peak- 2-4 hours
- Duration- 3-6 hours
3. INJECT- INTERMEDIATE-ACTING INSULIN
“Given 2 options, would you rather do four- four-hour shifts for ten dollars or better yet get that 10 dollars in one sixteen-hour shift.”
- Onset- 2-4 hours
- Peak – 4 hours
- Duration- 10-16 hours
4. MNEMONIC FOR LOVE-LONG ACTING INSULIN
“2 climbers are better than 1 for a mountain that doesn’t seem to have a peak. It might take an entire day (24 hours) “
- Onset -2-4 hours
- Peak- non-existent
- Duration – 24 hours or an entire day
Mnemonic For The Different Types of Insulin
Types of Rapid Acting Insulin
The letters “I” and “N” the word INsulin represent rapid-acting insulin in this mnemonic. The intersection of the letter “I” in both rapId and InsulIn brings these two terms together.
Remember:
- The “N” in iNsulin is for Novolog
- The “L” in insuLin is for HumAlog
- All rapid-acting insulin analogs end with the postfix “log.”
Humalog and Novolog
Humalog and Novolog are brand names for insulin lispro and insulin aspart, respectively. They are both rapid-acting types of insulin. Remember the mnemonic
“15 year old wanted to grow up fast, 60-90-year-old grandparents misses his childhood days when he was 3-4 years old.”
Both Novolog and Humalog have an:
- Onset of 15 minutes
- Peak of 60-90 minutes
- Duration of 3-4 hours
Short-Acting Insulin Mnemonic
The letter “S” in insulin (written vertically) is used as the first word for Short, which represents short-acting insulin.
The “R” in short is also written vertically as “REG,” which represents regular insulin, a type of short-acting insulin.
Regular Insulin
Regular insulin is also known as Novolin. It is a type of short-acting insulin with a high absorption rate that gets to work on the blood faster.
However, to avoid confusion with other types of insulin, use regular instead of Novolin. Remember the mnemonic:
“Within half a year, one short-staffed hospital in the twenty-fourth state lost and gained thirty-six nurses, Congratulations.”
This means that regular insulin has a:
- Onset of about half an hour to one hour
- A peak of 2-4 hours
- Duration of 3-6 hours
Types Of Intermediate Acting Insulin
Intermediate-acting insulin is an insulin analog that is between long-acting and short-acting insulin. That’s why in this mnemonic, it takes the letter “U” in insUlIn which is a midpoint in the term.
The letter “U” is shared by both insUlin (written vertically) and HUmulin (written horizontally) to give the first intermediate-acting analog in this formula.
The “N” in both HumuliN written vertically and NPH written horizontally gives us the two types of intermediate-acting insulin.
Humulin and NPH
NPH, which is neutral protamine Hagedorn, is a type of intermediate insulin designed to have a low absorption rate that delays both its duration and onset.
NPH works by the addition of a protein called protamine, which a scientist by the name of Hans Hagedorn discovered reduces the absorption of insulin from the subcutaneous layer into the bloodstream.
Remember the mnemonic:
“Given 2 options, would you rather do four- four-hour shifts for ten dollars or better yet get that 10 dollars in one sixteen-hour shift.”
This shows that Humulin and NPH have an:
- Onset of 2 hours
- A peak of 4-10 hours
- A duration of 10-16 hours
Types of Long-Acting Insulin
The rest of the letters in the term insulin written vertically from the word L downwards represent long-acting insulin.
Remember:
- The “L” in insuLin written vertically is for long
- The “I” in insulIn written vertically is for LevemIr
- The “N” in insuliN written vertically is for LaNtus
- Both Levemir and Lantus, which are long-acting insulin, start with the letter “L.”
Levemir and Lantus
Levemir is a solution of insulin detemir, and Lantus is a solution of insulin glargine. Both are absorbed from the subcutaneous fat layer into the bloodstream over 24 hour period.
Levemir and Lantus don’t have a defined peak. This makes them suitable for blood sugar regulation over long periods.
Remember the mnemonic:
“2 climbers are better than 1 for a mountain that doesn’t seem to have a peak. It might take an entire day (24 hours) ”
This shows that Levemir and Lantus have :
- An onset of about 1-2 hours
- No defined peak
- A duration of 24 hours
Summary For Insulin Mnemonic
This is a summary of two of the three mnemonics we’ve covered in this blog. Repeating them over and over is the key to mastery.
- Ready Set Inject Love
- “15 year old wanted to grow up fast, 60-90-year-old grandparents misses his childhood days when he was 3-4 years old.”
- “Within half a year, one short-staffed hospital in the twenty-fourth state lost and gained thirty-six nurses, Congratulations.”
- “Given 2 options, would you rather do four- four-hour shifts for ten dollars or better yet get that 10 dollars in one sixteen-hour shift.”
- “2 climbers are better than 1 for a mountain that doesn’t seem to have a peak. It might take an entire day (24 hours) “
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