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Which Insulin Is Clear?

Types Of Insulin - Topic Overview

Types Of Insulin - Topic Overview

Insulin is used to treat people who have diabetes. Each type of insulin acts over a specific amount of time. The amount of time can be affected by exercise, diet, illness, some medicines, stress, the dose, how you take it, or where you inject it. Insulin strength is usually U-100 (or 100 units of insulin in one milliliter of fluid). Short-acting (regular) insulin is also available in U-500. This is five times more concentrated than U-100 regular insulin. Long-acting insulin (glargine) is also available in U-300. This is three times more concentrated than U-100 long-acting insulin. Be sure to check the concentration of your insulin so you take the right amount. Insulin is made by different companies. Make sure you use the same type of insulin consistently. Types of insulin Type Examples Appearance When it starts to work (onset) The time of greatest effect (peak) How long it lasts (duration) Rapid-acting Apidra (insulin glulisine) Clear 5-15 minutes 30-60 minutes 3-5 hours Humalog (insulin lispro) Clear 5-15 minutes 30-90 minutes 3-5 hours NovoLog (insulin aspart) Clear 5-15 minutes 40-50 minutes 3-5 hours Afrezza (insulin human, inhaled) Contained in a cartridge 10-15 minutes 30-90 minutes 2½-3 hours Short-acting Humulin R, Novolin R (insulin regular) Clear 30 minutes 1½-2 hours 6-8 hours Intermediate-acting Humulin N, Novolin N (insulin NPH) Cloudy 1-4 hours 4-12 hours 14-24 hours Long-acting Lantus (insulin glargine) Clear 1-2 hours Minimal peak Up to 24 hours Levemir (insulin detemir) Clear 2 hours Minimal peak Up to 24 hours Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal. Rapid-acting insulin acts most like insulin that is produced by the human pancreas. It quickly Continue reading >>

Types Of Insulin

Types Of Insulin

Insulin analogs are now replacing human insulin in the US. Insulins are categorized by differences in onset, peak, duration, concentration, and route of delivery. Human Insulin and Insulin Analogs are available for insulin replacement therapy. Insulins also are classified by the timing of their action in your body – specifically, how quickly they start to act, when they have a maximal effect and how long they act.Insulin analogs have been developed because human insulins have limitations when injected under the skin. In high concentrations, such as in a vial or cartridge, human (and also animal insulin) clumps together. This clumping causes slow and unpredictable absorption from the subcutaneous tissue and a dose-dependent duration of action (i.e. the larger dose, the longer the effect or duration). In contrast, insulin analogs have a more predictable duration of action. The rapid acting insulin analogs work more quickly, and the long acting insulin analogs last longer and have a more even, “peakless” effect. Background Insulin has been available since 1925. It was initially extracted from beef and pork pancreases. In the early 1980’s, technology became available to produce human insulin synthetically. Synthetic human insulin has replaced beef and pork insulin in the US. And now, insulin analogs are replacing human insulin. Characteristics of Insulin Insulins are categorized by differences in: Onset (how quickly they act) Peak (how long it takes to achieve maximum impact) Duration (how long they last before they wear off) Concentration (Insulins sold in the U.S. have a concentration of 100 units per ml or U100. In other countries, additional concentrations are available. Note: If you purchase insulin abroad, be sure it is U100.) Route of delivery (whether they a Continue reading >>

Intermittent Insulin Injections Insulin Overview

Intermittent Insulin Injections Insulin Overview

Insulin is the cornerstone of therapy in the management of type 1 diabetes. Insulin therapy also has a clear role in type 2 diabetes mellitus in patients with long-standing or poorly controlled disease. Since the discovery of insulin approximately 80 years ago, insulin therapy has undergone various changes in formulations with different pharmacokinetics. In the 1930s, protamine zinc insulin, the first long-acting preparation, was introduced. In the 1950s, the neutral protamine hagedorn (NPH) and insulin zinc (lente) were introduced. [1] Newer formulations have since been developed, allowing insulin to be provided in more physiologically appropriate ways. These provide more flexibility in dosing, mimic endogenous production of insulin, and lower the incidence of nocturnal hypoglycemia. [2, 3, 4] When used as monotherapy, oral hypoglycemic drugs generally lower glycated hemoglobin (HgbA1C) by only 0.5%-1.5%. Most patients with type 2 diabetes eventually require multidrug therapy or insulin. Some guidelines encourage early use of insulin if HgbA1C remains poorly controlled on maximal-dose, single-drug therapy. Insulins have varying pharmacokinetics that allow for specific products from which to choose. Table 1 provides a comparison between insulins for onset of action and duration of action. Table 2 provides a list of combination insulin products. Insulin Category Onset of Action Duration of Action Insulin aspart (NovoLog) Rapid-acting 5-15 minutes 3-5 hours Insulin aspart (Fiasp) Rapid-acting 16-20 minutes 5-7 hours Insulin lispro (Humalog) Rapid-acting 5-15 minutes 4-5 hours Insulin glulisine (Apidra) Rapid-acting 5-15 minutes 3-4 hours insulin regular (Humulin R, Novolin R) Short-acting 30-60 minutes 8-10 hours Insulin NPH (Humulin N, Novolin N) Intermediate-acting 2-4 Continue reading >>

Insulin Injection: Two Bottle Injection Instructions

Insulin Injection: Two Bottle Injection Instructions

Wash your hands. Pick up the CLOUDY bottle and turn it upside down. Roll the bottle gently between your hands to mix the insulin. Wipe the top of both (clear and cloudy) bottles with alcohol. Remove the caps from the top and bottom of the syringe. Pull the plunger down to the correct unit mark for your CLOUDY insulin dose as ordered. Insert the needle into the CLOUDY bottle. Push the plunger down to inject air into the CLOUDY bottle. Withdraw the empty syringe from the bottle. Set the bottle aside. Pull the plunger down to the correct unit mark for the CLEAR insulin dose as ordered. Insert the needle into the CLEAR bottle. Push the plunger down to inject air into the CLEAR bottle. Leave the needle in the bottle. Turn the bottle upside down with the needle in it. Pull the plunger down to the correct unit mark for the CLEAR insulin dose. Look for air bubbles in the syringe. If you see air bubbles in the syringe, push the insulin back into the bottle, and repeat steps 17 and 18. Pull the bottle away from the needle, and set aside the CLEAR bottle. Pick up the CLOUDY bottle of insulin. Turn the CLOUDY bottle upside down and push the needle into the bottle. Be very careful not to move the plunger. Pull the plunger down and withdraw the correct number of units for the CLOUDY insulin. The plunger should now be on the unit mark showing the total units of both the CLEAR and CLOUDY types of insulin. For example, 6 units of CLEAR insulin are already in the syringe. Add 14 units of CLOUDY insulin for a total of 20 units in the syringe. Pull the bottle away from the needle. Set both bottles on the table. Look for air bubbles in the syringe. If you see air bubbles, discard the dose and begin again. Set the syringe down. Do not let the needle touch anything. Pinch or spread the skin a Continue reading >>

Insulin Type

Insulin Type

Insulin Type: Rapid-acting analogue (clear) Humalog (insulin Lispro) NovoRapid (insulin Aspart) Apidra (insulin glulisine) Onset Peak Humalog 1-2 h NovoRapid 1- 1.5 h Apidra 1-1.5 h Duration Humalog 3.5 - 4.75 h Novorapid 3 -5 h Apidra 3 - 5 h Considerations Client should eat within 10–15 minutes of injection. Insulin Compatibility Rapid-acting insulin can be mixed with N, NPH. Mixture should be given within 15 minutes of a meal. Insulin Type: Short-acting analogue (clear) Humulin R Novolin ge Toronto Onset 30 minutes Peak 2 - 3 hours Duration 6.5h Considerations Should be given 30 - 45 minutes prior to meals. Insulin Type: Intermediate-acting (cloudy) Novolin ge NPH Humulin N Onset 1 – 3 hours Peak 5 - 8 hours Duration Up to 18 hours Considerations Must be adequately re-suspended before injecting. Insulin Compatibility N or NPH & short-acting insulin may be mixed & used immediately or stored, refrigerated, for future use. Pre-filled syringes should be stored in the fridge, with needle tips up. They are stable for 1 month. NPH or N cannot be mixed with Lentus or Levemir insulin. Insulin Type: Long - acting analogues (clear) Lantus (insulin glargine) Levemir (insulin detemir) Onset 90 min Peak not applicable Duration Up to 24 h (glargine 24 h, determir 16-24 h) Considerations Lantus is available in vials, catridges & pre-filled disposable pens (SoloStar). Levemir is only available in catridges. Both Lantus and Levemir are clear. Clients must be alerted to the potential danger of confusing Lantus or Levamir with other clear insulin (rapid or short-acting insulins). Use of pre-filled syringes are not recommended Insulin Compatibility Glargine and Levemir cannot be mixed with any other insulin or solution Insulin Type: Premixed (cloudy) A single vial contains a fixed ra Continue reading >>

Insulin: Compare Common Options For Insulin Therapy

Insulin: Compare Common Options For Insulin Therapy

Insulin therapy is a critical part of treatment for people with type 1 diabetes and also for many with type 2 diabetes. The goal of insulin therapy is to maintain blood sugar levels within your target range. Insulin is usually administered in the fat under your skin using a syringe, insulin pen or insulin pump. Which insulin regimen is best for you depends on factors such as the type of diabetes you have, how much your blood sugar fluctuates throughout the day and your lifestyle. Each insulin type is characterized by: How long it takes to begin working (onset) When it's working the hardest (peak) How long it lasts, ranging from about 3 to 26 hours Many types of insulin are available. Here's how they compare. Keep in mind that your doctor may prescribe a mixture of insulin types to use throughout the day and night. Insulin type and name Onset Peak How long it lasts Rapid-acting Insulin aspart (NovoLog) Insulin glulisine (Apidra) Insulin lispro (Humalog) 5-15 min. 45-75 min. 3-4 hours Short-acting Insulin regular (Humulin R, Novolin R) 30-45 min. 2-4 hours 6-8 hours Intermediate-acting Insulin NPH (Humulin N, Novolin N) 2 hours 4-12 hours 16-24 hours Long-acting Insulin glargine (Lantus/ Toujeo) Insulin detemir (Levemir) 2 hours No clear peak 14-24 hours In some cases, premixed insulin — a combination of specific proportions of intermediate-acting and short- or rapid-acting insulin in one bottle or insulin pen — may be an option. Continue reading >>

Insulin: How To Give A Mixed Dose

Insulin: How To Give A Mixed Dose

Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful because the needles are short and thin and the insulin shots are placed into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection. In some cases, the doctor prescribes a mixed dose of insulin. This means taking more than one type of insulin at the same time. A mixed dose allows you to have the benefits of both short-acting insulin along with a longer acting insulin — without having to give 2 separate shots. Usually, one of the insulins will be cloudy and the other clear. Some insulins cannot be mixed in the same syringe. For instance, never mix Lantus or Levemir with any other solution. Be sure to check with your doctor, pharmacist, or diabetes educator before mixing. These instructions explain how to mix two different types of insulin into one shot. If you are giving or getting just one type of insulin, refer to the patient education sheet Insulin: How to Give a Shot. What You Will Need Bottles of insulin Alcohol swab, or cotton ball moistened with alcohol Syringe with needle (You will need a prescription to buy syringes from a pharmacy. Check with your pharmacist to be sure the syringe size you are using is correct for your total dose of insulin.) Hard plastic or metal container with a screw-on or tightly-secured lid Parts of a Syringe and Needle You will use a syringe and needle to give the shot. The parts are labeled below. Wash the work area (where you will set the insulin and syringe) well with soap and water. Wash your hands. Check the drug labels to be sure they are what your doctor prescribed. Check the expiration date o Continue reading >>

Types Of Insulin

Types Of Insulin

Topic Overview Insulin is used to treat people who have diabetes. Each type of insulin acts over a specific amount of time. The amount of time can be affected by exercise, diet, illness, some medicines, stress, the dose, and where the insulin has been injected. Insulin strength is usually U-100, or 100 units of insulin in one milliliter of fluid. Short-acting (regular) insulin is also available in U-500, or 500 units of insulin in one milliliter of fluid. This is five times more concentrated than U-100 regular insulin. Insulin is made by different companies. Make sure you use the same type of insulin consistently. Types of insulin Type Examples Appearance When it starts to work (onset) The time of greatest effect (peak) How long it lasts (duration) Rapid-acting Apidra (insulin glulisine) Clear 5–15 minutes 30–60 minutes 3–5 hours Humalog (insulin lispro) Clear 5–15 minutes 30–90 minutes 3–5 hours NovoLog (insulin aspart) Clear 5–15 minutes 40–50 minutes 3–5 hours Short-acting Humulin R, Novolin R (insulin regular) Clear 30 minutes 1½–2 hours 6–8 hours Intermediate-acting Humulin N, Novolin N (insulin NPH) Cloudy 1–4 hours 4–12 hours 14–24 hours Long-acting Lantus (insulin glargine) Clear 1–2 hours Minimal peak Up to 24 hours Levemir (insulin detemir) Clear 2 hours Minimal peak Up to 24 hours Rapid-acting insulins work over a narrow, more predictable range of time. The insulin Humalog is a quick-acting insulin with a short length (duration) of action. Rapid- and short-acting types of insulin take effect and wear off more quickly than long-acting insulins. The liquid insulins are clear and do not settle out when the bottle (vial) sits for a while. Rapid-acting insulin acts most like insulin produced by the human pancreas. It quickly drops th Continue reading >>

How To Mix Insulin Clear To Cloudy

How To Mix Insulin Clear To Cloudy

Learn how to mix insulin clear to cloudy. Drawing up and mixing insulin is a skill that nurses will utilize on the job. Insulin is administered to patients who have diabetes. These type of patients depend on insulin so their body can use glucose. Therefore, nurses must be familiar with how to mix insulin. The goal of this article is to teach you how to mix insulin. Below are a video demonstration and step-by-step instructions on how to do this. How to Mix Insulin Purpose of mixing insulin: To prevent having to give the patient two separate injections (hence better for the patient). Most commonly ordered insulin that are mixed: NPH (intermediate-acting) and Regular insulin (short-acting). Important Points to Keep in Mind: Never mix Insulin Glargine “Lantus” with any other type of insulin. Administer the dose within 5 to 10 minutes after drawing up because the regular insulin binds to the NPH and this decreases its action. Check the patient’s blood sugar and for signs and symptoms of hypoglycemia to ensure they aren’t hypoglycemic …if patient is hypoglycemic hold the dose and notify md for further orders. Key Concept for Mixing Insulin: Draw up CLEAR TO CLOUDY Remember the mnemonic: RN (Regular to Nph) Why? It prevents contaminating the vial of clear insulin with the cloudy insulin because if contaminated it can affect the action of the insulin. Why does this matter because they will be mixed in the syringe? You have 5 to 10 minutes to give the insulin mixed in the syringe before the action of the insulins are affected Demonstration on Drawing Up Clear to Cloudy Insulin Steps on How to Mix Insulin 1. Check the doctor’s order and that you have the correct medication: Doctor’s order says: “10 units of Humulin R and 12 units of Humulin N subcutaneous before b Continue reading >>

Insulin In The Uk

Insulin In The Uk

Tweet Insulin may be a key part of your treatment if you suffer from diabetes. Insulin enables your body to use glucose. Different types of insulin can act very differently in different people. Insulin regime suitable for individual patients are tailored by your diabetes care team. Type or dosage of insulin can be changed if required to meet the individual needs of the patient. Insulin can be packaged in vials (bottles), cartridges or prefilled pens. The vials are used with syringes, whereas the cartridges are used with pen injectors. Prefilled pens are disposable pen injectors, which contain insulin. Prefilled pens are useful for people with dexterity or visual problems. List of insulins The table highlights the various insulin types, their manufacturers, the insulin source and how it's available. It also highlights insulin ranges that have been discontinued. Insulin type Name Manufacturer Type Source Rapid-acting analogue Apidra Sanofi analogue vial & cartridge Apidra Sanofi analogue prefilled pen Humalog Lilly analogue vial & cartridge Humalog Lilly analogue prefilled pen Novorapid Novo Nordisk analogue vial Novorapid Penfill Novo Nordisk analogue cartridge Novorapid Novolet Novo Nordisk analogue prefilled pen Long-acting analogue Lantus Sanofi analogue vial, cartridge & prefilled pen Levemir Novo Nordisk analogue cartridge & prefilled pen Tresiba Novo Nordisk analogue cartridge & prefilled pen Short-acting Human Actrapid Novo Nordisk human vial Actrapid Pen* Novo Nordisk human prefilled pen Actrapid Penfill* Novo Nordisk human cartridge Human Velosulin* Novo Nordisk human vial Pork Actrapid* Novo Nordisk pork vial Humaject S* Lilly human prefilled pen Humulin S Lilly human vial & cartridge Hypurin Bovine Neutral CP Pharmaceuticals beef vial & cartridge Hypurin Porci Continue reading >>

Insulins - Brand Names

Insulins - Brand Names

Sort Which types of insulin are clear? Which types are cloudy? Three CLEAR (1) rapid-acting (2) short-acting (3) long-acting Three CLOUDY (1) intermediate-acting (2) human mixture (3) analog mixture Which insulin mixtures include insulin analogs? Are they cloudy or clear? (1) insulin lispro protamine 75% / insulin lispro (Humalog Mix 75/25) (2) insulin lispro protamine 50% / insulin lispro 50% (Humalog 50/50) (3) insulin aspart protamine 70% / insulin aspart 30% (NovoLog Mix 70/30) CLOUDY Continue reading >>

Insulin Types

Insulin Types

What Are the Different Insulin Types? Insulin Types are hormones normally made in the pancreas that stimulates the flow of sugar – glucose – from the blood into the cells of the body. Glucose provides the cells with the energy they need to function. There are two main groups of insulins used in the treatment of diabetes: human insulins and analog insulins, made by recombinant DNA technology. The concentration of most insulins available in the United States is 100 units per milliliter. A milliliter is equal to a cubic centimeter. All insulin syringes are graduated to match this insulin concentration. There are four categories of insulins depending on how quickly they start to work in the body after injection: Very rapid acting insulin, Regular, or Rapid acting insulins, Intermediate acting insulins, Long acting insulin. In addition, some insulins are marketed mixed together in different proportions to provide both rapid and long acting effects. Certain insulins can also be mixed together in the same syringe immediately prior to injection. Rapid Acting Insulins A very rapid acting form of insulin called Lispro insulin is marketed under the trade name of Humalog. A second form of very rapid acting insulin is called Aspart and is marketed under the trade name Novolog. Humalog and Novolog are clear liquids that begin to work 10 minutes after injection and peak at 1 hour after injection, lasting for 3-4 hours in the body. However, most patients also need a longer-acting insulin to maintain good control of their blood sugar. Humalog and Novolog can be mixed with NPH insulin and are used as “bolus” insulins to be given 15 minutes before a meal. Note: Check blood sugar level before giving Humalog or Novalog. Your doctor or diabetes educator will instruct you in determini Continue reading >>

Short-acting Insulins

Short-acting Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Onset: 30 minutes Peak: 2.5 - 5 hours Duration: 4 - 12 hours Solution: Clear Comments: Best if administered 30 minutes before a meal. Mixing NPH: If Regular insulin is mixed with NPH human insulin, the Regular insulin should be drawn into the syringe first. Aspart - Novolog ®: Compatible - but NO support clinically for such a mixture. Draw up Novolog first before drawing up Regular Insulin. Lispro - Humalog ®: Compatible - but NO support clinically for such a mixture. Draw up Humalog first before drawing up Regular Insulin. Mixtures should not be administered intravenously. When mixing insulin in a syringe, draw up the quickest acting insulin first (e.g. draw up Humalog or Novolog before drawing up Regular Insulin, or draw up Regular insulin before Novolin N (NPH) or Lente insulin. CLINICAL PHARMACOLOGY Insulin is a polypeptide hormone that controls the storage and metabolism of carbohydrates, proteins, and fats. This activity occurs primarily in the liver, in muscle, and in adipose tissues after binding of the insulin molecules to receptor sites on cellular plasma membranes. Insulin promotes uptake of carbohydrates, proteins, and fats in most tissues. Also, insulin influences carbohydrate, protein, and fat metabolism by stimulating protein and free fatty acid synthesis, and by inhibiting release of free fatty acid from adipose cells. Insulin increases active glucose transport through muscle and adipose cellular membranes, and promotes conversion of intracellular glucose and free fatty acid to the appropriate storage forms (glycogen and triglyceride, respectively). Although the liver does not require active glucose transport, insulin increases hepatic gl Continue reading >>

Insulin Administration

Insulin Administration

Insulin is necessary for normal carbohydrate, protein, and fat metabolism. People with type 1 diabetes mellitus do not produce enough of this hormone to sustain life and therefore depend on exogenous insulin for survival. In contrast, individuals with type 2 diabetes are not dependent on exogenous insulin for survival. However, over time, many of these individuals will show decreased insulin production, therefore requiring supplemental insulin for adequate blood glucose control, especially during times of stress or illness. An insulin regimen is often required in the treatment of gestational diabetes and diabetes associated with certain conditions or syndromes (e.g., pancreatic diseases, drug- or chemical-induced diabetes, endocrinopathies, insulin-receptor disorders, certain genetic syndromes). In all instances of insulin use, the insulin dosage must be individualized and balanced with medical nutrition therapy and exercise. This position statement addresses issues regarding the use of conventional insulin administration (i.e., via syringe or pen with needle and cartridge) in the self-care of the individual with diabetes. It does not address the use of insulin pumps. (See the American Diabetes Association’s position statement “Continuous Subcutaneous Insulin Infusion” for further discussion on this subject.) INSULIN Insulin is obtained from pork pancreas or is made chemically identical to human insulin by recombinant DNA technology or chemical modification of pork insulin. Insulin analogs have been developed by modifying the amino acid sequence of the insulin molecule. Insulin is available in rapid-, short-, intermediate-, and long-acting types that may be injected separately or mixed in the same syringe. Rapid-acting insulin analogs (insulin lispro and insulin a Continue reading >>

Diabetes Clear Liquid Diets And Insulin

Diabetes Clear Liquid Diets And Insulin

Your doctor has suggested you have a procedure that requires you to be on a clear liquid diet before the procedure. If you have diabetes and take Insulin this Test Facts will help you follow the clear liquid diet and control your blood sugar (glucose) levels. If, after reading this information you are still unsure as to how to dose your insulin, check with the doctor who prescribes your insulin for advice. Types of Clear Liquids Clear liquids that contain sugars include: Gatorade, G1,2,3, sodas, fruit juices, popsicles, regular Jell-O. Clear liquids that do not contain sugar include: Unsweetened tea, black coffee, water, diet sodas, sugar-free Jell-O, clear broth, bullion, Vitamin water (Vitamin water has a small amount of sugar) GoLYTELY and HalfLYTELY do not contain sugars. Drink at least 8 ounces, but not more than 16 ounces, of a sugar-containing liquid at usual mealtimes while on the clear liquid diet. Long-Acting Insulin (Lantus®, Levemir®, NPH or Novolin®) If you take Levemir or Lantus, take your usual full dose of this long-acting insulin on the days you are on the clear liquid diet and on the day of the test. If you are on an insulin pump, keep your basal rate unchanged. If you take NPH insulin (Humulin N, Novolin N), lower your usual dose by half on the days you are on the clear liquid diet and on the day of your test. If your blood sugar goes over 200 on half doses, go back to your full dose. Mealtime (Short-Acting) Insulin )Humalog®, NovoLog®, Apidra®, Humulin® R, Novolin® R) If you count carbohydrates as a way to dose mealtime insulin, dose your insulin based on the carb content of the clear liquid diet. Example: Say, for breakfast, you usually take 1 unit of short-acting insulin for every 10 gram carb serving (insulin: carb ratio is 1:10). You deci Continue reading >>

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