Insulin: Nursing Pharmacology

Insulin is a medication used to treat clients with diabetes mellitus. Now, there are two main types of diabetes mellitus. Type 1 diabetes mellitus arises when the pancreas is unable to produce insulin in order to maintain normal blood glucose levels.

On the other hand, type 2 diabetes mellitus is characterized by insulin resistance, which is when tissue cells have trouble responding to insulin in order to use glucose from the blood; as a result, tissue cells starve for energy despite having high blood glucose levels, which is called hyperglycemia.

Insulin is also used in the management of gestational diabetes, diabetic complications, like diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic coma, as well as in hyperkalemia.

Now, there are five main categories of insulin based on their onset of action and duration of effect. These include rapid-acting, short-acting or regular, intermediate-acting, long-acting, and ultra long-acting insulins.

All categories of insulin can be given subcutaneous injection or through an insulin pump, while the short-acting insulin can also be given intravenously.

Now the short-acting, or regular, insulin starts working 30 minutes after administration, with a peak effect at 2 to 3 hours, and can last between 6 to 8 hours.

Next, there’s rapid acting insulins which include insulin aspart, lispro, and glulisine. These medications begin working within 5 to 15 minutes of administration, with a peak effect at 30 minutes, and may last for 3 to 5 hours. Another rapid acting insulin is inhaled insulin, which can only be used as an adjunct to therapy with injected insulins, and never by itself.