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✨ Featured Lessons · Lesson 7 of 8 · 60 sec

Insulin Peaks in One Picture

💉 Rapid peaks in an hour, regular in a few, NPH around lunch for a breakfast dose, and glargine never peaks at all. The exam asks when the client will crash. Here is the picture.

💡 Key idea

Rapid 1 to 3 hours, regular 2 to 4, NPH 4 to 12, glargine none. Clear before cloudy. Rule of 15.

🧠 Why it matters

RAPID (lispro, aspart): onset 15 minutes, peak about 1 to 3 hours, lasts 3 to 5 hours; give with a meal in reach. REGULAR: onset 30 to 60 minutes, peak 2 to 4 hours, lasts 5 to 8 hours; the standard insulin for IV infusions. NPH: onset 1 to 2 hours, peak 4 to 12 hours, lasts 12 to 18 hours; cloudy, draw clear before cloudy. GLARGINE and DEGLUDEC: no real peak, 24 hours or longer; never mixed. Hypoglycemia under 70: 15 grams of fast carbohydrate, recheck in 15 minutes.

🏥 In the real world

🥪 A nurse gives NPH at 0800. The client sleeps through lunch. At 1400 he is sweaty and confused. The nurse who knew the peak window was already at the bedside with juice. The nurse who did not finds out from the rapid response team.

📌 Takeaways

  • Regular is the standard IV insulin; rapid-acting needs food in reach
  • Clear (regular) before cloudy (NPH); glargine is never mixed
  • Hypoglycemia: 15 grams of carbohydrate, recheck in 15 minutes

✅ Test yourself

A client received NPH insulin at 0730. When is hypoglycemia most likely?
  1. Between about 1130 and 1930
  2. 0900
  3. After midnight
  4. 0800

Answer: A · Between about 1130 and 1930

NPH peaks 4 to 12 hours after the dose; a missed lunch during that window is the classic trap.

Which insulin can be administered intravenously?
  1. Glargine
  2. Degludec
  3. NPH
  4. Regular

Answer: D · Regular

Regular insulin is the standard insulin for IV infusions, such as in DKA. NPH, glargine and degludec are never given IV.

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