Intermediate Acting Insulin

Summary

Intermediate acting insulin formulations include NPH insulin. This type of insulin works slower than rapid or short-acting insulins but faster than long-acting insulins, with a peak time averaging around 5 hours after administration. Remember that NPH has a cloudy appearance and that when mixed with regular insulin, it should be drawn up in the syringe last, after regular insulin has already been drawn.

Key Points

• Intermediate Acting Insulin
  • Drug Names
    • NPH (Humulin N, Novolin N)
  • Onset, Peak, Duration
    • Onset = 1.5-4 hours
    • Peak = ~5 hours
      • Exact peak depends on patient and ranges from 4-12 hours
    • Duration = 12-18 hours
  • Nursing Considerations
    • “Cloudy” in appearance
    • When mixing with Regular insulin, draw NPH insulin LAST
      • Clear before cloudy, or “RN” - regular before NPH