USMLE

Long Acting Insulin

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Anti-Diabetic Drugs
  1. Insulin Overview
  2. Rapid Acting Insulin
  3. Short Acting Insulin
  4. Intermediate Acting Insulin
  5. Long Acting Insulin
  6. Metformin
  7. Sulfonylureas
  8. Canagliflozin
  9. Pioglitazone

Summary

Long-acting insulins include the drugs glargine and detemir. Long acting insulins are given once daily, have no peak, and instead work steadily over a duration of around 24 hours. Long acting insulins cannot be mixed; they must be given in their own syringe.

Key Points

  • Long Acting Insulin
    • Drug Names
      • Glargine (Lantus)
      • Detemir (Levemir)
    • Onset, Peak, Duration
      • Onset = 1-2 hours
      • Peak = ~1 day (no peak)
        • Exact peak for detemir depends on patient and ranges from 4-9 hours
        • Glargine’s peak is so slow and long (>12 h) that there is no apparent peak in dose
      • Duration = up to 24 hours
    • Nursing Considerations
      • Cannot be mixed
        • Never mix long-acting insulins with other insulin formulations (e.g. regular insulin)
      • Inject once daily, at the same time each day
      • Given to prevent, not correct, hyperglycemia
        • Long peak is intended to counteract baseline production of glucose by liver