Insulin PocketCard™ Effective Action Insulin Name Onset Peak Duration Considerations Aspart (Novolog) Rapid Acting Lispro (Humalog) 5 - 15 min 30 - 90 min < 5 hrs Bolus insulin Analogs lowers after-meal Glulisine (Apidra) Bolus glucose. Post meal Regular 30 - 60 min 2 - 3 hrs 5 - 8 hrs BG reflects efficacy. Short Acting Concentrated Regular Insulin Basal insulin 30 - 60 min 2 - 3 hrs Up to 24 hrs 500 units/mL reg insulin “U-500” controls BG between meals and nighttime. Intermediate NPH 2 - 4 hrs 4 - 10 hrs 10 - 16 hrs Fasting BG reflects Detemir (Levemir) 3 - 8 hrs No peak 6 - 24 hrs efficacy. Basal Glargine (Lantus) 2 - 4 hrs No peak 20 - 24 hrs Side effects: Long Acting hypoglycemia, Concentrated Glargine (Toujeo) 6 hrs No Peak 24 hrs 300 units/mL in 1.5 mL Pen weight gain. Combo of NPH + Reg Typical dosing Intermediate 70/30 = 70% NPH + 30% Reg 30 - 60 min range: 0.5-1.0 units/ + short Basal 50/50 = 50% NPH + 50% Reg kg body wt/day. Dis- + Dual peaks 10 - 16 hrs card opened insulin Bolus Intermediate Novolog® Mix - 70/30 vials after 28 days. 5 - 15 min + rapid Humalog® Mix - 75/25 or 50/50 Insulin action times can vary with each injection, time periods listed here are general guidelines only; please consult prescribing information for details. REV 03/2015 © 2015 A Diabetes PocketCard™ Inhaled Insulin from Diabetes Education Services | DiabetesEd.Net Action Insulin Name Dose Range Onset Peak Duration Considerations Assess lung function before starting. Afrezza Inhaled 4 and 8 unit Avoid in chronic lung disease — Bolus – regular human cartridges 15 mins 1 hr 3 hrs acute . Side effects: Rapid-acting insulin before meals bronchospasm risk hypoglycemia, cough, throat irritation. Injectables That Lower Glucose Class/Main Action Name Dose Range Considerations GLP-1 Agonist exenatide (Byetta) 5 or 10 mcg BID (renally excreted) Side effects for all: “Incretin Mimetic” exenatide XR (Bydureon) 2mg 1x a week (renally excreted) Nausea, vomiting, weight loss, injection • Increases insulin site reaction. Report signs of acute release with food pancreatitis (severe abdominal pain, • Slows gastric liraglutide (Victoza) 0.6 - 1.8 mg daily vomiting), stop med. emptying Black box: Thyroid C-cell tumor • Promotes satiety 30 and 50 mg warning for liraglutide, exenatide XR, albiglutide (Tanzeum) • Suppresses glucagon 1x a week pen injector albiglutide, and dulaglutide (avoid Lowers A1c 0.5 – 1.6% if family history of medullary thyroid 0.75 and 1.5 mg Wt loss of ~ 3lbs dulaglutide (Trulicity) cancer, notify MD of hoarseness, throat 1x a week pen injector lump). Amylin Mimetic For Type 1 or 2 on insulin. • Slows gastric Type 1: 15 - 60 mcg; Black box warning: severe emptying hypoglycemic risk 3 hrs post injection. pramlintide (Symlin) Type 2: 60 - 120 mcg • Supresses glucagon Prevent hypoglycemia, decrease insulin • Promotes satiety immediately before major meals dose when starting pramlintide. Side Lowers A1c 0.5 – 1% effects: nausea, weight loss. The information listed here are general guidelines only; please consult prescribing information for details..