spectrum comparison

Insulin Types: Rapid vs Short vs Intermediate vs Long — Onset, Peak, Duration Chart

The NCLEX gives you a time stamp — "NPH at 0800" — and expects you to calculate when hypoglycemia hits. If you confuse NPH's 4–12 hour peak with glargine's peakless profile, you'll monitor at the wrong time and miss the crash.

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Comparison

Progression4 stages

Progression — 4 stages

Rapid-Acting
Onset · peak · duration
- Onset 15 min, peak ~1 hr, lasts 3–4 hr
Key features
- Clear solution
- lispro, aspart, glulisine
Nursing focus
- ★Give with meal — food must be present
Hypoglycemia response
- 15 g fast carbs
- recheck glucose in 15 min
→
Short (Regular)
Onset · peak · duration
- Onset 30 min, peak 2–3 hr, lasts 5–8 hr
Key features
- Clear solution
- Only insulin given IV (e.g., DKA)
Nursing focus
- Give 30 min before meals
- When mixing: draw up clear before cloudy
Hypoglycemia response
- 15 g fast carbs
- recheck glucose in 15 min
→
Intermediate (NPH)
Onset · peak · duration
- Onset 1–2 hr, peak 4–12 hr, lasts ~16 hr
Key features
- ★Cloudy — gently roll to mix, never shake
- Peak 4–12 hr = hypoglycemia window
Nursing focus
- When mixing: draw up clear before cloudy
- Watch hypoglycemia at peak (afternoon)
Hypoglycemia response
- 15 g fast carbs
- recheck glucose in 15 min
→
Long-Acting
Onset · peak · duration
- ★Onset 1–2 hr, NO peak, lasts ~24 hr
Key features
- Clear
- once-daily basal coverage
- Do not mix with other insulins
Nursing focus
- Give same time daily
- provides basal level
Hypoglycemia response
- 15 g fast carbs
- recheck glucose in 15 min