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.

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