Review Question - QID 109305

The patient in the question likely has diabetic ketoacidosis; Profile A is a rapid-acting insulin, such as aspart or lispro, will most rapidly correct the patient's blood glucose when given subcutaneously (Profile A).

Insulin is administered to reduce blood sugar levels. There are many different kinds of insulin with different onsets and durations of action. Rapid-acting insulin like lispro has an onset of 15 minutes, peak of 30-90 minutes, and lasts a total of 3-4 hours. They are used for rapid adjustment and titration of blood glucose levels as seen with diabetic ketoacidosis or hyperglycemic hyperosmolar non-ketotic state.

Figure/Illustration A shows the explanation for each of the insulin curves. Profile A is rapid-acting like lispro and aspart. Profile B refers to short-acting insulin like regular insulin. Profile C is intermediate-acting like NPH. Profile D is also a longer form of intermediate-acting insulin like detemir, and profile E is a long-acting insulin like glargine.

Incorrect Answers:
Answer 2: Profile B is short-acting insulin like regular insulin. It is slower than the desired onset of action for a DKA episode when given subcutaneously.

Answer 3: Profile C is intermediate-acting insulin like NPH. It is not appropriate to use as the initial treatment for DKA.

Answer 4: Profile D is a longer form of intermediate-acting insulin like detemir.

Answer 5: Profile E is long-acting insulin like glargine for use for basal glucose control.

Bullet Summary:
Rapid-acting insulin like lispro and aspart are used for rapid adjustment of blood glucose levels and have an onset of 15 minutes, peak of 30-90 minutes, and lasts between 3-4 hours.