Which is the long acting insulin?

Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017

Explanation

Glargine is classified as a long-acting insulin.
It has an onset of action of 1-2 hours, no pronounced peak, and a duration of action that lasts up to 24 hours.
This profile provides a steady, basal insulin level, which is crucial for maintaining glycemic control between meals and overnight.
Its unique property of forming microprecipitates at the injection site allows for slow, continuous absorption into the bloodstream.

Option B: NPH (Neutral Protamine Hagedorn) is an intermediate-acting insulin, not long-acting. Its duration is 10-18 hours, and it has a distinct peak, which increases the risk of hypoglycemia compared to long-acting insulins.
Option C: Regular insulin is a short-acting insulin. It is used to cover insulin needs for meals eaten within 30-60 minutes and has a duration of 6-10 hours.
Option D: Lispro is a rapid-acting insulin. It begins to work in about 15 minutes and is used to control blood sugar spikes from meals. Its duration is only 3-5 hours.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology of Insulin Types as background academic context rather than a clinical decision trigger.
Understanding the different action profiles of insulin is fundamental for safe and effective diabetes management. Administering the wrong type of insulin can lead to severe hypoglycemia or hyperglycemia.
Nurses must educate patients on the correct timing of insulin injections relative to meals based on the insulin type. For example, Lispro is taken just before a meal, while Glargine can be taken once daily regardless of meal times.
A common and dangerous error is confusing long-acting and short-acting insulins. A patient receiving a large dose of rapid-acting insulin (like Lispro) instead of their long-acting basal insulin (like Glargine) is at high risk for severe, life-threatening hypoglycemia.

How to Approach the Question

First, identify the key term in the question: 'long acting insulin'.
This is a factual recall question that requires knowledge of pharmacological classifications.
Mentally review or recall the different categories of insulin: rapid-acting, short-acting, intermediate-acting, and long-acting.
Categorize each of the given options: Lispro (rapid), Regular (short), NPH (intermediate), and Glargine (long).
Select the option that matches the category asked for in the question.

Concept Tested & Keywords

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E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 1 (pp 26-370 of 370) p. 202-204

E6 Medicine Harrison 22e Part 2 p. 1114-1116

E6 Pharmacology Nursing Lilley 11e Part 2 p. 202-204

Practise the full AIIMS Rishikesh & Jodhpur NO - 2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.