Which of the following is an example of basal insulin?

NORCET -4 , 2023

Pharmacology

Easy

Appeared in: NORCET -4 , 2023

Explanation

Basal insulin is designed to provide a steady, background level of insulin to control blood glucose between meals and overnight.
Degludec is classified as an ultra-long-acting insulin.
Its pharmacokinetic profile shows a duration of action exceeding 42 hours with no significant peak, making it an ideal example of a basal insulin.
This long, flat action profile mimics the natural, continuous insulin secretion of a healthy pancreas.

Option A: Regular insulin is a short-acting insulin, not a basal insulin. Its primary role is to cover the glucose spike from meals (bolus insulin).
Option B: NPH is an intermediate-acting insulin. While it can be used to provide basal coverage, it has a pronounced peak and a shorter duration than modern long-acting insulins, making it a less ideal example.
Option C: Glulisine is a rapid-acting insulin. Its function is to provide a quick bolus of insulin to manage post-meal blood glucose levels.

Visual 1: Chart: A graph comparing the pharmacokinetic profiles (onset, peak, duration) of rapid-acting, short-acting, intermediate-acting, and long-acting insulins. This visual would clearly illustrate why Degludec has a 'basal' profile (long and flat) compared to the 'bolus' profiles of Regular and Glulisine (sharp peaks).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of Insulin Types (Basal vs. Bolus) as background academic context rather than a clinical decision trigger.
A core nursing responsibility is the safe administration of insulin. Confusing a basal insulin (like Degludec) with a bolus insulin (like Glulisine) can lead to severe hypoglycemia or hyperglycemia, which are medical emergencies.
Long-acting insulins like glargine and degludec should never be mixed in the same syringe with other insulins, as this can alter their pH and absorption profile, rendering them ineffective.
What if? If a patient with Type 1 diabetes is made NPO (nothing by mouth) for surgery, their bolus (mealtime) insulin should be held, but their basal insulin dose should typically be continued (often at a reduced rate) to prevent diabetic ketoacidosis (DKA). This highlights the essential, continuous role of basal insulin.

How to Approach the Question

First, identify the key term in the question: 'basal insulin'.
Recall the two main functional categories of insulin: basal and bolus (prandial).
Remember that 'basal' refers to the background, long-acting insulin that maintains glucose stability between meals and overnight.
Classify each option based on its duration of action: Regular (short), NPH (intermediate), Glulisine (rapid), and Degludec (ultra-long).
Select the option that best fits the definition of a basal insulin, which is the one with the longest and most peakless action profile.

Concept Tested & Keywords

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