Insulin is classified into three categories:

• How quickly they start to act
• When they have maximal effect
• How long they start to act

These three characteristics are called

• Onset
  • Onset refers to the length of time before the insulin gets into the bloodstream and starts the process of lowering blood sugar.

• Peak
  • This refers to a time period in which the insulin in the blood is at its optimum when lowering blood sugar.

• Duration
  • Duration refers to the length of the time from the onset where the insulin you inject into a patient lowers their blood sugar.

Mnemonic For Onset Times 

• READY
• SET
• INJECT
• LOVE

1. Ready- Rapid Acting Insulin

Regular or rapid-acting insulin will start lowering your patient’s blood sugar fifteen minutes after the injection.

Rapid-acting insulin usually peaks in an hour but has a duration that lasts a few hours after the injection.

2. Set- Short-Acting Insulin

This type of insulin will reach your patient’s bloodstream 30 minutes after injection.

It will reach its peak within 2-3 hours and stays effective for a duration of about 3-6 hours.

3. Inject- Intermediate Acting Insulin

Intermediate insulin has an onset of about 1-2 hours, a peak of about 4-6 hours, and a duration of about 12 hours.

4. Love- Long-Acting Insulin

Long-acting insulin has an onset of 1-2 hours.

It has a duration of about 24 hours and a gradual peak throughout the 24 hours due to its slow absorption.

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Mnemonic  Duration, Onset, and Peak

1. READY- RAPID-ACTING MNEMONIC

“15 year old wanted to grow up fast, 60-90-year-old grandparents misses his childhood days when he was 3-4 years old.”

• Onset- 15 minutes
• Peak- 60-90 minutes
• Duration-3-4 hours

2. SET- SHORT-ACTING INSULIN MNEMONIC

One of the most heartwarming stories of the last decade occurred in the twenty-fourth state to be admitted in the Union (Missouri), where 36 already short-staffed nurses became pregnant at the same time in one hospital.

Besides being heartwarming, this story from Missouri serves to help you remember 24 (Missouri) and thirty-six, which play a significant role in the short-acting insulin mnemonic.

“Within half a year,  one short-staffed hospital in the twenty-fourth state lost and gained  thirty-six nurses, Congratulations.”

• Onset- 30 minutes to 1 hour
• Peak- 2-4 hours
• Duration- 3-6 hours

3. INJECT- INTERMEDIATE-ACTING INSULIN

“Given 2 options, would you rather do four- four-hour shifts for ten dollars or better yet get that 10 dollars in one sixteen-hour shift.”

• Onset- 2-4 hours
• Peak – 4 hours
• Duration- 10-16 hours

4. MNEMONIC FOR LOVE-LONG ACTING INSULIN

“2 climbers are better than 1 for a mountain that doesn’t seem to have a peak. It might take an entire day (24 hours) “

• Onset -2-4 hours
• Peak- non-existent
• Duration – 24 hours or an entire day

Mnemonic For The Different Types of Insulin

Types of Rapid Acting Insulin

The letters “I” and “N” the word INsulin represent rapid-acting insulin in this mnemonic. The intersection of the letter “I” in both rapId and InsulIn brings these two terms together.

Remember:

• The “N” in iNsulin is for Novolog
• The “L” in insuLin is for HumAlog
• All rapid-acting insulin analogs end with the postfix “log.”

Humalog and Novolog

Humalog and Novolog are brand names for insulin lispro and insulin aspart, respectively. They are both rapid-acting types of insulin. Remember the mnemonic

“15 year old wanted to grow up fast, 60-90-year-old grandparents misses his childhood days when he was 3-4 years old.”

Both Novolog and Humalog have an:

• Onset of 15 minutes
• Peak of 60-90 minutes
• Duration of 3-4 hours

Short-Acting Insulin Mnemonic

The letter “S” in insulin (written vertically) is used as the first word for Short, which represents short-acting insulin.

The “R” in short is also written vertically as “REG,” which represents regular insulin, a type of short-acting insulin.

Regular Insulin

Regular insulin is also known as Novolin. It is a type of short-acting insulin with a high absorption rate that gets to work on the blood faster.

However, to avoid confusion with other types of insulin, use regular instead of Novolin. Remember the mnemonic:

“Within half a year,  one short-staffed hospital in the twenty-fourth state lost and gained  thirty-six nurses, Congratulations.”

This means that regular insulin has a:

• Onset of about half an hour to one hour
• A peak of 2-4 hours
• Duration of 3-6 hours

Types Of Intermediate Acting Insulin

Intermediate-acting insulin is an insulin analog that is between long-acting and short-acting insulin. That’s why in this mnemonic, it takes the letter “U” in insUlIn which is a midpoint in the term.

The letter “U” is shared by both insUlin (written vertically) and HUmulin (written horizontally) to give the first intermediate-acting analog in this formula.

The “N” in both HumuliN written vertically and NPH written horizontally gives us the two types of intermediate-acting insulin.

Humulin and NPH

NPH, which is neutral protamine Hagedorn, is a type of intermediate insulin designed to have a low absorption rate that delays both its duration and onset.

NPH works by the addition of a protein called protamine, which a scientist by the name of Hans Hagedorn discovered reduces the absorption of insulin from the subcutaneous layer into the bloodstream.

Remember the mnemonic:

“Given 2 options, would you rather do four- four-hour shifts for ten dollars or better yet get that 10 dollars in one sixteen-hour shift.”

This shows that Humulin and NPH have an:

• Onset of 2 hours
• A peak of 4-10 hours
• A duration of 10-16 hours

Types of Long-Acting Insulin

The rest of the letters in the term insulin written vertically from the word L downwards represent long-acting insulin.

Remember:

• The “L” in insuLin written vertically is for long
• The “I” in insulIn written vertically is for LevemIr
• The “N” in insuliN written vertically is for LaNtus
• Both Levemir and Lantus, which are long-acting insulin, start with the letter “L.”

Levemir and Lantus

Levemir is a solution of insulin detemir, and Lantus is a solution of insulin glargine. Both are absorbed from the subcutaneous fat layer into the bloodstream over 24 hour period.

Levemir and Lantus don’t have a defined peak. This makes them suitable for blood sugar regulation over long periods.

Remember the mnemonic:

“2 climbers are better than 1 for a mountain that doesn’t seem to have a peak. It might take an entire day (24 hours) ”

This shows that Levemir and Lantus have :

• An onset of about 1-2 hours
• No defined peak
• A duration of 24 hours

Summary For Insulin Mnemonic

This is a summary of two of the three mnemonics we’ve covered in this blog. Repeating them over and over is the key to mastery.

1. Ready Set Inject Love
2. “15 year old wanted to grow up fast, 60-90-year-old grandparents misses his childhood days when he was 3-4 years old.”
3. “Within half a year,  one short-staffed hospital in the twenty-fourth state lost and gained  thirty-six nurses, Congratulations.”
4. “Given 2 options, would you rather do four- four-hour shifts for ten dollars or better yet get that 10 dollars in one sixteen-hour shift.”
5. “2 climbers are better than 1 for a mountain that doesn’t seem to have a peak. It might take an entire day (24 hours) “