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444 Unit 4 | Common Illnesses or Disorders in Childhood and Home Care

TABLE 183 Types of Insulin Used to Treat Diabetes Mellitus—cont’d

INSULIN TYPE

ONSET

PEAK

DURATION AVAILABILITY DOSE

ROUTE CONSIDERATIONS

Long-Acting Insulin

Detemir: 0.1– 0.2 units/kg once daily in the evening or divided dose over 2 daily doses or 10 units once or twice daily

Detemir:

Insulin

Only administered SQ Only indicated for children >6 years old Glargine cannot be given in the same site as other insulin

detemir: 24 hours

detemir: 3– 14 hours

detemir (Levemir)

detemir: 3–4 hours

100 units/ mL in 10-mL vials, 3-mL cartridges, or prefilled syringes

Insulin

glargine: 24 hours

Insulin glar- gine:

glargine: 3–4 hours

glargine (Lantus)

Glargine:

No peak

100 units/mL in 10-mL vials, 3-mL prefilled disposable pens

Glargine:

(children over age 6): 50%–75% of daily insulin requirements once daily

Degludec 100 units/mL

prefilled pens and vials and 200 units/mL prefilled pens

Insulin-

naïve type 1 diabetics one-third of total daily dose given once then titrate to blood sugar goal type 2 diabetics 0.2 units/kg up to 10 daily and titrate to goal blood sugar

Degludec

(children >1 year old and already on insulin) give

as 80% of total daily

dose of long- or intermediate- acting insulin and titrate to goal blood sugar