What is NPH insulin used for?
- Basal insulin in type 1 and type 2 diabetes
- Steroid-induced hyperglycemia
Intermediate-acting human insulin. Cloudy suspension. Also part of premixed 70/30 insulin.
How NPH insulin works
Insulin combined with protamine to slow absorption: intermediate onset with a peak several hours after injection.
Common side effects
- Hypoglycemia, especially around the peak
- Weight gain
- Injection-site reactions
Report right away
- Signs of low blood sugar, often in the afternoon (morning dose) or overnight (evening dose)
Nursing considerations for NPH insulin
- Onset about 1 to 2 hours, peak about 4 to 12 hours, duration about 12 to 18 hours.
- Roll the vial or pen gently between the palms to mix; do not shake.
- When mixing with regular insulin: clear before cloudy (draw up regular first).
- Subcutaneous only; never IV.
Patient teaching
- Eat meals and snacks on schedule to match the insulin peak.
- Watch for low blood sugar several hours after the dose.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
Insulins practice questions
NCLEX-style questions on the class NPH insulin belongs to.
3 questions. Choose an answer to see the rationale.
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When mixing regular and NPH insulin in one syringe, which insulin is drawn up first?
Show answer
Answer A: Regular (clear) Clear before cloudy: draw up regular first so that NPH (which contains protamine) does not contaminate the regular insulin vial.
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A patient received NPH insulin at 0700. At what time is hypoglycemia most likely?
Show answer
Answer A: Early to mid-afternoon NPH peaks about 4 to 12 hours after injection, so a morning dose peaks in the afternoon.
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Which insulin can be given by continuous IV infusion?
Show answer
Answer D: Regular Regular insulin is the insulin routinely used for IV infusions. Glargine, NPH and premixed insulins are subcutaneous only.
Frequently asked questions
What is NPH insulin used for?
Basal insulin in type 1 and type 2 diabetes; Steroid-induced hyperglycemia.
What drug class is NPH insulin?
NPH insulin (isophane) belongs to the class insulins. Insulin combined with protamine to slow absorption: intermediate onset with a peak several hours after injection.
What are the nursing considerations for NPH insulin?
Onset about 1 to 2 hours, peak about 4 to 12 hours, duration about 12 to 18 hours. Roll the vial or pen gently between the palms to mix; do not shake.
What should patients report while taking NPH insulin?
signs of low blood sugar, often in the afternoon (morning dose) or overnight (evening dose).