Pharmacology Diabetes meds #8

Question

A nurse is teaching a Type 2 diabetic patient about the prescribed once daily detemir insulin injection. Which is the best time of day for the patient to take the Levemir insulin?

Answers

  1. Midday prior to lunch
    • Rationale:

      This answer is not correct because administering levemir midday prior to lunch is not the best time of administration. When detemir is prescribed for once a day, the best time to administer the medication is after the evening meal or at bedtime.

  2. Morning with breakfast
    • Rationale:

      This answer is not correct because when detemir is prescribed for once a day, the best time to administer the medication is after the evening meal or at bedtime. If the insulin was prescribed for twice a day, then 12 hours earlier, in the morning, would be appropriate, but the medication is prescribed once a day.

  3. Evening or bedtime
    • Rationale:

      This answer is correct because when detemire is prescribed for once a day, the best time to administer the medication is after the evening meal or at bedtime. Detemir insulin is a long-acting insulin that is given once a day or twice a day to treat diabetes mellitus. It should be administered by subcutaneous injection. Side effects include irritation or redness at the injection site, swelling of the hands/feet, flu-like symptoms, and hypoglycemia.

  4. Three hours after midday meal
    • Rationale:

      This answer is not correct because administration of detemir insulin prescribed for once a day, is not appropriate to administer three hours after the midday meal. When detemir is prescribed for once a day, the best time to administer the medication is after the evening meal or at bedtime. If the insulin was prescribed for twice a day, then 12 hours earlier, in the morning, would be appropriate.

Overview

Once daily detemir insulin injection should be given in the evening or bedtime.

Explanation

The recommended once-daily dose should be administered with the evening meal or at bedtime. The other times for administration of the medication are incorrect (Answer A, B, D). If the insulin is ordered twice daily, then injections may be in the am and 12 hours later. Levemir is basal insulin that is long-acting and made to replace insulin that the body would normally make. It may be used in patients with Type 2 diabetes. Additionally, it may be used alone or with metformin or even shorter-acting insulins if needed.

Learning Outcomes

Detemir insulin is a long-acting insulin that is given once a day or twice a day to treat diabetes mellitus. When it is prescribed for once a day, the best time to administer the medication is after the evening meal or at bedtime. It should be administered by subcutaneous injection. Side effects include irritation or redness at the injection site, swelling of the hands/feet, flu-like symptoms, and hypoglycemia. Patients should be taught about detemir insulin, including best time of day to administer, how to administer, side effects, and symptoms of hypoglycemia.

Test Taking Tip

Remember that times within a question are generally an essential component and make a difference as to the correct answer. An example is what the nurse should do preoperatively, intraoperatively, or postoperatively. Time matters.

Video Rationale