A client newly diagnosed with diabetes mellitus is started on a 2-dose insulin protocol combination of short- and intermediate-acting insulin injected twice daily. What portion of the total dose is given before breakfast, and what portion is given before the evening meal?

The Short acting insulin is administered before breakfast while the intermediate-acting insulin is administered before the evening meal.

Explanation: Humulin R is an example of short acting insulin while Humulin N is an example of intermediate acting insulin. Humulin R which is a short-acting insulin covers your insulin needs during meals. It is taken about 30 minutes to an hour before a meal to help control blood sugar levels. This type of insulin onset of action, takes effect in about 30 minutes to one hour, and peaks after two to four hours. Its effects tend to last about five to eight hours. The short acting insulin is advantageous because you don't have to take it at each meal. It can be taking at breakfast and supper and still have good control because it lasts a little longer.

Humulin N (NPH), which is an Intermediate-acting insulin can control blood sugar levels for about 12 hours or longer, so it can be used overnight. It starts to work within one to four hours, and peaks between 4 and 12 hours, depending on the brand. It is important to know that Intermediate-acting insulin offer baseline insulin coverage and can be used with short-acting insulin to boost synergy of the drugs.

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