Author: Dylan Luyten, M.D. Educational Pearls Hypoglycemia is very common in type 2 diabetics, and is often caused by insulin overdose or missed meals. Knowing the peak time of action for common diabetes medications can help inform treatment and disposition. Regular insulin’s action peaks around 60 minutes. By the time most of these patients present to the ED, the drug has had most of its effect. Lantis’ action does not peak, and will continue to exert its effect for 12 or more hours. Levamir has a peak around 6-8 hours. Metformin sensitizes tissues to insulin, so it cannot cause hypoglycemia alone. Glipizides have half-lives over 12 hours and work by increasing insulin release by the pancreas. Hypoglycemia in a patient taking a glipizide usually indicates there is another medical issue interfering with clearance References: http://emedicine.medscape.com/article/122122-workup