Types of insulin 1
| Examples | Appearance | The time of greatest effect (peak) |
|---|
| NovoRapid (insulin aspart) | Clear | 1–1.5 hours |
| Entuzity (insulin regular) | Clear | 4–8 hours |
| Humulin R, Novolin ge Toronto (insulin regular) | Clear | 2–3 hours |
| Humulin N, Novolin ge NPH(insulin NPH) | Cloudy | 5–8 hours |
Short-acting insulin: This type takes about 30 to 60 minutes to become active in your bloodstream. It peaks in two to four hours, and its effects can last for five to eight hours.
Tresiba (insulin degludec) is the longest acting insulin available, and there don't appear to be any coming down the pipeline that give this duration of effect. What makes Tresiba a hero is its long duration of action (more than 40 hours) with minimal fluctuations in blood levels of the drug. It's given once a day.
What Type of Insulin Is Best for My Diabetes?
| Type of Insulin & Brand Names | Onset | Peak |
|---|
| Long-Acting |
| Insulin glargine (Basaglar, Lantus, Toujeo) | 1-1 1/2 hours | No peak time. Insulin is delivered at a steady level. |
| Insulin detemir (Levemir) | 1-2 hours | 6-8 hours |
| Insulin degludec (Tresiba) | 30-90 min. | No peak time |
NPH insulin is an isophane suspension of human insulin and is categorized as an intermediate-acting insulin.
When mixing insulin NPH with other preparations of insulin (eg, insulin aspart, insulin glulisine, insulin lispro, insulin regular), insulin NPH should be drawn into the syringe after the other insulin preparations. After mixing NPH with regular insulin, the formulation should be used immediately.
The American Diabetes Association characterizes insulin by the way it works. Onset is defined as the length of time insulin hits your bloodstream and begins to lower blood glucose. Peak is the time during which insulin is at its “peak†or maximum effectiveness at lowering blood glucose.
The insulin that has the longest duration of action, which is the length of time it works, is usually either the intermediate-acting insulins such as NPH insulin (human), or the long-acting insulins such as insulin glargine (Lantus) or insulin determir (Levemir). Their duration of action can be up to 24 hours long.
Short-acting insulin is Regular (R) insulin (Humulin® & Novolin®). The onset of action is 30 min -1 hour, and the peak action time is 2-5 hours after administration. Regular insulin lasts for about 5-8 hours and provides coverage for meals consumed within 30-60 minutes after administration.
Lente insulin products, along with other insulin analogs in the same family, were discontinued by their manufacturers in the mid 2000s, and are no longer permitted to be marketed for use in humans in the US.
Description of Onset, Peak, and Duration of Insulins
| Insulin | Onset | Peak (hours) |
|---|
| Aspart (NovoLog) | 5 to 10 minutes | 1 to 3 |
| Lispro (Humalog) | < 15 minutes | 0.5 to 1.5 |
| Regular (Humulin R, Novolin R) | 30 to 60 minutes | 2 to 3 |
| Basal insulin | | |
One unit of insulin should cause your blood sugar level to drop 30 to 50 mg per dL, but you may need more insulin to get the same effect.
Insulin is a hormone. It controls how much sugar is in your blood. A high level of sugar in your blood can cause problems in many parts of your body, including your heart, kidneys, eyes, and brain. Over time, this can lead to kidney disease and kidney failure.
Use the 500 Rule to estimate insulin-to-carb ratio: 500/TDD = number of carb grams covered by a unit of insulin. Example: 500/50=10; 1unit of insulin will cover about 10 grams of carbohydrate.
Insulin shots are most effective when you take them so that insulin goes to work when glucose from your food starts to enter your blood. For example, regular insulin works best if you take it 30 minutes before you eat.
Uses: To improve glycemic control in patients with diabetes mellitus; U-500 insulin is for use in patients requiring more than 200 units of insulin per day.
Mealtime insulin also comes with other risks. If you take your mealtime insulin, but are unable to eat, you could become hypoglycemic. Hypoglycemia occurs when your blood sugar levels get too low. This can be very dangerous.
Diabetes and fatiguePeople on stronger diabetes medication such as insulin, may also experience fatigue as a symptom of low blood glucose levels. Blood glucose testing can help to determine whether high or low sugar levels may be the cause of fatigue.
Rapid-acting insulin starts to work within 30 minutes after injection. Its effects only last 2 to 3 hours. Regular- or short-acting insulin takes about 30 minutes to work and lasts for about 3 to 6 hours. Intermediate-acting insulin takes up to 4 hours to work fully.
Lantus is designed to give a steady level of insulin over 24 hours, even when you are not eating such as between meals and overnight. This helps keep blood glucose levels consistent during the day and at night.
Short-acting insulins take effect and wear off more quickly than long-acting insulins. A short-acting insulin is often used 30 minutes before a meal so that it has time to work. These liquid insulins are clear and do not settle out when the bottle (vial) sits for a while.
When your blood sugar level gets too high — known as hyperglycemia or high blood glucose — the quickest way to reduce it is to
take fast-acting insulin. Exercising is another fast, effective way to lower blood sugar.
Eat a consistent diet
- whole grains.
- fruits.
- vegetables.
- lean proteins.
You may need it if long-acting insulin isn't enough. The right dose depends on your target blood sugar level, how many carbs you're eating, and how active you are. You might start with four to six units of insulin. Your dose may go up two to three units every 3 days until you reach your blood sugar target.
Rapid-acting insulin starts to lower blood sugar within 15 minutes and its effects last for 2 to 4 hours. Short-acting insulin starts to work within 30 minutes and its effects last for 3 to 6 hours. Intermediate-acting insulin starts to work within 2 to 4 hours and lasts for 12 to 18 hours.
Lantus is a long-acting insulin that works for 24 hours and should be taken regularly at the same time each day. If you miss taking your dose at the regular scheduled time, your blood sugar levels may become high (hyperglycaemia).
The dawn phenomenonThis triggers beta cells in the pancreas to release insulin in order to keep blood glucose levels in check. But if you have diabetes, you may not make enough insulin or may be too insulin resistant to counter the increase in blood sugar. As a result, your levels may be elevated when you wake up.
