Types of Insulin for Diabetes Treatment

Many forms of insulin treat diabetes. They're grouped by how fast they start to work and how long their effects last.

The types of insulin include:

  • Rapid-acting
  • Short-acting
  • Intermediate-acting
  • Long-acting
  • Pre-mixed

What Type of Insulin Is Best for My Diabetes?

Your doctor will work with you to prescribe the type of insulin that's best for you and your diabetes. Making that choice will depend on many things, including:

  • How you respond to insulin. (How long it takes the body to absorb it and how long it remains active varies from person to person.)
  • Lifestyle choices. The type of food you eat, how much alcohol you drink, or how much exercise you get will all affect how your body uses insulin.
  • Your willingness to give yourself multiple injections per day
  • How often you check your blood sugar
  • Your age
  • Your goals for managing your blood sugar

Afrezza, a rapid-acting inhaled insulin, is FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in your blood in about 15-20 minutes and it clears your body in 2-3 hours. It must be used along with long-acting insulin in people with type 1 diabetes.

The chart below lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood sugar), peak (the time period when it best lowers blood sugar) and duration (how long insulin continues to work). These three things may vary. The final column offers some insight into the "coverage" provided by the different insulin types in relation to mealtime.

Type of Insulin & Brand Names Onset Peak Duration Role in Blood Sugar Management
Rapid-Acting
Lispro (Humalog) 15-30 min. 30-90 min 3-5 hours Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with longer-acting insulin.
Aspart (Novolog) 10-20 min. 40-50 min. 3-5 hours
Glulisine (Apidra) 20-30 min. 30-90 min. 1-2 1/2 hours
Short-Acting
Regular (R)  or novolin 30 min. -1 hour 2-5 hours 5-8 hours Short-acting insulin covers insulin needs for meals eaten within 30-60 minutes.
Velosulin (for use in the insulin pump) 30 min.-1 hour 1-2 hours 2-3 hours
Intermediate-Acting
NPH (N) 1-2 hours 4-12 hours 18-24 hours Intermediate-acting insulin covers insulin needs for about half the day or overnight. This type of insulin is often combined with a rapid- or short-acting type.
Long-Acting
Insulin glargine (Basaglar, Lantus, Toujeo) 1-1 1/2 hours No peak time. Insulin is delivered at a steady level. 20-24 hours Long-acting insulin covers insulin needs for about one full day. This type is often combined, when needed, with rapid- or short-acting insulin.
Insulin detemir (Levemir) 1-2 hours 6-8 hours Up to 24 hours
Insulin degludec (Tresiba) 30-90 min. No peak time 42 hours
Pre-Mixed*
Humulin 70/30 30 min. 2-4 hours 14-24 hours These products are generally taken two or three times a day before mealtime.
Novolin 70/30 30 min. 2-12 hours Up to 24 hours
Novolog 70/30 10-20 min. 1-4 hours Up to 24 hours
Humulin 50/50 30 min. 2-5 hours 18-24 hours
Humalog mix 75/25 15 min. 30 min.-2 1/2 hours 16-20 hours
*Premixed insulins combine specific amounts of intermediate-acting and short-acting insulin in one bottle or insulin pen. (The numbers following the brand name indicate the percentage of each type of insulin.)

 

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How Are Doses Scheduled?

Follow your doctor's guidelines on when to take your insulin. The time span between your shot and meals may vary depending on the type you use.

In general, though, you should coordinate your injection with a meal. From the chart on page 1, the "onset" column shows when the insulin will begin to work in your body. You want that to happen at the same time you're absorbing food. Good timing will help you avoid low blood sugar levels.

  • Rapid acting insulins: About 15 minutes before mealtime
  • Short-acting insulins: 30 to 60 minutes before a meal
  • Intermediate-acting insulins: Up to 1 hour prior to a meal
  • Pre-mixed insulins: Depending on the product, between 10 minutes or 30 to 45 minutes before mealtime

Exceptions to Insulin Dosing and Timing

Long-acting insulins aren’t tied to mealtimes. You’ll take detemir (Levemir) once or twice a day no matter when you eat. And you’ll take glargine (Basaglar, Lantus, Toujeo) once a day, always at the same time. Deglutec is taken once a day, and the time of day can be flexible. But some people do have to pair a long-acting insulin with a shorter-acting type or another medication that does have to be taken at meal time.

Rapid-acting products can also be taken right after you eat, rather than 15 minutes before mealtime. You can take some of them at bedtime.

For more information about when to take insulin, read the "dosing and administration" section of the insulin product package insert that came with your insulin product, or talk with your doctor.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on June 21, 2016

Sources

SOURCES:

The Department of Endocrinology at The Cleveland Clinic. 

Thomson Micromedex. 

Sanofi-aventis Group in the United States. 

New Zealand Ministry of Health.

News release, FDA.

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