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Types of Insulin for Diabetes Treatment

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There are many forms of insulin to treat diabetes. They are classified 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 is best for you and your diabetes. Deciding what type of insulin might be best for you will depend on many factors, including:

  • Your body's individualized response to insulin (how long it takes insulin to be absorbed in the body and remain active in the body varies slightly from person to person).
  • Your own lifestyle choices -- for instance, the type of food you eat, if/how much alcohol you drink, or how much exercise you get -- are all factors that influence your body's processing of insulin.
  • How willing you are to give yourself multiple injections per day.
  • How frequently you are willing to check your blood sugar level.
  • Your age.
  • Your blood sugar management goals.

A rapid-acting inhaled insulin  is now FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in the blood in about 15-20 minutes, researchers say, and clears the body in 2-3 hours. Afrezza must be used in combination with long-acting insulin in patients with type 1 diabetes 

The following chart 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 the insulin is the most effective in lowering blood sugar) and duration (how long insulin continues to lower blood sugar). These three factors may vary, depending on your body's response. The final column provides some insight into the "coverage" provided by the different insulin types in relation to mealtime.

Type of Insulin & Brand NamesOnsetPeakDurationRole in Blood Sugar Management
Rapid-Acting
Humalog or lispro15-30 min.30-90 min3-5 hoursRapid-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.
Novolog or aspart10-20 min.40-50 min.3-5 hours
Apidra or glulisine20-30 min.30-90 min.1-2½ hours
Short-Acting
Regular (R) humulin or novolin30 min. -1 hour2-5 hours5-8 hoursShort-acting insulin covers insulin needs for meals eaten within 30-60 minutes
Velosulin (for use in the insulin pump)30 min.-1 hour2-3 hours2-3 hours
Intermediate-Acting
NPH (N)1-2 hours4-12 hours18-24 hoursIntermediate-acting insulin covers insulin needs for about half the day or overnight. This type of insulin is often combined with rapid- or short-acting insulin.
Long-Acting
Long-acting insulin covers insulin needs for about one full day. This type of insulin is often combined, when needed, with rapid- or short-acting insulin.
Lantus (insulin glargine)1-1½ hourNo peak time; insulin is delivered at a steady level20-24 hours
Levemir (insulin detemir)1-2 hours6-8 hoursUp to 24 hours
Pre-Mixed*
Humulin 70/3030 min.2-4 hours14-24 hoursThese products are generally taken two or three times a day before mealtime.
Novolin 70/3030 min.2-12 hoursUp to 24 hours
Novolog 70/3010-20 min.1-4 hoursUp to 24 hours
Humulin 50/5030 min.2-5 hours18-24 hours
Humalog mix 75/2515 min.30 min.-2½ hours16-20 hours
*Premixed insulins are a combination of specific proportions 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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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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