Types of Insulin

Insulin has come a long way since its initial discovery back in 1922. Once derived only
from animals, today's insulins are the result of sophisticated genetic engineering
techniques that have allowed researchers to alter the human insulin gene to create a
variety of drugs that behave in different ways.
In fact, there are so many insulin options today that figuring out which type does what
can be confusing. From the fastest acting to the longest lasting, this guide to insulin will
help demystify the drug.
Insulin can be classified by how fast it starts to work and how long its effects last. Each
type of insulin has an onset, peak, and duration time. Onset is the length of time it takes
for the insulin to begin working. The peak is when the insulin is most effective at
lowering blood sugar. Duration refers to how long the insulin continues to lower blood
sugar. Onset, peak, and duration vary significantly across insulins. The "fastest" can start
working in as little as 10 minutes and peak in 30. The longest lasting, sometimes called
"basal" insulins, have an undetectable peak and work for 24 hours.
Rapid-Acting Insulin
Brand and Generic Names: Humalog (lispro), NovoLog (aspart), Apidra (glulisine)
What It Does: A fast acting insulin that starts lowering blood sugar soon after injection
and works hardest around 2 hours after a meal, which is when blood sugars are the
highest.
When To Take It: Right before meals to "cover" the carbohydrates in the food you eat.
How It Works*:
Onset: 10-20 minutes
Peak of Action: 30 minutes-3 hours
Duration: 3-5 hours
*NOTE: Exact onset, action, and duration are dependent on the generic/brand used.
Regular Insulin
Brand Names: Humulin R, Novolin R
What It Does: A short-acting insulin that is identical to the insulin produced by the
human body. It begins working about 30 minutes after a meal and peaks later than rapidacting insulin.
When To Take It: Take 30-60 minutes before meals to control the blood sugar spike that
occurs after meals.
How It Works*:
Onset: 30-60 minutes
Peak of Action: 2-5 1/2 hours
Duration: 4-8 hours
*NOTE: Exact onset, action, and duration are dependent on the generic/brand used.
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NPH Human Insulin
Brand Names: Humulin N, Novolin N [NPH (rDNAorgin) isophane]
What It Does: An intermediate-acting form of human insulin. It starts working more
slowly, has a lower
peak, and has a longer duration than either rapid-acting or regular insulin. It usually
covers background insulin needs for about half a day and may be used in combination
with regular insulin to cover mealtime spikes.
When To Take It: Can be taken once or twice a day, typically before morning and
evening meals, to control blood sugar levels throughout the day.
How It Works*:
Onset: 1 1/2-4 hours
Peak of Action: 4-12 hours
Duration: 8-24 hours
*NOTE: Exact onset, action, and duration are dependent on the generic/brand used.
Insulin Mixes
Brand Names: Humalog 75/25, Humulin 70/30, Novolin 70/30, Humulin 50/50,
NovoLogMix 70/30
What It Does: Insulin mixes are a combination of either intermediate-acting plus rapidacting insulin or intermediate-acting plus short-acting insulin. They provide intermediateacting insulin to control blood sugar levels throughout the day and short- or rapid-acting
insulin to cover mealtime spikes. Insulin mixes come in insulin pens that contain a
premeasured insulin cartridge so that you don't have to measure out two separate doses of
insulin. Pens can either be disposable or reusable. The disposable kind comes prefilled
with insulin while the reusable pens need to be loaded with insulin cartridges. The user
places the pen against the injection site and presses a button to administer the insulin.
When To Take It: Can be taken twice daily, about 10-30 minutes before meals.
How It Works*:
Onset: 10-30 minutes
Peak of Action: 1-12 hours
Duration: 18-24 hours
*NOTE: Exact onset, action, and duration are dependent on the generic/brand used.
Long-Acting Insulin
Brand and Generic Names: Lantus (glargine), Levemir (detemir)
What It Does: A long-lasting insulin, sometimes called basal insulin, that controls blood
sugar levels for a 24 hour period. It works longer than intermediate-acting insulin and has
less of a peak, or no peak at all. It may be used in combination with short- or rapid-acting
insulin to cover mealtime spikes.
When To Take It: Can be administered once or twice daily and does not have to be
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taken with meals. If taken twice daily, the full dose is split in half.
How It Works*:
Onset: 1-4 hours
Peak of Action: Minimal
Duration: Up to 24 hours
*NOTE: Exact onset, action, and duration are dependent on the generic/brand used.
The type of insulin you need depends on a variety of factors, including your body's
response to insulin, your lifestyle choices, and your blood sugar management goals. Most
of today's insulins are available in injectable pen devices, as well as vials for syringe and
pump use. You should speak with your doctor about which type of insulin will best help
you manage your diabetes.
SOURCES:
1. Food & Drug Administration. http://www.fda.gov (Accessed 11/10) 2. NovoNordisk A/S.
http://www.novonordisk.com (Accessed 11/10) 3. Sanofi-Aventis US. http://www.sanofiaventis.us/live/us/en/index.jsp (Accessed 11/10) 4. Eli Lilly and Company. http://www.lilly.com
(Accessed 11/10)

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