Insulin has three characteristics:
Onset: is the length of time before insulin reaches the bloodstream and begins lowering blood glucose.
Peak time: is the time during which insulin is at maximum strength in terms of lowering blood glucose.
Duration: is how long insulin continues to lower blood glucose.
2. Characteristics of Insulin
Insulin has three characteristics:
● Onset: is the length of time before insulin
reaches the bloodstream and begins
lowering blood glucose.
● Peak time: is the time during which
insulin is at maximum strength in terms
of lowering blood glucose.
● Duration: is how long insulin continues to
lower blood glucose.
4. Rapid-acting Insulin (analogues)
● Onset 5-15 minutes after injection, peaks in
about 1-2 hours after injection, and last
between 2-4 hours.
● It usually taken right before a meal.
● It is typically used to control blood sugar
levels during meals or to correct high blood
sugar.
● Examples:
Insulin lispro (Humalog)
insulin aspart (NovoRapid)
insulin glulisine (Apidra)
5. Short-acting Insulin
● Also called; Regular, Soluble, Neutral
● Onset within 30 minutes after injection,
peaks 1-3 hours after injection, and is effective
for approximately 3-6 hours.
● Usually taken 30-60 minutes before a meal.
● It is the only type given IV in diabetic
emergencies.
● Example:
– Actrapid
– Humulin R
– Novolin R
6. Intermediate-acting Insulin
● Also called Isophane (NPH).
● Onset about 2-4 hours after
injection, peaks 4-12 hours later,
and is effective for about 12-18
hours.
● Covers insulin needs for half a
day or overnight. Often used with
rapid- or short-acting insulin.
● Example: Humulin N, Novolin N
7. ● Onset about 1-2 hours, it doesn’t peak and
lasts for up to 24 hours or more.
● It is used to provide a consistent basal
insulin level throughout the day and night.
● The are usually taken once/day.
● Often used, when needed, with rapid- or
short-acting insulin.
● Examples:
– glargine (Lantus)
– detemir (Levemir)
– degludec (Tresiba)
Long-acting Insulin
8. Ultra Long-acting
● Onset in 6 hours,
doesn’t peak, and
lasts about 36 hours
or longer.
● Examples: glargine
U-300 (Toujeo)
9. Pre-Mixed Insulin (Biphasic)
● It combines 2 types of insulin (rapid- or
short-acting + intermediate-acting).
● Usually taken 10 to 30 minutes before
breakfast and dinner.
● They provide rapid onset with prolonged
duration (12-16 h).
● They are usually injected twice/day.
● Examples:
Human Mixtard 30/70,
Humalog Mix 75/25,
NovoLog Mix 70/30,
Humulin 70/30.
11. Inhaled Insulin
● The FDA approved an inhaled insulin
product, Afrezza, in 2015.
● Afrezza is a rapid-acting inhaled insulin.
● It is taken at the beginning of each meal
● It can be used by adults with type 1 or 2 DM.
● It must be used in combination with
injectable long-acting insulin.
Onset within 10-15 minutes
peaks by 30 minutes
Last for 3 hours
12. Insulin strength
● All insulins come dissolved or suspended in liquids.
● The standard and most commonly used strength is U-100,
which means it has 100 units of insulin per milliliter of
fluid.
● U-500 insulin is available for patients who are extremely
insulin resistant.
● U-40, which has 40 units of insulin per milliliter of fluid,
has generally been phased out around the world, but it is
still used in veterinary care.