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Types of Insulin

Topic Overview

Insulin is used to treat people who have diabetes. Each type of insulin acts over a specific amount of time. The amount of time can be affected by exercise, diet, illness, some medicines, stress, the dose, how you take it, or where you inject it.

Insulin is made by different companies. It also comes in different strengths. Make sure you use the same type of insulin consistently so you take the right amount.

Types of insulinfootnote 1

Type

Examples

Appearance

When it starts to work (onset)

The time of greatest effect (peak)

How long it lasts (duration)

Rapid-acting

Apidra (insulin glulisine)

Clear

10–15 minutes

1–1.5 hours

3.5–5 hours

Fiasp (faster-acting insulin aspart)

Clear

4 minutes

0.5–1.5 hours

3–5 hours

Humalog (insulin lispro)

Clear

10–15 minutes

1–2 hours

3–4.75 hours

NovoRapid (insulin aspart)

Clear

9–20 minutes

1–1.5 hours

3–5 hours

Humalog ,U-200 (insulin lispro)Clear30-45 minutes1-3 hours3-5 hours

Short-acting

Humulin R, Novolin ge Toronton (insulin regular)Clear
30 minutes

2–3 hours

6.5 hours

Intermediate-acting

Humulin N, Novolin ge NPH (insulin NPH)
Cloudy1–3 hours5–8 hours
Up to 18 hours

Long-acting

Lantus, Basaglar (insulin glargine)

Clear

1.5 hours

Does not apply

24 hours

Levemir (insulin detemir U-300)

Clear

1.5 hours

Does not apply

16 to 24 hours

Toujeo (insulin glargine U-300)

Clear

1.5 hours

Does not apply

Up to 30 hours

Ultra long-acting

Tresiba (insulin degludec) available as U-100 and U-200

Clear

1.5 hours

Does not apply

42 hours

Other
Entuzity U-500 (insulin regular)Clear15 minutes4–8 hours17–24 hours

Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal. Rapid-acting insulin acts most like insulin that is produced by the human pancreas. It quickly drops the blood sugar level and works for a short time. If a rapid-acting insulin is used instead of a short-acting insulin at the start of dinner, it may prevent severe drops in blood sugar level in the middle of the night.

Short-acting insulins take effect and wear off more quickly than long-acting insulins. A short-acting insulin is often used 30–60 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.

Intermediate acting insulins contain added substances (buffers) that make them work over a long time and that may make them look cloudy. When these types of insulin sit for even a few minutes, the buffered insulin settles to the bottom of the vial. But insulin glargine and insulin detemir are clear liquids (not cloudy).

Long-acting insulins are typically given once a day but may be given twice a day. If a long-acting insulin is used instead of an intermediate-acting insulin, it may prevent severe drops in blood sugar level in the middle of the night.

Ultra long-acting insulin doses should only be adjusted once every 4 days. Missed doses may be taken when you remember if at least 8 hours have passed since the previous dose.

Mixtures of insulin can sometimes be combined in the same syringe, for example, intermediate-acting and rapid- or short-acting insulin. Not all insulins can be mixed together.

For convenience, there are premixed rapid- and intermediate-acting insulin. The insulin will start to work as quickly as the fastest-acting insulin in the combination. It will peak when each type of insulin typically peaks, and it will last as long as the longest-acting insulin. Examples include:

  • 30% regular and 70% NPH (Humulin 30/70, Novolin ge 30/70).
  • 50% lispro and 50% lispro protamine (Humalog Mix 50).
  • 25% lispro and 75% lispro protamine (Humalog Mix 25).
  • 30% aspart and 70% aspart protamine (NovoMix 30).

References

Citations

  1. Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Types of insulin. Canadian Journal of Diabetes, 42(Suppl 1): S314. DOI: 10.1016/j.jcjd.2017.12.006. Accessed November 16, 2018.

Other Works Consulted

  • Insulin degludec injection (2015). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/MonoDisp.aspx?monoid=fandc-hcp19982&book=DFC&fromtop=true&search=580363%7c24&isStemmed=True&asbooks=. Accessed December 30, 2015.
  • Insulin detemir injection (2014). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/PrintMonoDisp.aspx?id=fandc-hcp14499&sections. Accessed May 13, 2015.
  • Insulin glargine (rDNA origin) injection (2015). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/PrintMonoDisp.aspx?id=fandc-hcp12721&sections. Accessed May 13, 2015.
  • Insulin glulisine (rDNA origin) injection (2014). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/PrintMonoDisp.aspx?id=fandc-hcp13023&sections. Accessed May 13, 2015.
  • Insulin isophane (NPH)/insulin regular injection (2013). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/PrintMonoDisp.aspx?id=fandc-hcp12321&sections. Accessed May 13, 2015.
  • Insulin isophane injection (2014). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/PrintMonoDisp.aspx?id=fandc-hcp12320&sections. Accessed May 13, 2015.
  • Insulin lispro injection (2014). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/PrintMonoDisp.aspx?id=fandc-hcp12722&sections. Accessed May 13, 2015.
  • Insulin regular (human) inhalation (2015). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/PrintMonoDisp.aspx?id=fandc-hcp19696&sections. Accessed May 13, 2015.
  • Insulin regular (human) injection (2015). Facts and Comparisons eAnswers. http://online.factsandcomparisons.com/PrintMonoDisp.aspx?id=fandc-hcp12645&sections. Accessed May 13, 2015.

Credits

Adaptation Date: 8/18/2021

Adapted By: Alberta Health Services

Adaptation Reviewed By: Alberta Health Services

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