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Dr. Andrew Rynne

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Article Home Adult and Senior Health Types of insulin

Types of insulin

There are four main types of insulin they are short acting, rapid acting, intermediate and long acting insulin. Regular and intermediate insulin?s are referred as human insulin?s. Rapid and long acting insulin?s are chemically modified forms of human insulin.

 

 

Insulin preparations

The primary indication of insulin is in type I diabetes mellitus and gestational diabetes.

If Antidiabetic medications fail, insulin therapy may be necessary – usually in addition to oral medication therapy – to maintain normal or near normal glucose levels.

Types of insulin

Types of insulin

Examples (Brand names)

Onset in (hr)

Peak (hr)

Duration (hr)

Rapid acting insulin

Aspart, Glulisine, Lispro

0.2 - 0.5

0.5 - 2

3 - 4

Short acting insulin

Regular

0.5 - 1

2 - 3

6 - 8

Short acing insulin

Velosulin

0.5 - 1

2 - 3

2 - 3

Intermediate acting

NPH

1.5

4 - 10

16 - 24

Intermediate acting

Lente

1.5 – 3

7 – 15

16 - 24

Long acting

Ultralente

3 - 4

9 – 15

22 -24

Long acting

Levimer

1 - 2

6 – 8

Up to 24

Long acting

Lantus

1 - 2

No peak

20 – 24 P

Premixed

Humulin 70/30

0.5

2 - 4

14 – 24

Premixed

Humulin 50/50

0.5

2 - 5

18 - 24

Premixed

Humalog 75/25

0.2

0.5 – 2.5

16 – 24


Protocol for insulin therapy

Bed time NPH or Glargine insulin with anti diabetic medications, start 10- 15 units and titrate the fasting glucose to 120 mg/dl.

For twice day insulin start 0.5 U/kg with 2/3 in morning and 2/3 as NPH, to give insulin 20-30 min before meals.

For 2 or more injections daily, add Metformin or glitazone, if total insulin dosage exceeds >1-2 U/kg


Glycemic goals

  • Self monitoring of glucose
  • Laboratory monitoring of glucose

 

Test

Blood glucose (FBS, PPBS)

HbAIc

Lipid profile

DM with insulin treatment

Depends on blood glucose level

Every 3 months

yearly

DM without insulin treatment

Every 3 months

Every 3-6 months

yearly

 

Types of insulin syringes

  • Normal insulin syringes: size ranging from 28-31 gauge.
  • Insulin pens or pen injections: these look like pens with cartridges which are filled with insulin.
  • Jet injectors: The jet injectors use high pressure air to send a find spray of insulin through the skin. These devices have no needles.
  • Insulin pumps: Insulin pumps are small sized pumping devices worn outside the body.