Supplemental insulin, a manufactured version of a hormone produced naturally by the cells of the pancreas to regulate blood glucose (sugar) levels, is vital for managing type 1 diabetes (diabetes mellitus). It is also a treatment for gestational diabetes , a temporary form of the condition that can develop during pregnancy. Insulin may also be needed to treat type 2 diabetes in people who do not have enough lifestyle changes and oral medications to keep blood sugar stable.
There are more than 20 types of insulin sold in the United States, according to the American Diabetes Association (ADA). For healthcare providers, this means that there are many options to tailor treatment to the specific needs of patients. It also means that the prospect of taking insulin can seem overwhelming, if not intimidating, since insulin must be injected directly into the body. If you have been prescribed insulin for diabetes, it can help you understand the important role of the hormone in your health, as well as some of the main differences between types of insulin.
The importance of insulin
Insulin is produced by certain cells in the pancreas called beta cells . Its function is to help the body use or store glucose from carbohydrates in the diet. Glucose is essential for all bodily functions; circulates in the bloodstream and is consumed by cells for energy.
When the body does not produce insulin (as in type 1 diabetes) or when it becomes resistant to the correct use of insulin (as in gestational diabetes and type 2 diabetes), cells can no longer access the energy they need and glucose builds up in the blood, which can lead to a number of serious and even life-threatening consequences .
The pancreas produces insulin in two different ways:
- Basal insulin (sometimes called background insulin) regulates glucose between meals and is released 24 hours a day, whether the person is eating or not.
- The pancreas releases bolus insulin in direct response to food intake to control the immediate rise in blood glucose levels.
Types of insulin replacement
The different types of supplemental insulin are designed to replace bolus and basal insulin, in fact they differ in three characteristics:
- Onset: how much time elapses between taking insulin and its effect on blood sugar; the time interval between injection and when insulin begins to lower blood sugar levels.
- Duration: how long the insulin lasts after it takes effect.
- Peak: the point where insulin is at its maximum level.
The ADA lists five types of supplemental insulins: fast-acting, short-acting (sometimes called conventional), intermediate-acting, long-acting, and ultra-long-acting.
Short and fast acting insulin
Both types are used to replace the natural bolus insulin produced by the pancreas. Because they start to work quickly, they are used just before meals or snacks to compensate for the immediate glucose spike that occurs with meals .
There is only one type of intermediate-acting insulin on the market: Hagedorn Neutral Protamine (NPH). The duration of NPH can vary significantly, so people who use it often take a dose of regular or rapid-acting insulin to cover their food intake. NPH is also different from other types of insulin. In contrast to the clear liquid that characterizes short and fast acting insulins, NPH has a cloudy consistency caused by crystals of insulin in solution.
Long-acting and ultra-long-acting insulin
Intermediate, long-acting, and ultra-long-acting insulins are used to replace basal insulin in order to keep blood glucose levels constant throughout the day and night. They take effect about two hours after injection and are released slowly, peaking at four to eight hours after injection and last at least 24 hours .
Each type of insulin, as detailed here, can have more than one brand.
|Characteristics of the different types of insulin.|
|Insulin type||Onset (time taken to reach blood flow)||Duration||Top||Trademarks and Common Names|
|Fast acting||15 minutes||2 to 4 hours||After 1 hour||Apidra (insulin glulisine), Admelog, Humalong (insulin lispro), Fiasp, NovoLog (insulin aspart)|
|Short action||30 minutes||3 to 6 hours||2 to 3 hours||Humulin R, Novolin R, Velosulin R (normal for humans)|
|Intermediate action||2 to 4 hours||12 to 18 hours||4 to 12 hours||Humulin N, Novolin N, Relion (NPH)|
|Long acting||Reaches blood flow a few hours after injection.||24 hours or more||N / A||Tojeo (glargine u-300), Levemir (detemir), Basaglar, Lantus (glargine), Semgli (glargin-yfgn)|
|Ultra long action||6 o'clock||36 hours||N / A||Tresiba (degludek)|
Apart from these standard types of insulin, there are other options.
Premixed insulins , which combine varying amounts of medium-acting insulin with short-acting or rapid-acting insulin, are a convenient way to get the benefits of both types of insulin in a single injection . Its appearance lasts from 15 minutes to an hour, depending on the mixture. Peak hours vary and can last up to 24 hours .
There is also a form of insulin that can be inhaled called Afrezza (Insulin Inhalation System with Technosphere). Approved by the FDA in 2014, this is a fast-acting insulin that takes 12-15 minutes to work, peaks in about 30 minutes, and is cleared from the system after three hours.
Get the word of drug information
Knowing that you need to inject insulin to treat your diabetes can be difficult, but you can be sure that your healthcare provider will work closely with you to make sure that both your dose and the type of insulin they prescribe are right for your style. of life. It will also give you all the support you need to get used to taking insulin or using a pump, if that is the best option for you.