Diabetes Insulin

All type 1 diabetics and some people with type 2 diabetes need to take insulin to survive. Insulin is not just a single medication, however. Many types of insulin are available to suit the needs of individual diabetics. Your doctor will decide which of the insulin types is right for you based on many factors, including your:

  • Age
  • Blood sugar level targets
  • Body’s response to insulin (the time it takes for your body to absorb insulin, and how long it remains active)
  • Lifestyle (alcohol consumption, diet, exercise)
  • Willingness to monitor blood sugar levels frequently
  • Willingness to give yourself multiple daily injections.

As these factors change, it’s likely that the best types of insulin for you will change as well.

Where Does Insulin Come From?

Until recently, most types of insulin were made from the pancreas of pigs or cattle. More common now are synthetic insulin types, genetically engineered and structurally identical to those made by a functioning human pancreas. Because insulin is a protein destroyed by digestive enzymes, it must be taken by injection. However, many drug companies are currently working on developing inhaled insulin types.

Available Types of Insulin

There are many types of insulin, produced in different strengths and classified according to how fast they begin to work, how long until their action reaches its peak, and how long the effect lasts:

  • Rapid-Acting Insulin: Rapid acting insulin provides the insulin needed for food eaten at the time it is taken, and is generally prescribed along with long-acting insulin. Depending on the individual medication, rapid-acting insulin will begin to work within 10 to 30 minutes, with peak performance is in the 30 or 40 to 90 minute range, lasting for roughly three to five hours. The exceptions are Apidra or Glulisine–these rapid-acting insulin brands generally last for one to two and a half hours.
  • Short-Acting Insulin: Short-acting insulin products supply the insulin needed to process sugar from meals eaten within 30 to 60 minutes. Peak performance may range from two to five hours, with a total duration of five to eight hours. However, the short-acting insulin Velosulin is used with an insulin pump, and has a peak and duration time of only two to three hours.
  • Intermediate-Acting Insulin: Unlike other types of insulin, intermediate-acting insulin covers a diabetic’s needs overnight, or for about half of a day. These types of insulin are often prescribed along with short-acting insulin or rapid-acting insulin. Depending on the individual brand, onset is in one to two and a half hours, with peaks ranging from three to 12 hours, and a total duration of 18 to 24 hours.
  • Long-Acting Insulin: Long-acting insulins will care for a diabetic’s needs for approximately one whole day, and are often prescribed along with rapid-acting insulin or short-acting insulin. Depending on the individual brand, onset of long-acting insulin can be within 30 minutes to 3 hours, with peak ranges from six to 20 hours, and a duration of roughly 20 to 36 hours. Note that the long-acting insulin Lantus has no peak and delivers insulin at a steady level throughout its duration.
  • Pre-Mixed Insulin: These types of insulin are actually a combination of short-acting insulin and intermediate-acting insulin, prepared in a bottle or insulin pen. Pre-mixed insulin is usually taken twice a day before meals. Performance times vary depending on individual product brand.

Typically, the process of prescribing an insulin regimen requires several trial-and-error attempts. Continuous monitoring and close physical supervision and communication is strongly recommended.

Resources

Advmeg. (2010). How products are made: Insulin. Retrieved April 10, 2010, from http://www.madehow.com/Volume-7/Insulin.html.

Beaser, R. S.