Insulin is a hormone that is produced by the pancreas and helps the body to use glucose, also called blood sugar, for energy. Diabetes is a chronic disease in which the body does not make or use insulin properly, which means if you have diabetes, you may need to take insulin to control your blood sugar levels. There are many different types of insulin, and each type has its own characteristics, strengths, and uses. In this article, we will discuss the different types of insulin and how they are used to treat diabetes so you can be informed when discussing with your doctor or healthcare team which one is right for you.
What is insulin?
The hormone insulin helps your body use glucose for energy. When you have diabetes your body either does not make enough insulin or cannot use insulin properly, which is called insulin resistance. Insulin therapy can help your diabetes by controlling your blood glucose level although it is not the only treatment option for certain forms of diabetes. When left untreated, diabetes can cause high blood pressure, cardiovascular disease, kidney damage, as well as other medical conditions.
Your body produces insulin in your pancreas using cells called beta cells and it is used to help regulate your metabolism of carbohydrates, fats, and protein. When you digest food or drink, they break down into different components, one of them being glucose. The glucose then gets absorbed into your bloodstream and your body responds by releasing insulin which takes the glucose from your bloodstream and allows your cells to use it for energy. However, if there is any excess glucose it will be stored in your fat tissue, liver, or muscles.
How does insulin help treat diabetes?
There are three common types of diabetes: type 1, type 2, and gestational diabetes. Type 1 diabetes is when your body does not produce insulin at all and it is usually diagnosed in children or young adults. If you have type 1 diabetes you will need to take insulin for the rest of your life usually through an insulin injection or insulin pump. Type 2 diabetes is when your body does not use insulin properly, which is called insulin resistance, and it is the most common form of diabetes. Type 2 diabetes does not require you to take insulin although it may be necessary in some cases. Gestational diabetes is when you have high blood sugar levels during pregnancy; however, your body will usually return to normal after your baby is born and insulin therapy is not usually needed.
Characteristics of insulin
There are three different characteristics of insulin which are classified by how long they work. The onset describes how long it takes for insulin to start lowering your blood sugar. The peak is when insulin is at its highest level of effectiveness. Lastly, the duration describes how long the insulin will continue to work.
What are the different types of insulin?
Different types of insulin have different onsets, peaks, and durations. The types of insulin include:
Rapid-acting insulin has a fast onset, usually within 15 minutes after injection, a peak of around 1 to 2 hours, and a short duration of around 2 to 4 hours. Examples of rapid-acting insulin brands include:
- Fiasp and NovoRapid (insulin aspart)
- Humalog, ADMELOG, Lyumjev (insulin lispro)
- Apidra (insulin glulisine)
Short-acting insulin has an onset of 30 to 60 minutes, has a peak of 2 to 3 hours, and a duration of 3 to 6 hours. Popular brands of short-acting insulin include:
- Humulin R, Novolin R, Velosulin R, Actrapid (insulin human regular)
Intermediate-acting insulin has an onset of 2 to 4 hours after injection, a peak time of 4 to 12 hours, and a duration of 12 to 18 hours. Examples of common intermediate-acting insulin include:
- Humulin N, Novolin N, ReliOn (neutral protamine Hagedorn insulin also called NPH insulin or isophane insulin)
Long-acting insulin has an onset of several hours (slower than short-acting insulin), does not have a peak as it works relatively evenly over time, and can last for 24 hours or more. Some types of long-acting insulin include:
- Toujeo, Lantus, Basaglar (insulin glargine)
- Levemir (insulin detemir)
- Tresiba (insulin degludec)
Ultra long-acting insulin
There is one type of ultra long-acting insulin that has an onset of 6 hours or more, does not have a peak while working relatively evenly over time, and can last for 36 hours or more. The only type of ultra long-acting insulin available on the market is:
- Toujeo Max SoloStar (U-300 insulin glargine)
There are also premixed insulins that contain a combination of short-acting and intermediate or long-acting insulin. The most common types of premixed insulin include:
- Humalog Mix 75/25 (containing 75% NPH insulin and 25% insulin lispro)
- Novolog Mix 70/30 (containing 70% NPH insulin and 30% insulin aspart)
- Humulin 70/30 (containing 70% NPH insulin and 30% insulin human regular)
- Novolin 70/30 (containing 70% NPH insulin and 30% insulin human regular)
Afrezza is an inhaled insulin that has a rapid onset, usually within 12 to 15 minutes, a peak of 30 minutes, and a duration of 3 hours.
What are the different insulin strengths?
Insulin is available in different strengths, which are measured in units. One unit of insulin will raise your blood sugar by approximately 35 mg/dl when injected under the skin. For example, the insulin strength may be listed as U-300, which means there are 300 units of insulin per milliliter of fluid. U-100 is now the standard in the U.S. and the strengths range up to U-500. Please talk to your doctor about the right dose of insulin for you.
How do I take insulin?
Unlike other medicines, insulin is not available through oral medication or pill. However, insulin is available in different forms including:
- Insulin pens which are prefilled with an insulin cartridge and come with a needle that attaches to the pen
- Insulin pumps which are small, computerized devices that deliver insulin through a catheter placed under the skin
- Insulin syringes which are insulin shots with a needle that is used to inject insulin under the skin
- Insulin inhalers which are a new way to take insulin with an inhaler
Which insulin do I take for my diabetes?
The type of insulin you need to take depends on many factors including:
- The type of diabetes you have
- How well your body controls blood sugar levels with diet and exercise
- Whether you have other health problems
Your doctor will work with you to determine which types of insulin are best for your individual needs. You may need to take more than one type of insulin.
If you have type 1 diabetes, you will need to take insulin. If you have type 2 diabetes and your pancreas still makes some insulin, you may be able to control your blood sugar with diet and exercise alone or with oral medicines.
Insulin is a hormone that helps the body use sugar for energy and is used to treat diabetes. There are different types of insulin available, which vary in terms of onset, peak, and duration and the type of insulin you need will depend on your individual situation. Insulin is available in different forms, including an insulin pen, pump, syringe, and inhaler and your insulin dose will be prescribed by your doctor. You may need to take more than one type of insulin to effectively manage your diabetes. If you have any more questions, please talk to your doctor, healthcare professional, or diabetes management team to determine the best treatment plan for you.
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