Types of Insulin: What to Use and When?
What’s the difference between the different types of insulin? Long-acting, short-acting, premixed, learn more about all three.
You may have a lot of questions as you begin insulin therapy. What are the different types of insulin available? Which should I be using and when? Insulins differ based on 3 key factors: 1
- how quickly they work
- when they peak
- how long they last (duration)
This table compares these factors in the types of insulin available:2
| Type | Onset (How quickly it starts working) | Onset (What it is most effective) | Duration (How long it works) | Timing of injection (When it should be given) |
|---|---|---|---|---|
|
Bolus insulins |
||||
|
Rapid acting analogues
|
10-15 min |
1-2 hours |
3-5 hours |
Given with 1 or more meals per day. To be given 0-15 minutes before or after meals. |
|
Short-acting
|
30 min |
2-3 hours |
6.5 hours |
Given with one or more meals per day. Should be injected 30-45 minutes before the start of the meal. |
|
Basal Insulins |
||||
|
Intermediate-acting
|
1-3 hours |
5-8 hours |
Up to 18 hours |
Often started once daily at bedtime. May be given once or twice daily. Not given at any time specific to meals. |
|
Long-acting
|
90 min |
N/A |
Lantus: Up to 24 hours
Levemir: 16-24 hours |
Often started once daily at bedtime. Insulin detemir (Levemir) may be given once or twice daily. Not given at any time specific to meals. |
|
Premixed Insulins |
||||
|
Premixed regular insulin
|
Varies according to types of insulin |
Contains a |
N/A |
Given with one or more meals per day. Should be injected 30-45 minutes before the start of the meal. |
|
Premixed insulin
|
Varies according to types of insulin |
N/A |
Given with one or more meals per day. Should be injected 0-15 minutes before or after meals |
|
The optimal insulin therapy is considered to be a basal-bolus regimen or insulin pump therapy. In a basal-bolus regimen, basal insulin is provided by an intermediate- or long-acting insulin analogue taken once or twice daily. Bolus insulin is provided by a rapid-acting insulin analogue taken at each meal. However, your insulin regimen will depend on your specific needs. It can change over time. You and your healthcare team will determine what is right for you. Your insulin plan includes:
- How to take it (syringe, pen or pump)
- How often to take each type of insulin
- When to take each type
- How much to take (dose)
References:
1 American Diabetes Association. Insulin Basics. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-basics.html. Accessed September 30, 2018.
2 Canadian Diabetes Association. Insulin: Things you should know. Available at: http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/blood-glucose-insulin/getting-started-with-insulin. Accessed September 30, 2018.