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Types of Insulin: What to Use and When?

Syringe-insulin

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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

  • Apidra/Humalog/NovoRapid

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

  • Humulin-R/Toronto

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

  • Humulin-N/NPH

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
analogues

  • Lantus
  • Levemir

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

  • Humulin 30/70 and Novolin ge 30/70, 40/60, 50/50

Varies according to types of insulin

Contains a
fixed ratio of
insulin (% of
rapid-acting or short-acting insulin to % of intermediate-acting insulin): See above
for information about
peak actions based
on insulin contained

N/A

Given with one or more meals per day. Should be injected 30-45 minutes before the start of the meal.

Premixed insulin
analogues

  • NovoMix 30 and Humalog Mix 25, Mix 50

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 May 25th, 2017.

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 Last accessed: June 15th, 2017

NACO/LFS/0517/0377a(1)