Types Of Insulin : Latest Update on Insulin

 Types of Insulin: An Overview

Introduction:

Insulin is a hormone that plays a vital role in regulating blood sugar levels in the body. It enables cells to absorb glucose from the bloodstream and convert it into energy. People with diabetes, who either do not produce enough insulin or have developed insulin resistance, often require external insulin therapy. There are various types of insulin available, each with specific characteristics and purposes. In this note, we will discuss the ten main types of insulin.

1. Rapid-acting insulin:

Rapid-acting insulin, also known as mealtime or bolus insulin, is characterized by its quick onset of action, typically within 15 minutes. It is intended to be taken just before or after a meal to handle the glucose released during digestion. Examples of rapid-acting insulin include insulin lispro, insulin aspart, and insulin glulisine.

2. Short-acting insulin:

Short-acting insulin, also referred to as regular insulin or soluble insulin, is the traditional form of insulin. It takes effect within 30 minutes to an hour after injection and lasts for up to 8 hours. Short-acting insulin is often used in combination with intermediate- or long-acting insulin. Regular human insulin is an example of short-acting insulin.

3. Intermediate-acting insulin:

Intermediate-acting insulin starts working within 1 to 2 hours, peaking in effectiveness between 4 to 12 hours after injection. The effects usually last up to 24 hours. It is commonly used to manage blood sugar levels between meals and during sleep. Examples of intermediate-acting insulin are NPH (Neutral Protamine Hagedorn) insulin and Lente insulin.

4. Long-acting insulin:

Long-acting insulin, also known as basal insulin, has a slow and steady release that mimics the continuous low level of insulin secretion by the pancreas. It starts working within 1 to 2 hours after injection and can last up to 24 hours or beyond. These insulins provide a baseline level of insulin throughout the day and night. Examples include insulin glargine and insulin detemir.

5. Mixed insulin:

Mixed insulin combines both short- or rapid-acting insulin and intermediate-acting insulin in one preparation. It aims to cover both immediate blood sugar needs post-meals and the basal insulin requirements throughout the day. This type of insulin is available in different ratios, such as 70-30, 75-25, or 50-50. Examples include Humalog Mix 75/25 and Novolin 70/30.

6. Inhaled insulin:

In recent years, inhaled insulin has emerged as an alternative to injectable insulin. It is delivered through a small inhaler device instead of using a needle and syringe. Inhaled insulin acts rapidly, similar to rapid-acting insulin. However, it may not be suitable for all patients and is not considered a replacement for injectable insulin. Afrezza is an example of inhaled insulin.

7. Premixed insulin:

Premixed insulin is a combination of different types of insulin, typically a rapid- or short-acting insulin with an intermediate-acting insulin. These preparations provide a simpler dosing regimen by eliminating the need for mixing insulins independently. They are convenient for people who require both basal and mealtime insulin in fixed ratios. Examples include Humalog Mix 75/25 and Humulin 70/30.

8. Basal-bolus insulin regimen:

Basal-bolus insulin regimen involves combining long-acting insulin to provide the basal insulin requirement and rapid-acting insulin for mealtime coverage. This regimen provides more flexibility in matching insulin doses to food intake and allows better blood sugar control. It is commonly used in type 1 diabetes but can also be employed in type 2 diabetes. 

9. Insulin pump therapy:

Insulin pumps are small devices that deliver a continuous basal infusion of rapid-acting insulin. They closely mimic the natural pattern of insulin release by delivering small doses throughout the day. Users can also program the device to deliver additional insulin at mealtimes. Insulin pump therapy offers increased flexibility, precision, and convenience. 

10. Ultra-rapid insulin:

Ultra-rapid insulin is a recently developed type of insulin that has an exceptionally fast onset of action. It can start working within minutes, which is beneficial for those who desire even quicker insulin absorption to match their mealtime needs. This type of insulin is still under development and not yet widely available.

Conclusion:

The ten types of insulin mentioned above provide a range of options to manage blood sugar levels in individuals with diabetes. They vary in terms of onset, duration, and method of administration, allowing for personalized treatment plans. It is crucial to consult with a healthcare professional to determine the most suitable type and regimen for each patient based on their specific needs and lifestyle.

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