An overview of the five types of supplemental insulin
In the previous post, I discussed the role of insulin and glucagon, as well as the two main types of insulin, basal and bolus. In this post, I will discuss supplemental insulin, how each type works and insulin brands.
There are more than 20 brands of supplemental insulin available in the United States. There are five types of brands: rapid acting, short acting, intermediate-acting, long-acting, and ultra long-acting. In addition to these categories, you can get premixed insulin or inhaled insulin as well.
Rapid-acting Insulin & Short-acting Insulin
To replace the natural bolus insulin produced by the pancreas, rapid-acting and short-acting insulins are used. These types of insulin are administered just before a meal or snack to counteract sugar spikes that are caused by eating.
In the medical world, short acting insulin is known as regular bolus insulin. Short-acting insulin begins to work within 30 minutes, reaches its peak between 2 and 3 hours, and lasts for 3 to 6 hours.
Examples of short-acting insulin:
- Humulin R
- Novolin R
- Velsulin R
Rapid-acting insulin, however, works the fastest of all types of supplemental insulin. In the case of rapid-acting insulin, onset occurs after 15 minutes, peak within an hour, and then lasts 2-4 hours.
Examples of rapid-acting insulin:
- Apidra (glulisine)
- Humalog (lispro)
- Fiasp (insulin aspart)
- Novolog (insulin aspart)
Intermittent-acting insulin replaces basal insulin. Only one type of intermediate insulin exists, Hagedorn or NPH. Within 2-4 hours, the onset occurs. Peak hours are between 4 and 12 hours and the duration varies from 12 to 18 hours. As a result, some people use short-acting or rapid-acting insulin to cover meals.
Examples of intermediate-acting insulin:
- Humulin N
- Novolin N
- ReliOn (NPH)
Long-acting Insulin & Ultra Long-acting Insulin
The long-acting and ultra-long-acting insulins are used to replace basal insulin by maintaining glucose levels throughout the day and night. They begin around four to six hours apart, but the duration is at least 24 hours. This type of insulin doesn’t have any peak points as it is designed to remain in the system for longer.
Examples of long-acting insulin:
- Toujeo (glargine u-300)
- Levemir (detemir)
- Lantus (glarine)
Example of ultra long-acting insulin:
- Tresiba (degludec)
In a premixed insulin injection, varying amounts of intermediate-acting insulin are combined with short-acting or rapid acting insulin. Depending on the mix, onset can take between 15 minutes and an hour. It peaks at varying times and lasts for up to 24 hours.
Examples of premixed insulin:
- Humulin 70/30, Novolin 70/30 and Humulin 50/50 are mixtures of intermediate and short acting insulin.
- Humalog Mix 75/25 and Novolog Mix 70/30 are mixtures of intermediate and rapid-acting insulin.
As far as we know, Afrezza is the only rapid-acting insulin that is inhaled. As soon as Afrezza is inhaled, it begins to take effect within 12 to 15 minutes, peaks in around 30 minutes, and dissipates around 3 hours after taking it.
SOUND OFF: What type of insulin are you currently using? Let’s have a conversation and comment below!
Until Next Time,
The Genetic Diabetic
American Diabetes Association: Insulin Basics