It is important to understand that there are different types of Insulin. Insulin as a medication that is used to treat Diabetes and some other conditions. There are many different types of insulin dependent on what is needed for treatment.

Insulin can be created in a lab and is engineered from the Pancreas of pigs or cows. The process is intense and effective.

Insulin, as a medication, can be essential for treatment in those with Diabetes.

As a medication, Insulin is relatively safe for use during Pregnancy.  This means little to no side effects to the fetus and largely no change in blood sugar.

Uses:

–  Type I Diabetes
–  Type II Diabetes
–  Gestational Diabetes
–  Diabetic Ketoacidosis
–  Hyperosmolar Hyperglycemic States
–  Others – often currently being studied for a variety of areas. (Far less common use)
.  Wound healing
.  Body building
.  Cancer treatment
.  Management of Shock
. Others

Onset of Action for People with Diabetes

1.)  Rapid Acting

–  Taken before or just after a meal
–  Covers the elevated glucose associated with eating
–  Also used to drop BS when abnormally high
–  Begins working: 10-30 minutes
–  Peak: 30 minutes – 3 hours
–  Duration: 3-5 hours
–  Insulin Types: Humalog, Novolog, Apidra

2.)  Short Acting

–  Taken 30 minutes before a meal
–  Covers the elevated glucose associated with eating
–  Begins working: 30-60 minutes
–  Peak: 2-5 hours
–  Duration: up to 12 hours
–  Insulin Types: Regular

3.)  Intermediate Acting

–  Taken before meals or after
–  Covers the elevated glucose between meals
–  Helps after rapid acting stops working
–  Usually taken twice a day along with rapid or short acting
–  Begins working: 90 minutes – 4 hours
–  Peak: 4-12 hours
–  Duration: up to 24 hours
–  Insulin Types: NPH

4.)  Long Acting

–  Typically given at night only
–  Some patients take twice a day – Morning and at night
–  Covers the elevated glucose throughout the day
–  Used with rapid or short acting medications
–  Begins working: 30 minutes – 4 hours.
–  Peak: Minimal Peak
–  Duration: up to 12 hours
–  Insulin Types: Lantus and Levemir

Insulin Types

1.)  Insulin Aspart (Novolog)

–  Rapid Acting
–  Marketed by Novo Nordisk
–  Manufacture reports that it lasts 28 days without refrigeration

2.)  Insulin Lispro (Humalog)

–  Rapid Acting
–  Similar to Novolog but different Manufacture

3.)  Regular Insulin (Novolin R, Humulin R)

–  Short Acting
–  Neutral or Soluble insulin
–  Novolin – created by one manufacture
–  Humulin – created by another manufacture

4.)  NPH Insulin (Novolin N, Humulin N)

–  Intermediate Acting
–  Isophane Insulin
–  Used typically twice a day

5.)  Insulin detemir (Levemir)

–  Long Acting
–  Marketed under Novo Nordisk

6.)  Insulin glargine  (Lantus, Basaglar, Toujeo)

–  Long Acting
–  Lantus – made by Sanofi Aventis
–  Basaglar – made by Eli Lilly
–  Toujeo – made by Sanofi Aventis (newer than Lantus)

7.)  Insulin degludec (Tresiba)

–  Ultra Long Acting
–  Developed by Novo Nordisk
–  Can last up to 42 hours

8.)  Premixed Insulin 70/30 (70%N and 30%R) and 50/50 (50% N and 50%R)

–  Humulin 70/30 (Insulin isophane and insulin regular)
–  Intermediate and short acting combined together
–  Humalog 50/50 (Insulin lispro protamine suspension and insulin lispro injection)

9.)  Insulin glulisine (Apidra)

–  Rapid Acting
–  Developed by Sanofi-Aventis

Side Effects:

–  Low Blood Sugar
–  Pain at injection site
–  Redness at injection site
–  Swelling at injection site
–  Low blood potassium
–  Allergic Reactions

Method of Administration

Subcutaneous

–  Insulin is typically given by subcutaneous injections.
–  This could be by a single needle or insulin pens

Insulin pump

–  Are like electrical injectors attached to implanted catheter or cannula
–  A pump controls, process the insulin given
–  There is a reservoir to hold the insulin
–  Through the cannula, the insulin is given under the skin (subcutaneous)
–  Allows for less “daily sticking” of needles

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