Types Of Insulin

Types of insulin

There are many different types of insulin with different profiles. The easiest way to think of these is as insulins which have different time spans over which they work and some which may have been mixed in varying proportions to give profiles of action of both.

  • Rapid Acting
  • Intermediate acting
  • Long acting

For each of these the are different types of insulin :

  1. An Insulin analog is an altered form of insulin, different from any occurring in nature, but still available to the human body for performing the same action. The insulin is made using the genetic sequence from human DNA which has been altered to alter absorption, duration of the effect etc.
  2. Insulins may also be derived from animals e.g. Pigs, Cows. These are not so used so much anymore. However, if you are well controlled these do not need to be changed unless this is limited by their production.

Time Profiles of insulins (in development)

Rapidly acting analogue e.g. Novorapid Aspart, Humalog Lispro.

  • Inject immediately before food
  • Onset may be within 15 minutes, duration 3-5 hours
  • Peak action 30-45 minutes

 

Short acting soluble insulin e.g. Actrapid, Humulin S

  • Injected 15-30 minutes before food
  • Onset 30-60 minutes, Duration 6-8 hours
  • Peak action 2-4 hours

Intermediate Human Isophane Insulin’s: Insulatard, Humulin I

Peak action 4-6 hours.Duration 14-16 hours

Long acting insulin e.g. insulatard

  • Onset 6-8 hours, Duration 24-36 hours
  • Can be administered as a once daily basal insulin.
  • No discenernable peak

Long acting analogue insulin e.g.lantus (glargine), Levemir® (insulin detemir [rDNA origin] injection)

Onset ~2hrs

Duration 18-24hrs


Lantus is a clear formula made with glargine, a genetically modified form of human insulin, dissolved in a special solution. Levemir is also a clear formula, but it contains dissolved detemir, a different form of genetically modified insulin.

Unlike glargine, detemir does not form a precipitate upon injection. Instead, detemir’s action is extended because its altered form makes it stick to itself in the subcutaneous depot (the injection site), so it’s slowly absorbed. Once the detemir molecules dissociate from each other, they readily enter the blood circulation, but there the added fatty acid binds to albumin.

More than 98 percent of detemir in the bloodstream is bound to albumin. With the albumin stuck to it, the insulin cannot function. Because it slowly dissociates from the albumin, it is available to the body over an extended period.

http://www.novonordisk.com/diabetes/levemir_splash.asp

http://www.novonordisk.co.uk/documents/home_page/document/index.asp

http://www.sanofi.co.uk/l/gb/en/layout.jsp?scat=4E9D46E4-0AE1-4CC9-8CBF-B8FAB8FB9EF4

Pre-mixed Human Soluble/Isophane: Mixtard 30, Humulin M3 etc

Mixtard 30, M3 refers to % of soluble insulin ie. 30% Soluble 70% Isophane

Onset: See above
Peak: See above
Duration: See above

Pre-mixed Analogues/Isophane: Novo Mix 30, Humalog M50 + M25

Pen Mix 30, M50/M25 refers to % of analogue insulin ie. 30% Analogue : 70% Isophane

Onset: See above
Peak: See above
Duration: See above

Activity of insulin

1 U deals with roughly 10 g of carbohydrate.

However we are all individuals and requirements vary between 0.4 and 0.8 U insulin/kg body weight.

Our requirements of insulin may vary according to :

  • when we ate, what we ate, what combination of foods we ate (fat slows down sugar absorption. This is not saying frequently eat fat as this is harmfuls !!)
  • our activity levels etc.

We need a some  insulin in the background with some peaks to manage our meals.

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