Understanding the different types of insulin and their onset, peak, and duration of action is crucial for managing diabetes effectively. The following chart provides a comprehensive overview of the various insulin types, their characteristics, and how they can be used to tailor a diabetes management plan to an individual’s specific needs.
Rapid-Acting Insulins
- Onset: 15 minutes to 1 hour after injection
- Peak: 1 to 3 hours after injection
- Duration: 3 to 5 hours
- Examples:
- Humalog (Insulin Lispro): Begins working within 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours.
- Novolog (Insulin Aspart): Starts working in about 15 minutes, peaks in 1 to 3 hours, and has effects for about 3 to 5 hours.
- Apidra (Insulin Glulisine): Begins to work in 15 minutes, peaks in about 1 hour, and lasts for approximately 2 to 4 hours.
- Fiasp (Insulin Aspart): A faster-acting formulation of Novolog, starts working in about 15 minutes, peaks in 1 to 3 hours, and lasts for around 3 to 5 hours.
Short-Acting Insulins
- Onset: 30 minutes to 1 hour after injection
- Peak: 2 to 3 hours after injection
- Duration: 3 to 6 hours
- Examples:
- Humulin R (Regular Insulin): Begins to work in about 30 minutes, peaks between 2 to 3 hours after injection, and has effects for approximately 3 to 6 hours.
- Novolin R (Regular Insulin): Similar to Humulin R, starts working in about 30 minutes, peaks in 2 to 3 hours, and lasts for 3 to 6 hours.
Intermediate-Acting Insulins
- Onset: 1 to 2 hours after injection
- Peak: 4 to 12 hours after injection
- Duration: 12 to 18 hours
- Examples:
- NPH (Neutral Protamine Hagedorn) Insulin (Novolin N, Humulin N): Begins working in about 1 to 2 hours, peaks in 4 to 12 hours, and has an effect for about 12 to 18 hours.
Long-Acting Insulins
- Onset: 2 to 4 hours after injection
- Peak: Minimal peak, steady effect
- Duration: 20 to 42 hours
- Examples:
- Lantus (Insulin Glargine): Begins working within 2 hours and keeps a steady level of activity over 24 hours with little peak.
- Levemir (Insulin Detemir): Starts working in 2 hours, has a flat, steady effect, and lasts about 20 hours.
- Toujeo (Insulin Glargine U300): A more concentrated form of Lantus, starts working within 2 hours, has a minimal peak, and lasts for approximately 42 hours.
- Basaglar (Insulin Glargine): Similar to Lantus, begins working in about 2 hours and has a steady effect over 24 hours.
Ultra-Long-Acting Insulins
- Onset: 2 to 4 hours after injection
- Peak: Minimal peak, steady effect
- Duration: Beyond 42 hours
- Examples:
- Tresiba (Insulin Degludec): Starts working within 1 hour, has a flat effect, and lasts for more than 42 hours.
Premixed Insulins
- Onset, Peak, and Duration: Varies depending on the specific combination of insulins
- Examples:
- Humalog Mix 75⁄25 (Insulin Lispro Protamine/Insulin Lispro): Combines 75% insulin lispro protamine (NPL component similar to NPH) and 25% insulin lispro, starts working in about 15 minutes, peaks between 1 to 4 hours, and has an effect that lasts 12 to 18 hours.
- Novolog Mix 70⁄30 (Insulin Aspart Protamine/Insulin Aspart): Contains 70% insulin aspart protamine and 30% insulin aspart, starts working in 15 minutes, peaks between 1 to 4 hours after injection, and lasts 12 to 18 hours.
Understanding the pharmacokinetics of these insulin types is essential for optimizing glycemic control. The variability in onset, peak, and duration among the different types of insulin allows for personalized treatment plans that can be tailored to an individual’s lifestyle, diet, and specific needs.
