Types of insulins- Insulin onset, peak and duration vary ...



insulin Analogs

|TYPE OF INSULIN | Made by |Starts to work in |Works most |Lasts: |Best time to take |

| |

|RAPID-ACTING INSULINS (used to cover carbs and to lower high blood glucose) |

|Novolog |Novo |5-10 minutes |1-3 hours |3-5 hours |Take 5-15 minutes before meal. Can be adjusted |

|aspart |Nordisk | | | |based on carb count. |

| | | | | |Have a plan for missed meal doses. |

| | | | | |U200 pen holds 600 units. |

|Apidra |Sanofi |15 minutes |30-90 minutes |3-5 hours | |

|Glulisine | | | | | |

|Humalog |Lilly |15 minutes |30 –90 minutes |4-5 hours | |

|Lispro | | | | | |

|Humalog U200 |Lilly |15 minutes |30 –90 minutes |4-5 hours | |

|Kwikpen | | | | | |

| |

|LONG-ACTING INSULINS (BASAL/BACKGROUND)can take at same time as mealtime |

|Levemir |Novo |1 ½ hr |Little or no peak |Up to 24 hours |Do not mix with other insulin in same syringe |

|Detemir | | | | |Usually 2xday, doesn’t need to be 12 hrs apart |

|Lantus |Sanofi | | |Up to 24 hours |Do not mix with other insulin in same syringe |

|(solostar pen) | | | | |Occasionally sting because of pH |

|Glargine | | | | |Usually once a day, morning or evening. If 2xday, |

| | | | | |doesn’t need to be 12 hrs apart |

|Basaglar |Lilly | | | | |

|Kwikpen | | | | | |

|Glargine | | | | | |

|Dec 2016 | | | | | |

|Biosimilar | | | | | |

|Toujeo |Sanofi | | |36 hours |Pen holds 450 units. |

|Glargine | | | | |Once a day same time. Stable room temp for 42 days. |

|U300 | | | | |Adjust 3-4 days apart |

|Tresiba Flexpen |Novo | | |36 hours |Once a day same time. U 100, dials to 80 or U 200 |

|Degludec | | | | |dials to 160. Stable room temp for 56 days. Adjust |

| | | | | |3-4 days |

| |

|PREMIXED INSULIN Analogs |

|Novolog Mix 70/30 |10-20 minutes |1-3 ¾ |Up to 24 hours |Taken 2-3 times a day, before meals. |

|Aspart protamine suspension with aspart | |hours | | |

|Humalog Mix 75/25 |15-30 minutes |30 minutes to 2 ½ |14-24 hours | |

|Lispro protamine suspention with lispro | |hours | | |

Other Insulins

| |

|Short acting insulin |

|Humulin R |Lilly |30 |80minutes |5-7 hours |Usually taken 30 minutes |

|regular U100 | |minutes |-2 hours | |before meal. Can mix with NPH |

|Novolin R |Novo |30 |80minutes |8 hours | |

|Regular U100 |Nordisk |minutes |-2 hours | | |

| |

|Intermediate Acting Insulin |

|Humulin N |Lilly |90 |4-12 hrs |Up to 24 |Cloudy’ |

|NPH | |minutes | | |Roll 20 times to mix. |

| | | | | |Can be mixed in same syringe |

| | | | | |with Regular. |

| | | | | |Increased risk of nocturnal hypoglycemia |

|Novolin N |Novo | | | | |

| |Nordisk | | | | |

| |

|Premixed R with N |

|Humulin 70/30 |70%N |Novolin 70/30 |Cloudy, roll to mix. Usually taken 30 minutes before meal with breakfast |

|Humulin 50/50 |30%R | |and dinner. Less flexibility. Increased risk of nocturnal hypoglycemia |

| |

|Other insulins |

|Afreeza inhaled | |5 minutes |Available in 4 or 8 units color coded. Refrigerated good to expiration date. Room temperature |

| | |Before |and in sealed foil |

| | |meal |package, use within 10 days. Opened foil use within 3 days. |

| | | |PFT’s initial and yearly. |

| | | |Contraindicated in smokers, COPD. Not for DKA |

|Humulin R |2-3 times day before |Use of tuberculin syringe recommended. |

|U500 vial |Meals, onset 30 |Explain amount in both volume and unit |

|Or new pen, 5 unit |minutes but long |markings. Actual dose of U500 does not |

|increments |variable |equal markings on U 100 syringe. See dosing tables. |

| |duration up to 24hrs |Cost $1200 bottle. Stable 40 days room temp |

| | |Pen holds 1500 units. 2/pack |

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