What Are The 5 Types Of Insulin

What Are The Side Effects Of Insulin

Hypoglycemia is the most common side effect that may occur during insulin therapy. Symptoms of hypoglycemia include:

• Loss of consciousness

Patients may experience blurred vision if they have had elevated blood sugar levels for a prolonged period of time and then have the elevated levels rapidly brought to normal. This is due to a shift of fluid within the lens of the eye. Over time, vision returns to normal. Other side effects that may occur include headaches, skin reactions , worsening of diabetic retinopathy, changes in the distribution of body fat , allergic reactions, sodium retention, and general body swelling. Insulin causes weight gain and may reduce potassium blood levels. In addition to these side effects, inhaled insulin may cause throat pain or irritation and cough and patients should inform their healthcare professional of any unresolved symptoms affecting the lungs for follow up.

Different Types Of Insulin

Insulin is the medication used to manage type 1 and, in some cases, type 2 diabetes.

There are several things you should know about insulin.

• Insulin is a hormone that lowers glucose in your blood.
• Injected or inhaled insulin replaces what the body makes naturally. People with type 1 diabetes must take insulin to survive.
• About half the people with type 2 diabetes will need to take insulin at some point in their lives. Taking insulin doesnt mean youve failed your body may just need extra help.
• Insulin is safe and one of the most effective ways to lower blood glucose. It is measured in units just as milk is measured in pints and quarts.
• Insulin is made in different strengths. Most people use a strength called U-100.
• Insulins come in several different types. Some are faster-working and last for a shorter period of time while others are slower-working and last for a longer period of time.
• Different companies make different types of insulin. Always use the same brand and type of insulin that your provider has prescribed.
• Different injection sites may absorb some types of insulin at faster or slower rates.
• The main side effect of insulin is that it can cause low blood glucose levels. Knowing how to recognize and treat lows is an important part of taking insulin

Types of Insulin

All insulin is not the same. The types of insulin differ in:

• how fast they begin to work
• when they work their hardest
• how long they continue to work
• how is it being administered

Identifying Different Types Of Insulin

Most insulin types fall into one of four main groups. According to The Art and Science of Diabetes Care and Education, 5th Edition, these groups are as follows:

• Rapid-acting insulin takes about five to 15 minutes after injection to enter the bloodstream, has a peak time of roughly 3090 minutes, and has a duration of fewer than five hours.
• Short-acting insulin typically takes about 3060 minutes after injection to take effect, has a peak time of two to three hours, and has a duration of five to eight hours.
• Intermediate-acting insulin enters the blood stream between two to four hours after injection, has a peak time of anywhere from four to 10 hours, and has a duration of 1016 hours.
• Basal insulin starts to work several hours after injection and can lower blood glucose levels over a roughly 24-hour period.

Rapid- and short-acting insulin types are also known as bolus insulin or meal-time insulin. Basal insulin is sometimes referred to as long-acting insulin or background insulin.

Premixed insulin combines two types of insulin within a vial or insulin pen. Your healthcare professional may recommend premixed insulin if you have a vision impairment, poor dexterity, or have a difficult time getting an accurate dosage when drawing insulin from two separate vials.

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Comparing Human Insulin And Insulin Analogues

Insulin analogues were introduced to the market in the 1990s. Compared to human insulin, they start lowering blood sugar somewhat sooner after being injected. For many years now there has been a debate about whether people with diabetes benefit from this. But research has not found any to suggest they do.

If, for instance, a particular type of insulin were shown to prevent complications caused by poorly controlled blood sugar levels, that type of insulin would offer a clear advantage. It would also be an advantage if the insulin prevented strong fluctuations in blood sugar levels that lead to noticeably low or high blood sugar . Or if it made it easier for people to follow their daily treatment plan. But studies in this area suggest that insulin analogues and human insulin are equally effective in the treatment of diabetes.

How Are Doses Scheduled

Follow your doctor’s guidelines on when to take your insulin. The time span between your shot and meals may vary depending on the type you use.

In general, though, you should coordinate your injection with a meal. You want to time your shot so that the glucose from your food gets into your system at about the same time that the insulin starts to work. This will help your body use the glucose and avoid low blood sugar reactions. From the chart on page 1, the “onset” column shows when the insulin will begin to work in your body. You want that to happen at the same time you’re absorbing food. Good timing will help you avoid low blood sugar levels.

• Rapid acting insulins: About 15 minutes before mealtime
• Short-acting insulins: 30 to 60 minutes before a meal
• Intermediate-acting insulins: Up to 1 hour prior to a meal
• Pre-mixed insulins: Depending on the product, between 10 minutes or 30 to 45 minutes before mealtime

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What Are The 6 Different Types Of Insulin

If you need insulin, your doctor will recommend a specific type depending on your lifestyle, the type of diabetes you have, and your blood sugar levels at different times of the day. You may need more insulin coverage at mealtimes, overnight, or throughout the entire day. Currently, there are 5 types of injectable insulins and 1 inhaled insulin.

Types of insulin and how they work in your body

Insulin A To Z: A Guide On Different Types Of Insulin

Elizabeth Blair, A.N.P., at Joslin Diabetes Center, helps break down the different types of insulin and how they work for people with diabetes. Types of Insulin for People with Diabetes Rapid-acting: Usually taken before a meal to cover the blood glucose elevation from eating. This type of insulin is used with longer-acting insulin. Short-acting: Usually taken about 30 minutes before a meal to cover the blood glucose elevation from eating. This type of insulin is used with longer-acting insulin. Intermediate-acting: Covers the blood glucose elevations when rapid-acting insulins stop working. This type of insulin is often combined with rapid- or short-acting insulin and is usually taken twice a day. Long-acting: This type of insulin is often combined, when needed, with rapid- or short-acting insulin. It lowers blood glucose levels when rapid-acting insulins stop working. It is taken once or twice a day. A Guide on Insulin Types for People with Diabetes Type Brand Name Onset Peak Duration Rapid-acting Humalog Novolog Apidra 10 – 30 minutes 30 minutes – 3 hours 3 – 5 hours Short-acting Regular 30 minutes – 1 hour 2 – 5 hours Up to 12 hours Intermediate- acting NPH 1.5 – 4 hours 4 – 12 hours Up to 24 hours Long-acting Lantus Levemir 0.8 – 4 hours Minimal peak Up to 24 hours To make an appointment with a Joslin diabetes nurse educator, please call 732-2400.Continue reading > >

• How to use basal insulin: Benefits, types, and dosage

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How Do You Take Insulin Without A Syringe

• Insulin pens look like large writing pens and can help prevent under- and overdosing. They also dont require refrigeration, are conveniently prefilled, and are more durable than syringes.
• Insulin pumps are attached to a thin tube thats implanted under your skin. Pumps are computerized or motorized, and some models also act as glucose monitors. They deliver insulin before each meal along with small amounts through the course of the day. In the US, about 60% of people with diabetes use some form of insulin pump.
• Jet injection devices are a good option if you hate needles. A jet injector holds several doses of insulin. After placing it against your skin, you press a button, and the insulin is pushed through.
• Inhalable insulin comes in a premeasured inhaler and was first approved in 2014. Its short-acting and usually not covered by insurance, which makes it more cost prohibitive than other types of insulin for most people with diabetes.

Unless you have an insulin pump that also works as a glucose monitor, insulin dosing is based on self-monitoring your blood glucose levels. You can check them by doing finger pricks or wearing a device that continuously monitors them for you.

What Severe Complications Can Occur Because Of Rationing Or Running Out Of Insulin

Diabetic ketoacidosis is an emergency condition that results if you dont have enough insulin to regulate your blood sugar. DKA causes your body to break down fat for energy in the absence of insulin. This leads to a dangerous accumulation of acids known as ketones in your blood that can cause your brain to swell and your body to go into shock.

Signs of diabetic ketoacidosis include:

• Thirst or a very dry mouth
• Frequent urination
• High levels of ketones in your urine
• Fatigue
• Nausea, vomiting, or stomach pain
• Difficulty breathing
• A fruity or acetone odor on your breath
• Confusion or acting drunk while sober

DKA is so common and can come on so quickly that it is the first sign of Type 1 diabetes in 20% of cases, and the way many type 1 diabetics are first diagnosed with the condition. If you go into diabetic ketoacidosis, dont try to hide it or make light of it. Treat it as the emergency it is and get to a hospital as soon as possible to recover. Ive had people tell me theyre tired of taking insulin, or that theyre rationing it due to cost. In type 1 diabetes, thats all it takes to end up in a life-threatening situation, says Dr. Zilbermint.

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What Will Insulin Be Like In The Future

Pharmaceutical companies are working on very long-acting versions of insulin that could last for a week. There is also an ultra-fast version of insulin under development that will act in less than 15 minutes.

Another group of researchers is looking at glucose responsive insulin , which would react to the needs of your body in real time. It would have nanosensors bound to the insulin so that when insulin is needed, it releases, and when it isnt, it stops, according to Dr. Hirsch.

Exceptions To Insulin Dosing And Timing

Long-acting insulins arenât tied to mealtimes. Youâll take detemir once or twice a day no matter when you eat. And youâll take glargine once a day, always at the same time. Deglutec is taken once a day, and the time of day can be flexible. But some people do have to pair a long-acting insulin with a shorter-acting type or another medication that does have to be taken at meal time.

Rapid-acting products can also be taken right after you eat, rather than 15 minutes before mealtime. You can take some of them at bedtime.

For more information about when to take insulin, read the “dosing and administration” section of the insulin product package insert that came with your insulin product, or talk with your doctor.

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Ways Or Options To Administer Insulin

Injections

Multiple daily injections , involves taking several injections per day. Usually a person will take a basal insulin and then bolus with rapid or short acting insulin when they eat, or their blood sugar is high. Injection site include the stomach , the top and outer thighs, and upper and outer arms.

You can inject insulin using insulin syringes and pens. Refer to the device manufacturers website or speak with your doctor on how to use insulin syringes and pens correctly and which is right for you. Some people think the pen is more convenient when they only need a single type of insulin, and find pen needles to be more comfortable than syringes. On the other hand, syringes allow you to combine two types of insulin in a single dose and tend to be less expensive than pens.

Pumps

Another option to give insulin is using an insulin pump. An insulin pump is about the side of a small cell phone. It delivers small amounts of short or rapid-acting insulin per hour to act as the basal insulin and then when a person eats, or their blood sugar is high they program in the amount of insulin for the pump to deliver their bolus. Pumps come tubeless or tubed.

Inhaled Insulin/Insulin Inhalers

Lipohypertrophy Multiple Injections on the Same Part of the Skin

What Does Insulin Do

Insulin controls the amount of sugar in your blood by regulating the conversion of glucose into energy, or storage in the liver for future use.

When you eat, your body takes in glucose from food, and your blood sugar levels rise. This triggers the release of insulin in healthy individuals. The insulin signals your cells to absorb glucose and use it as energy, which reduces your blood sugar.

An insulin injection helps facilitate this process for people with diabetes. Overall, roughly 24% of people with diabetes are treated using insulin.

However, there are several different types of insulin that you can take. This depends on how well each person’s body utilizes insulin, as well as their diets.

“Patients who are more resistant to the effects of insulin or consume excessive amounts of carbohydrate, particularly simple sugars, require higher doses of insulin,” says Joseph Barrera, MD, an endocrinologist with Mission Hospital in Mission Viejo, California.

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Who Would Benefit From Short

Short-acting insulin has a few benefits that rapid-acting insulin lacks. First, you dont need to use it at each meal. You can take it at breakfast and supper and have good control throughout the day because it lasts so long. However, it’s important for a person to check their blood sugar to ensure it’s working correctly.

Type 1 Diabetes: Types Of Insulin

Insulin therapy is essential for everyone who has type 1 diabetes and some people who have type 2 diabetes. Various types of insulin are available. They differ in terms of how quickly and how long they are effective, as well as in their chemical structure.

Some types of insulin work quickly , while others only start to work after a certain amount of time, and then work over a longer time period .

Insulin can be extracted from the pancreas cells of pigs or cattle and prepared for use in humans. But nowadays most people use genetically engineered insulin for the treatment of diabetes. There are two types of genetically engineered insulin, known as human insulin and insulin analogues. Human insulin is similar to the insulin made in the human body. Insulin analogues have a different chemical structure, but they have a similar effect.

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How Is The Diabetes Drug Insulin Administered

Insulin must be injected for most patients, though there is a new inhaled form. Injections are done with a disposable fine needle and syringe or the use of a pump.

• People with diabetes generally rotate injection sites to prevent tissueinjury and for the best insulin absorption.
• Insulin is absorbed most quickly when it is injected into the abdomen the thighs and buttocks are other common injection sites.
• Some people with diabetes find it more convenient and comfortable to use newer insulin delivery systems, such as prefilled or cartridge pen insulin dispensers.
• While these eliminate the need to draw up insulin from a bottle, they may limit dosing flexibility. Still, others benefit from the use of insulin pumps, which deliver a continuous dose over 24 hours through an implanted catheter.
• Insulin pumps are more commonly used by people with type 1 diabetes.

Insulin Analogs Are Now Replacing Human Insulin In The Us

Insulins are categorized by differences in onset, peak, duration, concentration, and route of delivery.

Human Insulin and Insulin Analogs are available for insulin replacement therapy. Insulins also are classified by the timing of their action in your body specifically, how quickly they start to act, when they have a maximal effect and how long they act.Insulin analogs have been developed because human insulins have limitations when injected under the skin. In high concentrations, such as in a vial or cartridge, human clumps together. This clumping causes slow and unpredictable absorption from the subcutaneous tissue and a dose-dependent duration of action . In contrast, insulin analogs have a more predictable duration of action. The rapid acting insulin analogs work more quickly, and the long acting insulin analogs last longer and have a more even, peakless effect.

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What Are Alternative Medications For People With Diabetes That Arent Insulin

• Metformin a pill that stops sugar production in the liver
• Glitazones pills that remove sugar from the bloodstream
• Sufonylureas and glinides pills that increase the release of insulin from your pancreas
• Starch blockers pills that slow starch absorption
• Incretin therapies and amvlin analogs pills and injections that reduce sugar production in the liver and slow food absorption. Types of the former include DPP4 inhibitors and GLP1 analogs .
• SGLT2 inhibitors pills that are taken before meals that prevent the reabsorption of glucose