diabetestalk.net

Which Insulin Has The Fastest Onset Of Action?

Types Of Insulin For Diabetes

Types Of Insulin For Diabetes

Articles Insulin injections are more often associated with Type 1 Diabetes. All people with Type 1 Diabetes will require insulin injections for life, however some people with Type 2 Diabetes may progress to insulin dependence. There are many types of insulin available. The type of insulin you take will depend on many factors, including your individual reaction to insulin, lifestyle, exercise regimen and eating patterns. Your insulin regimen will aim to keep your BGL within the healthy range of 3.5-7.8mmol/L. This will require self blood glucose monitoring on a regular basis, and keeping records of your BGL to see if any alterations are needed in the future. There are five classes of insulins, as seen below. Fast Acting Insulin eg Novorapid, Humalog, Apidra Onset of action: 10-15 minutes Peak of action: 1-2 hours Duration of action: 4-5 hours Fast acting insulin is absorbed very quickly into the blood stream and should be injected right before a meal. This is convenient because you do not have to wait the usual 30 minutes before you can eat, as with regular insulin. Short Acting Insulin eg Actrapid, Humilin R Onset of action: 30 minutes Peak of action: 2.5-5 hours Duration of action: 8 hours This insulin begins to work 30mins after injection, so must be injected 30mins before a meal. This can be difficult when eating out, or if you are unsure how much the person on insulin is going to eat at each meal. Intermediate Acting Insulin eg Protaphane, Humilin NPH Onset of action: 3 hours Peak of action: 4-8 hours Duration of action: 16-24 hours Due to its longer acting time, intermediate insulin is often used as the ‘basal’ insulin replacement in intensive insulin therapy for type 1diabetes, with fast acting insulin boluses given at meal times. It is also used for insulin a Continue reading >>

Insulin Lispro: A Fast-acting Insulin Analog

Insulin Lispro: A Fast-acting Insulin Analog

Research has established the importance of maintaining blood glucose levels near normal in patients with type 1 (insulin-dependent) diabetes mellitus. Short-acting insulin analogs are designed to overcome the limitations of regular short-acting insulins. Compared with regular human insulin, the analog insulin lispro offers faster subcutaneous absorption, an earlier and greater insulin peak and a more rapid post-peak decrease. Insulin lispro begins to exert its effects within 15 minutes of subcutaneous administration, and peak levels occur 30 to 90 minutes after administration. Duration of activity is less than five hours. Rates of insulin allergy, lipodystrophy, hypoglycemia and abnormal laboratory test results are essentially the same in patients using insulin lispro and in those using regular human insulin. The Diabetes Control and Complications Trial (DCCT)1 established the importance of maintaining near-normal blood glucose levels in patients with type 1 (insulin-dependent) diabetes mellitus. In these patients, intensive therapeutic regimens have been found to delay the onset and reduce the progression of microvascular complications by 50 to 75 percent as compared with conventional regimens. Although no large-scale investigations have been completed, smaller studies have reported similar benefits for intensive therapeutic regimens in patients with type 2 (non–insulin-dependent) diabetes.2 Primary care physicians provide medical care for 75 percent of children and 90 to 95 percent of adults with diabetes.3 Regardless of the type of diabetes, improved glycemic control often can be achieved with individualized tools for patient self-management, carefully formulated nutrition plans and the use of alternative insulin regimens.4 Overview of Insulin Insulin is necessary Continue reading >>

Insulin Update: Just The Facts

Insulin Update: Just The Facts

Research has shown that tight glycemic control is beneficial to all patients in hospital, speeding up recovery and producing positive outcomes. The use of insulin during hospitalizations has increased, (including temporary use with non-diabetic patients). The variability of types of insulin available has increased since the development of synthetic products more than 30 years ago. Nurses need to be aware of the various types of insulin that are available, and how they work. Rapid-Acting Insulin Rapid-acting insulins are most commonly used with hospitalized patients. They are based on sliding scales to quickly correct blood sugar levels or provide coverage during meals. Short-acting insulins were previously common in hospitals, but have a longer onset than the rapid-acting variety. Intermediate-acting insulins are used in combination with rapid or short-acting insulin. The intermediate category provides coverage for approximately half a day. The long-acting insulins provide a basal coverage for about a day. Rapid-acting insulin includes Lispro (Humalog®), aspart (Novolog®) and glulisin (Apidra®). The onset of action for these rapid-acting insulins is between 10-30 minutes, with a peak action time range of 30-90 minutes after administration. These insulins last for about 1-5 hours, depending on the brand used. Rapid-acting insulin acts by rapidly correcting hyperglycemia, and are designed for mealtime coverage. Thus patients must eat immediately after administration. Rapid-acting insulin should be used together with long-acting insulin to provide better hyperglycemic control. Short- and Intermediate-Acting Insulin Short-acting insulin is Regular (R) insulin (Humulin® & Novolin®). The onset of action is 30 min -1 hour, and the peak action time is 2-5 hours after admin Continue reading >>

Rapid Acting Insulin

Rapid Acting Insulin

Tweet Rapid acting insulins are usually taken just before or with a meal. They act very quickly to minimise the rise in blood sugar which follows eating. Rapid acting insulins are commonly prescribed to people with type 1 diabetes, however, there may be times when they can be prescribed for type 2 diabetes as well. As rapid acting insulins act very quickly, they can lead to an increased chance of hypoglycemia. Care should be therefore taken when dosing. What type of insulin is a rapid acting insulin? Rapid insulins, which are a type of insulin known as analogue insulins, can either be injected or delivered via an insulin pump. Humalog Humalog is an Eli Lilly product, with the active ingredient insulin lispro. It is extremely rapid-acting, and will typically begin to work within 15 minutes. Effects of the insulin last for between 2 and 5 hours. It is faster-acting than soluble insulin, and is therefore extremely useful around mealtimes. Like many other rapid-acting forms of insulin, humalog may be combined with intermediate or longer-acting insulin for a longer period of blood glucose maintenance. Novorapid The active ingredient in Novorapid is insulin aspart. When novorapid is injected, it is extremely fast-acting, and works rapidly to normalise blood sugar levels. It typically begins working after 10-20 minutes, and will last for between 3 and 5 hours. It may be injected before a meal, and sometimes immediately after, to ensure strict control of post-prandial levels. Often, insulin aspart formulations such as novorapid will be combined with other longer lasting (intermediate-acting and longer-acting) insulin. In this way, control over blood glucose levels can be maintained throughout the day. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperg Continue reading >>

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. NovoLog® (insulin aspart injection) 100 U/mL is an insulin analog indicated to improve glycemic control in adults and children with diabetes mellitus. NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is re Continue reading >>

New Faster Aspart Insulin Gives Faster Onset, Earlier Exposure In T1 Kids

New Faster Aspart Insulin Gives Faster Onset, Earlier Exposure In T1 Kids

Insulin found to provide better control of post-prandial glucose without significantly elevating hypoglycemia risk. Type 1 diabetes is usually detected early in childhood or youth, which prompts them to use daily insulin therapy for life. This is also a period of continuous changes in diet, body weight and insulin sensitivity, and parental assistance. All these factors make their therapy more difficult to adjust. As a result, these young patients seldom meet their HbA1C goals. The use of rapid-acting insulin represents an advantageous therapy approach for reducing post-prandial glucose levels when they are not properly controlled with long-acting basal insulin. Commonly used fast-acting agents include: Lispro (Humalog) and Aspart (Novolog) insulin; however, they may not get absorbed fast enough to achieve the glycemic targets as well as delay the elimination, which may cause post-meal hypoglycemia. The introduction of faster-acting insulin may offer earlier exposure and higher absorption compared to normal fast-acting insulins. Faster-acting insulin Aspart (FIAsp) has already been approved in adults achieving great outcomes controlling the HbA1c when tested versus normal Aspart (IAsp). The focus of the following study is to test the effectiveness and safety of faster-acting insulin in children and youth. A randomized, double-blind, single-center crossover trial in Germany tested faster aspart in children ages 6 to 11, adolescents ages 12 to 17 and adults (over 18 years old). Patients who had major comorbid diseases or had been using insulin treatment for less than a year were excluded. The study included 3 single visits separated from 3 to 22 days, in which they were administered either faster Aspart or IAsp 0.2 units/kg SQ dosing immediately prior to a standardized me Continue reading >>

5 Types Of Insulin And How They Work

5 Types Of Insulin And How They Work

What you need to know If you have to take insulin to treat diabetes, there’s good news: You have choices. There are five types of insulin. They vary by onset (how soon they start to work), peak (how long they take to kick into full effect) and duration (how long they stay in your body). You may have to take more than one type of insulin, and these needs may change over time (and can vary depending on your type of diabetes). Find out more about the insulin types best for you. Rapid-acting insulin What it’s called: Humalog (lispro), NovoLog (aspart), Apidra (glulisine) Rapid-acting insulin is taken just before or after meals, to control spikes in blood sugar. This type is typically used in addition to a longer-acting insulin. It often works in 15 minutes, peaks between 30 and 90 minutes, and lasts 3 to 5 hours. “You can take it a few minutes before eating or as you sit down to eat, and it starts to work very quickly,” says Manisha Chandalia, MD, director of the Stark Diabetes Center at the University of Texas Medical Branch, in Galveston. Short-acting insulin What it’s called: Humulin R, Novolin R Short-acting insulin covers your insulin needs during meals. It is taken about 30 minutes to an hour before a meal to help control blood sugar levels. This type of insulin takes effect in about 30 minutes to one hour, and peaks after two to four hours. Its effects tend to last about five to eight hours. “The biggest advantage of short-acting insulin is that you don't have to take it at each meal. You can take it at breakfast and supper and still have good control because it lasts a little longer,” Dr. Chandalia says. Intermediate-acting insulin What it’s called: Humulin N (NPH), Novolin N (NPH) Intermediate-acting insulin can control blood sugar levels for about Continue reading >>

Types Of Insulin For Diabetes Treatment

Types Of Insulin For Diabetes Treatment

Many forms of insulin treat diabetes. They're grouped by how fast they start to work and how long their effects last. The types of insulin include: Rapid-acting Short-acting Intermediate-acting Long-acting Pre-mixed What Type of Insulin Is Best for My Diabetes? Your doctor will work with you to prescribe the type of insulin that's best for you and your diabetes. Making that choice will depend on many things, including: How you respond to insulin. (How long it takes the body to absorb it and how long it remains active varies from person to person.) Lifestyle choices. The type of food you eat, how much alcohol you drink, or how much exercise you get will all affect how your body uses insulin. Your willingness to give yourself multiple injections per day Your age Your goals for managing your blood sugar Afrezza, a rapid-acting inhaled insulin, is FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in your blood in about 15-20 minutes and it clears your body in 2-3 hours. It must be used along with long-acting insulin in people with type 1 diabetes. The chart below lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood sugar), peak (the time period when it best lowers blood sugar) and duration (how long insulin continues to work). These three things may vary. The final column offers some insight into the "coverage" provided by the different insulin types in relation to mealtime. Type of Insulin & Brand Names Onset Peak Duration Role in Blood Sugar Management Rapid-Acting Lispro (Humalog) 15-30 min. 30-90 min 3-5 hours Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with Continue reading >>

Types Of Insulin

Types Of Insulin

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 (and also animal insulin) clumps together. This clumping causes slow and unpredictable absorption from the subcutaneous tissue and a dose-dependent duration of action (i.e. the larger dose, the longer the effect or duration). 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. Background Insulin has been available since 1925. It was initially extracted from beef and pork pancreases. In the early 1980’s, technology became available to produce human insulin synthetically. Synthetic human insulin has replaced beef and pork insulin in the US. And now, insulin analogs are replacing human insulin. Characteristics of Insulin Insulins are categorized by differences in: Onset (how quickly they act) Peak (how long it takes to achieve maximum impact) Duration (how long they last before they wear off) Concentration (Insulins sold in the U.S. have a concentration of 100 units per ml or U100. In other countries, additional concentrations are available. Note: If you purchase insulin abroad, be sure it is U100.) Route of delivery (whether they a Continue reading >>

What Is Rapid Or Fast-acting Insulin?

What Is Rapid Or Fast-acting Insulin?

You may take rapid acting or fast acting insulin (also known as insulin analogues) for your diabetes, either through injections prior to your meals, or in your insulin pump. You may use it alone, or in combination with other insulins and diabetes medications, including injections and pills. In a person without diabetes, the pancreas puts out small amounts of insulin, continuously bringing down blood sugars to a normal level with no difficulty. When a person has diabetes, they may not make any insulin, as occurs in Type 1 Diabetes. They may make some insulin, but it’s not working well, and it’s just not enough to bring blood sugars into a normal range, as occurs in Type 2 Diabetes. When there is no insulin, or not enough insulin, the goal is to try to simulate what the body normally does to bring down blood sugars through injections of insulin, inhaled insulin, or via an insulin pump. To do this, rapid or fast acting insulin must be taken in relation to food that is eaten in many cases. Not everyone with diabetes must take insulin to control their blood sugars, though. Let’s learn how Christie uses rapid acting insulin… Christie’s story Christie has had Type 1 Diabetes for 24 years. She uses a Medtronic insulin pump. Every day, Christie’s pump gives her fast or rapid acting insulin. This is all that insulin pumps need to control blood sugar. For Christie, she uses Humalog lispro insulin. She gets a little bit of this rapid or fast acting insulin continually through her pump via a basal. She also gets some of this insulin through her pump, in a bolus dose every time she eats a meal. In a pump, the same insulin is used all the time, and it is always rapid insulin. Christie also has a new Continuous Glucose Monitor, CGM. She has found with this new technology, s Continue reading >>

Insulin Actions Times And Peak Times

Insulin Actions Times And Peak Times

A good way to improve your glucose levels is to track the peaks and drops in your glucose , so you can figure out why they happened and how to correct them. Once you identify glucose patterns (they ARE there!), you also want to understand when each of your insulins is active and when they typically stop lowering your glucose. This helps you adjust your doses or food intake to stop unwanted ups and downs in your readings. The table below shows the start, peak, and end times for various insulins with some explanations and typical uses for each. When Does My Insulin Peak and How Long Does It Last? designed to peak, covers meals and lowers high BGs Humalog , Novolog and Apidra insulins currently give the best coverage for meals and help keep the glucose lower afterward. Their glucose lowering activity starts to work about 20 minutes after they are taken, with a gradual rise in activity over the next 1.75 to 2.25 hours. Their activity gradually falls over the next 3 hours with about 5 to 6 hours of activity being common with these insulins.Although insulin action times are often quoted as 3-5 hours, the actual duration of insulin action is typically 5 hours or more. See our article Duration of Insulin Action for more information on this important topic. In general, "rapid" insulins are still too slow for many common meals where the glucose peaks within an hour and digestion is complete within 2-3 hours. The best kept secret on stopping post meal spiking is to eake the injection or bolus earlier before the meal and to eat slower low glycemic carbs. Regular insulin still carries its original name of "fast insulin" but its slower action often works better for people who take Symlin or for those who have gastroparesis (delayed digestion). It is also a great choice for those who Continue reading >>

New Inhaled Insulin Has Rapid Onset Of Action

New Inhaled Insulin Has Rapid Onset Of Action

ADA 2009: New Inhaled Insulin Has Rapid Onset of Action With No Adverse Effect on Lung Function June 8, 2009 (New Orleans, Louisiana) A new formulation of inhaled insulin called technosphere insulin (Afresa, Mannkind Corp) is safe and effective, with an onset of action similar to endogenous insulin. It has an extremely low incidence of hypoglycemia and is associated with some weight loss in patients with type2 diabetes. Importantly, the new formulation appears to have little adverse effect on pulmonary function, unlike its former competitor Exubera (Pfizer, taken off the market in October 2007). Inhaled technosphere insulin is the subject of a large number of presentations here at the American Diabetes Association 69th Scientific Sessions. Elizabeth Potocka, MD, clinical researcher at Mannkind Corporation in Valencia, California, and colleagues conducted a comparison of 45U of inhaled technosphere insulin, 12IU of subcutaneous lispro insulin (Humalog, Eli Lilly), and 4mg of inhaled Exubera insulin with a meal challenge in 18 insulin-treated patients with type2 diabetes and normal pulmonary function. Technosphere insulin had an onset of action that was evident within 10 minutes of administration, compared with 30 to 40 minutes with both lispro and inhaled Exubera, Dr. Potocka told meeting attendees. Peak trough in blood glucose was approximately 1.0mmol/kg per minute with technosphere insulin at 40 minutes, compared with just over 2.0mmol/kg per minute at approximately 70 minutes with lispro and 2.0mmol/kg per minute at 2 hours with Exubera. "Significant differences between lispro and Exubera were observed for up to 40 minutes, compared with technosphere insulin (P< .002), and up to 2 hours for the Exuberatechnosphere insulin comparison (P< .05)," Dr. Potocka and collea Continue reading >>

Medsurg Ii Ch 49 Flashcards | Quizlet

Medsurg Ii Ch 49 Flashcards | Quizlet

Can an insulin vial that you are currently using be kept at room temperature? Yes, it usually is more pleasant to inject What should you do with vials of insulin not currently in use? How long are prefilled syringes of insulin good for? What are some generic names of rapid acting insulin? What are the brand names of rapid acting insulin? What is the onset of action of rapid acting insulin? What is the peak of action of rapid acting insulin? What is the duration of action of rapid acting insulin? If we gave rapid acting insulin at 0730, what time would we expect the peak to hit the patient? What are some generic names of short acting insulin? What are some brand names of short acting insulin? What is the onset of action of intermediate acting insulin? What is the peak of action of intermediate acting insulin? What is the duration of action of intermediate acting insulin? Why does intermediate acting insulin have a longer duration of action? If we gave Johnny 15 units of Novolin N at 0730, when would we expect the peak of action to hit? What are the generic names of long acting insulin? What are the brand names of long acting insulin? What is the onset of action of long acting insulin? What is the peak of action of long acting insulin? What is the duration of action of long acting insulin? Which insulin is considered a basal insulin? What kind of insulin is usually used in insulin pumps? Too much insulin/not enough food at night --> hypoglycemia during night --> counterregulatory hyperglycemia Counterregulatory hormone activation --> hyperglycemia What do we need to do to the nighttime dose of insulin with the Somogyi effect? What is the first choice drug for oral agent diabetic control? What is the only oral agent that can be used in both Type 1 and Type 2 diabetes? Wha Continue reading >>

Comparative Pharmacokinetics And Insulin Action For Three Rapid-acting Insulin Analogs Injected Subcutaneously With And Without Hyaluronidase

Comparative Pharmacokinetics And Insulin Action For Three Rapid-acting Insulin Analogs Injected Subcutaneously With And Without Hyaluronidase

Comparative Pharmacokinetics and Insulin Action for Three Rapid-Acting Insulin Analogs Injected Subcutaneously With and Without Hyaluronidase 1Profil Institute for Clinical Research, Chula Vista, California and 2Halozyme Therapeutics, San Diego, California Corresponding author: Daniel E. Vaughn, [email protected] Received 2012 Apr 26; Accepted 2012 Jul 31. Copyright 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details. This article has been cited by other articles in PMC. To compare the pharmacokinetics and glucodynamics of three rapid-acting insulin analogs (aspart, glulisine, and lispro) injected subcutaneously with or without recombinant human hyaluronidase (rHuPH20). This double-blind six-way crossover euglycemic glucose clamp study was conducted in 14 healthy volunteers. Each analog was injected subcutaneously (0.15 units/kg) with or without rHuPH20. The commercial formulations had comparable insulin time-exposure and time-action profiles as follows: 50% exposure at 123131 min and 50% total glucose infused at 183186 min. With rHuPH20, the analogs had faster yet still comparable profiles: 50% exposure at 7179 min and 50% glucose infused at 127140 min. The accelerated absorption with rHuPH20 led to twice the exposure in the first hour and half the exposure beyond 2 h, which resulted in 13- to 25-min faster onset and 40- to 49-min shorter mean duration of insulin action. Coinjection of rHuPH20 with rapid-acting analogs accelerated insulin exposure, producing an ultra-rapid time-action profile with a faster onset and shorter duration of insulin action. Rapid-acting insulin analogs with accelerated insulin absorption and m Continue reading >>

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

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 (length of time before insulin reaches bloodstream) Peak (time period when insulin is most effective) Duration (how long insulin works for) Rapid-acting Humalog Novolog Apidra 10 - 30 minutes 30 minutes - 3 hours 3 - 5 hours Short-acting Regular (R) 30 minutes - 1 hour 2 - 5 hours Up to 12 hours Intermediate- acting NPH (N) 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 (617) 732-2400. Continue reading >>

More in diabetes