Type 1 Diabetes Mellitus And The Use Of Flexible Insulin Regimens
The management of type 1 diabetes mellitus (formerly known as insulin-dependent diabetes) has changed dramatically over the past 30 years. In particular, new insulin strategies have improved the ability to maintain near-normal glycemia. Factors such as onset, peak and duration of action can influence the ability of a particular insulin regimen to help control glucose levels. Patient factors, including individual variations in insulin absorption, levels of exercise and types of meals consumed, also influence the effectiveness of an insulin regimen. Rapid-acting insulin lispro is an ideal mealtime insulin. The premeal dose of insulin lispro can be adjusted based on the content of the meal and the patient's blood glucose level. Intermediate-acting and long-acting insulins should not be given to account for the content of a specific meal. Long-acting insulin can be administered once daily at bedtime or, ideally, twice daily in addition to another type of insulin. Patients with type 1 diabetes typically require an insulin dosage of 0.5 to 1.0 unit per kg per day. Newly diagnosed patients may have lower initial requirements because of continued endogenous insulin production. Flexible insulin regimens are based on predetermined actions in response to self-monitoring of blood glucose levels and carbohydrate intake. Pharmacology of Insulin Several important factors affect the absorption of subcutaneously administered insulin and explain much of the unstable glycemia that occurs in patients with type 1 diabetes. The time it takes to absorb one half of an injected dose of insulin may vary by 25 to 50 percent among individual patients.5 For example, NPH insulin may have a duration of activity of 18 hours in one patient but an effective activity of only 9 or 10 hours in another pati Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Osteoporosis and Diabetes: Pros and Cons to Antidiabetic Regimens
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
Novolin 70-30 Innolet
Novolin® 70/30 InnoLet® 70% NPH, Human Insulin Isophane Suspension and 30% Regular, Human Insulin Injection (recombinant DNA origin) is a 3 mL disposable prefilled insulin syringe 100 units/mL (U-100) DESCRIPTION WARNING ANY CHANGE OF INSULIN SHOULD BE MADE CAUTIOUSLY AND ONLY UNDER MEDICAL SUPERVISION. CHANGES IN PURITY, STRENGTH, BRAND (MANUFACTURER), TYPE (REGULAR, NPH, LENTE®, ETC.), SPECIES (BEEF, PORK, BEEF-PORK, HUMAN), AND/OR METHOD OF MANUFACTURE RECOMBINANT DNA VERSUS ANIMAL-SOURCE INSULIN) MAY RESULT IN THE NEED FOR A CHANGE IN DOSAGE. SPECIAL CARE SHOULD BE TAKEN WHEN THE TRANSFER IS FROM A STANDARD BEEF OR MIXED SPECIES INSULIN TO A PURIFIED PORK OR HUMAN INSULIN. IF A DOSAGE ADJUSTMENT IS NEEDED, IT WILL USUALLY BECOME APPARENT EITHER IN THE FIRST FEW DAYS OR OVER A PERIOD OF SEVERAL WEEKS. ANY CHANGE IN TREATMENT SHOULD BE CAREFULLY MONITORED. PLEASE READ THE SECTIONS "INSULIN REACTION AND SHOCK" AND "DIABETIC KETOACIDOSIS AND COMA" FOR SYMPTOMS OF HYPOGLYCEMIA (LOW BLOOD GLUCOSE) AND HYPERGLYCEMIA (HIGH BLOOD GLUCOSE). Product Description This package contains Novolin® 70/30 in an InnoLet® disposable prefilled insulin syringe. Novolin 70/30 is a mixture of 70% NPH, Human Insulin Isophane Suspension and 30% Regular, Human Insulin Injection (recombinant DNA origin). The concentration of this product is 100 units of insulin per milliliter. It is a cloudy or milky suspension of human insulin with protamine and zinc. The insulin substance (the cloudy material) settles at the bottom of the insulin reservoir, therefore, the Novolin 70/30 InnoLet (70% nph, human insulin isophane suspension and 30% regular, human insulin injection) must be rotated up and down so that the contents are uniformly mixed before a dose is given. Novolin 70/30 has an intermediate d Continue reading >>
Long Acting Insulin
Tweet Long acting insulin may be prescribed for a number of different types of diabetes. Long acting insulins are available in animal and analogue forms. Their activity can last up to 24 hours with the exception of bovine PZI. Bovine PZI (protamine zinc insulin), can last anywhere up to 36 hours. Long acting analogue insulins have been favoured by the NHS because the insulins have no peak activity as such, which allows for a consistent delivery of activity through the day. However, as with any form of insulin, hypoglycemia is a common side effect which one should be wary of. How often should long acting insulins be injected? Long acting insulins will be injected either once or twice daily. Lantus The medical name for Lantus is insulin glargine. Lantus is an analogue insulin produced by Sanofi-Aventis. It has a consistent activity from within an hour after injecting up to 24 hours. Lantus can is usually injected once daily but may be injected twice daily if advised by your health team. Levemir Levemir is the brand name of insulin determir. Produced by Novo Nordisk, Levemir is an analogue insulin with a consistent activity similar to Lantus. The duration of Levemir is slightly shorter than Lantus and therefore it is often injected twice rather once daily. However, some people may only need one daily injection. Tresiba Tresiba is the brand name for insulin degludec, an ultra-long acting insulin produced by Novo Nordisk. Tresiba can be taken by people with type 1 or type 2 diabetes once per day. Tresiba has a duration of more than 42 hours and has been in clinical trials to reduce the rate of hypoglycemia compared to other long acting insulin. An advantage of the long duration of Tresiba is that it offers more flexibility in terms of injection timings. Hypurin Bovine Lente Continue reading >>
New Options In Insulin Therapy
REVIEW ARTICLE Helena Schmid Doutora. Professora titular, Programa de Pós Graduação em Ciências Médicas, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre (FFFCMPA), Porto Alegre, RS, Brazil ABSTRACT OBJECTIVE: To review the new options in insulin therapy for controlling diabetes mellitus in children and adolescents. SOURCES: Articles indexed in PubMed were located using the search terms insulin analogs in children and adolescents and reviewed. Information was also obtained from American Diabetes Association and Sociedade Brasileira de Diabetes consensus documents. SUMMARY OF THE FINDINGS: Information is presented on new analogs of insulin and, for purposes of comparison, the other insulin modalities currently available are also reviewed, focusing on insulin therapies which attempt to approximate basal-bolus treatment strategies to physiology. With the objective of obtaining improved metabolic control, more and more children are being put on multiple daily injection regimes or using continuous subcutaneous insulin infusion. It is difficult to achieve optimum glycemic control in children due to the increased risk of hypoglycemia resulting from the great variability in dietary intake habits and in physical activity levels. With diabetes type 1, if rapid-acting analogs are given subcutaneously in bolus, they generally reduce hypoglycemia episodes and postprandial glycemia levels, compared with regular human insulin, while basal analogs tend to reduce particularly the number of episodes of nocturnal hypoglycemia. CONCLUSIONS: Although the benefits to individual metabolic and clinical outcomes appear modest, the majority of studies demonstrate benefits when insulin analogs are used in the treatment of diabetes type 1 or 2. Keywords: Diabetes mellitus, i Continue reading >>
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 >>
Insulin Dosing Made Simple
I have found, in my years of practicing correctional medicine, that few practitioners who come to corrections are comfortable with insulin dosing. In my experience, this is especially true for physician assistants and nurse practitioners, but many physicians have problems, too. Insulin dosing can be complicated and tricky at times, but for most patients, 10 simple rules will get you to where you need to be. We first need to cover some groundwork and some terms. Insulin terminology can be confusing. First, it is very important to remember that this discussion applies to type 1 diabetics only. Type 2 diabetics sometimes use insulin, but that’s a “whole ‘nother ballgame.” There are two types of insulin used for two very different purposes when treating type 1 diabetics. The first is basal insulin, which is used to replace the insulin that the normal pancreas releases constantly—whether we eat or not. Long-acting insulin is used to provide coverage for the basal metabolic needs of type 1 diabetics. Examples are insulin glargine (Lantus) and insulin detemir (Levemir). The most commonly used long-acting insulin is Lantus, so I am going to use that name in this article. (I have no financial ties to the maker of Lantus—I use that name because it is the name most commonly used by patients). The second type of insulin that type 1 diabetics need is short-acting insulin, which is given to cover the carbohydrates in the food they eat. Short-acting insulins are given just before a meal or snack and, ideally, the dose should vary depending on how many carbohydrates are in the food. Examples of short acting insulins are insulin regular, insulin aspart (Novolog) and insulin lispro (Humalog). Again, I will use the term Humalog in this article because it is the term most often Continue reading >>
Nph Insulin
Neutral Protamine Hagedorn Insulin. Neutral protamine Hagedorn (NPH) insulin is a crystalline suspension of insulin with protamine and zinc, providing an intermediate-acting insulin with onset of action in 1 to 3 hours, duration of action up to 24 hours, and peak action from 6 to 8 hours. NPH insulin usually cannot be administered once daily in the setting of T1DM, at least in combination with rapid-acting monomeric analogue insulin. In the preanalogue era, NPH insulin was used successfully in combination with regular insulin, although this human insulin-based regimen has now been largely supplanted by analogue insulin because of a perceived lower risk of hypoglycemia.310 6.19.6.5.3.3 Intermediate-acting insulins Neutral Protamine Hagedorn ((NPH), lente, and insulin detemir) Neutral Protamine Hagedorn (NPH) and insulin zinc (lente) are different types of intermediate-acting insulins. NPH is a suspension of medium-sized crystals, which include zinc and protamine. Lente is a suspension of large, zinc-containing crystals that have been precipitated in an acetate buffer. These crystals dissolve slowly after subcutaneous injection. NPH and lente have similar pharmacodynamic profiles, with an onset of action approximately 2 h, a peak effect 6–14 h, and duration of action up to 24 h following subcutaneous injection. Intermediate-acting insulins can provide basal and/or prandial insulin, depending on dose and time of administration. Insulin detemir is an acylated insulin analog with threonine removed at position B30, and lysine at position B29 is acylated with a 14-carbon myristoyl fatty acid acylation, resulting in delayed action due to increased binding to albumin. It has a longer duration of action (20 h) than NPH or lente insulins, and less intradose pharmacokinetic varia Continue reading >>
The Abcs Of Insulin
Insulin is a naturally occurring hormone produced by the pancreas. Insulin is required to move sugar from the blood into the body’s cells, where it can be used for energy. For the symptoms of high blood sugar and low blood sugar, see Tables 1 and 2. Type 1 diabetes (T1D) is a chronic condition in which the pancreas produces little or no insulin. Only 5% of patients with diabetes have this form of the disease, according to the American Diabetes Association. Type 2 diabetes (T2D) is much more common; the risk factors are listed in online table 3. Individuals with T2D make insulin, but their bodies don’t respond well to it, a condition known as insulin resistance. Treatment of T2D usually begins with dietary and lifestyle changes, as well as oral medications. Over time, as the pancreas struggles to make an adequate amount of insulin to overcome insulin resistance, patients may require insulin supplementation. Insulin therapy must be individualized and balanced with meal planning and exercise. When a patient begins using insulin to manage diabetes, the initial dose is just a starting point. Over time, insulin requirements are affected by factors such as weight gain or loss, changes in eating habits, and the addition of other medications. The need for insulin often increases, and the dose must be readjusted to meet the new requirements. Insulin is injected subcutaneously, meaning not very deep under the skin. Common injection sites include the stomach, buttocks, thighs, and upper arms. By rotating the site of injection, patients can avoid lipohypertrophy, a slight increase in the growth or size of fat cells under the skin. When lipohypertrophy occurs, a soft pillowy growth may form at the repeated-use injection site. Therefore, for reliable absorption rates and cosmetic Continue reading >>
Caninsulin
Caninsulin Lente by Intervet intermediate-acting Porcine U40 Zinc Line Intervet Also known as Vetsulin in US Similar to Monotard Pork U100, Iletin II Lente U100 Action in cats onset 1-2h, peak 4-6h duration 8h Action in dogs onset <1 hour, gentle peak 4-8h, duration 14-24h Use and Handling Type cloudy Shelf Life 24 months When opened 28 days room temp. In pen N/A Notes Store Upright at 2-8C Do Not Freeze[1] Do not use if product does not re-suspend[2] Roll protect from light and heat Do not use intravenously[3] Not recomended for intramuscular use Dilution not advised Caninsulin[4], manufactured by Intervet and known in some countries as Vetsulin[5], is a veterinary porcine lente insulin, made up of 30% semilente (short-acting) and 70% ultralente (long acting) insulins. At present in the US, Caninsulin is FDA-approved for use only in dogs and, just recently, for cats, under the trade name Vetsulin. However, was often used in the US legally "off label" for cats, prior to formal approval.[6]. The majority of dogs on Caninsulin/Vetsulin (two-thirds) also will require twice-daily[7][8] injections. Intervet says that many dogs stabilize better on twice-daily insulin injections. They also point out that when shots are given twice instead of once daily, there are less hypoglycemia incidents and better blood glucose control[9][10]. Most vets are also not in favor of once-daily use because it is harder to regulate a dog on once-daily insulin than twice-daily dosing[11]. Caninsulin/Vetsulin is a lente insulin, which is classed as intermediate, not long acting. Long acting insulins (such as Lantus,[12][13] Ultralente, PZI) have a poor success rate among dogs. This blood glucose graph of Somogyi rebound shows a small dog on once-daily porcine lente injections. You can see how the l Continue reading >>
What Is Insulin? Everything To Know If You Have Diabetes
When you think about diabetes in a general sense, your mind might immediately flash to finger pricks. But while insulin therapy is common, it’s not for everyone who has been diagnosed with the disease. Indeed, according to the Centers for Disease Control and Prevention (CDC), only 18 percent of adults with the disease take insulin to manage diabetes, while 13 percent take insulin and oral medications. If you have type 2 diabetes, it’s important to understand the basics on insulin before making a decision with your doctor about whether you need it to control your blood sugar — including what it is, what it does, what its potential benefits are, and how to overcome the fear of finger pricks if you’ve been prescribed the therapy. What Does the Pancreas Do, and How Does Insulin Affect Blood Sugar Levels? The pancreas, a gland located deep in our abdomen, releases the hormone insulin. Insulin’s primary purpose is to help transport glucose, or blood sugar, to our liver, muscle, and fat cells to be used for energy or to be stored for later use, according to the National Institute of Diabetes and Digestive and Kidney Diseases. In people without diabetes, this process works smoothly, with the pancreas meeting the body’s demands for insulin and that sufficient insulin transporting glucose to cells. Consequently, blood sugar levels stay within a normal range. But when insulin resistance occurs, the body’s cells don’t respond correctly to insulin. With this condition — which can also occur in the absence of type 2 diabetes — the pancreas’s beta cells attempt to release more and more insulin to ferry glucose to cells. When beta cells aren’t able to meet the body’s demands for insulin, blood sugar accumulates, leading to diabetes and other health issues. How Continue reading >>
Lente Insulin Is A Nursing Alert
Last Updated on Tue, 11 Jul 2017 | Clinical Use Of Drugs Insulin requirements may change when the patient experiences any form of stress and with any illness, particularly illnesses resulting in nausea and vomiting. Insulin is ordered by the generic name (insulin zinc suspension, extended) or the trade (brand) name (Humulin U) (see the Summary Drug Table: Insulin Preparations). The nurse must never substitute one brand of insulin for another unless the substitution is approved by the health care provider because some patients may be sensitive to changes in brands of insulin. In addition, it is important never to substitute one type of insulin for another. For example, do not use insulin zinc suspension instead of the prescribed prota-mine zinc insulin. Care must be taken when giving insulin to use the correct insulin. Names and packaging are similar and can easily be confused. The nurse carefully reads all drug labels before preparing any insulin preparation. For example, Humalog (insulin lispro) and Humulin R (regular human insulin) are easily confused because of the similar names. Insulin must be administered via the parenteral route, usually the subcutaneous (SC) route. Insulin cannot be administered orally because it is a protein and readily destroyed in the gastrointestinal tract. Regular insulin is the only insulin preparation given intravenously (IV). Regular insulin is given 30 to 60 minutes before a meal to achieve optimal results. Insulin aspart is given immediately before a meal (within 5 to 10 minutes of beginning a meal). Insulin lispro is given 15 minutes before a meal or immediately after a meal. Insulin aspart and lispro make insulin administration more convenient for many patients who find taking a drug 30 to 60 minutes before meals bothersome. In addi Continue reading >>
Lente Insulin Drug Information, Professional
Commonly used brand name(s): Humulin 10/9010; Humulin 20/8010; Humulin 30/7010; Humulin 40/6010; Humulin 50/5010; Humulin 70/3010; Humulin 70/30 Pen10; Humulin L7; Humulin N9; Humulin N Pen9; Humulin R5; Humulin R, Regular U-500 (Concentrated)5; Humulin U3; Humulin-L7; Humulin-N9; Humulin-R5; Humulin-U3; Lente6; Lente Iletin6; Lente Iletin II6; NPH Iletin8; NPH Iletin II8; NPH Purified Insulin8; Novolin 70/3010; Novolin 70/30 PenFill10; Novolin 70/30 Prefilled10; Novolin L7; Novolin N9; Novolin N PenFill9; Novolin N Prefilled9; Novolin R5; Novolin R PenFill5; Novolin R Prefilled5; Novolin ge 10/90 Penfill10; Novolin ge 20/80 Penfill10; Novolin ge 30/7010; Novolin ge 30/70 Penfill10; Novolin ge 40/60 Penfill10; Novolin ge 50/50 Penfill10; Novolin ge Lente7; Novolin ge NPH9; Novolin ge NPH Penfill9; Novolin ge Toronto5; Novolin ge Toronto Penfill5; Novolin ge Ultralente3; Regular (Concentrated) Iletin II, U-5004; Regular Iletin II4; Regular Insulin4; Velosulin BR1; Velosulin Human1. Semilente insulin Prompt Insulin Zinc Ultralente insulin Extended Insulin Zinc Note:For a listing of dosage forms and brand names by country availability, see Dosage Forms section(s). diagnostic aid (pituitary growth hormone reserve) Note:Bracketed information in the Indications section refers to uses that are not included in U.S. product labeling. Diabetes, type 1Insulin is indicated in the treatment of type 1 diabetes (previously called Type I, ketosis-prone, brittle, or juvenile-onset diabetes), which occurs in individuals who produce little or no endogenous insulin. One of two regimens (conventional or intensive therapy) is commonly used to treat this condition. The intensive regimen provides more rigid control of blood glucose than the conventional regimen does, but requires more frequen Continue reading >>
Insulin Therapy In Cats (proceedings)
123Next Few diseases are as frustrating for a veterinarian as diabetes mellitus. Realistically, control of hyperglycemia is rarely accomplished, and clinical signs of diabetes often persist. The landscape is changing in feline diabetes, however, and as clinicians learn more about new insulin preparations, diets, and treatment monitoring strategies, cats with diabetes may be better controlled. Insulin Therapy There are many different types of insulin that vary with species of origin and with chemical modifications and formulations that affect onset and duration of action. Unfortunately, no feline insulin formulation is currently available, so human, bovine, or porcine insulin are used in treating diabetic cats. Data concerning the pharmacokinetics and pharmacodynamics of insulin in the cat are difficult to interpret. Most published studies have been conducted in normal cats, and some have been done in cats with diabetes. In either case, it is difficult to determine the effects of endogenous vs. exogenous insulin. Determinations of potency, time to peak activity and duration of activity, factors that influence choice of doses and dosing intervals, vary widely from cat to cat. In fact, there is no reasonable way to predict the kinetics of an given insulin preparation in any given patient. The most commonly used insulin preparations in cats are Regular insulin (Humulin-R™ ), NPH insulin (Humulin-N™ ), porcine lente insulins (Vetsulin™ ), PZI, Insulin glargine (Lantus™ ), and insulin detemir (Levemir™ ). Regular insulin is not used for chronic treatment of diabetes in cats, but is commonly used in the treatment of diabetic ketoacidosis. NPH, PZI, and Lente NPH is considered an intermediate-acting insulin, and is available as a human recombinant product. NPH is used Continue reading >>
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 >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- How to use long-acting insulin: Types, frequency, peak times, and duration
- Insulin pens: Types, benefits, and how to use them
Information For Owners Of Canine's With Diabetes Mellitus
Diabetes in animals is very similar to that of humans. Therefore this page may contain links that are about humans or other animals. Background Information about Insulin When we eat, our bodies break food down into organic compounds, one of which is glucose. The cells of our bodies use glucose as a source of energy for movement, growth, repair, and other functions. But before the cells can use glucose, it must move from the bloodstream into the individual cells. This process requires insulin. Insulin is produced by the beta cells in the islets of Langerhans in the pancreas. When glucose enters our blood, the pancreas should automatically produce the right amount of insulin to move glucose into our cells. Canines with type 1 diabetes produce no insulin. Felines with type 2 diabetes do not always produce enough insulin. (Felines can be type 1 or 2 and Canines are always type 1) Insulin Tips: - NPH cannot be mixed with any Lente (L or U) insulin, they are chemically incompatible. - Insulin does not have to be refrigerated if kept at a moderate temp., although it is recommended. - Do not give cold injections, it could cause discomfort. - Popular opinion is to dispose of opened insulin after 30 days or 100 sticks. - To prevent abscesses, infections, and discomfort, only use syringes once. - Rotation of injection sites is recommended. - It is best to feed before the injection to make sure the animal eats. (generally 30 min. before) - Human insulins are shorter acting than animal insulins of the same type. - Never shake "cloudy" insulins. Roll the bottle between the palms of your hands. Duration and Peak Times for the Most Common Insulins There are more than 20 types of insulin products available in four basic forms, each with a different time of onset and duration of action. Continue reading >>
