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Long Acting And Short Acting Insulin

Long-acting Insulin: How It Works

Long-acting Insulin: How It Works

When you eat, your pancreas releases a hormone called insulin. Insulin moves sugar (glucose) from your blood to your cells for energy or storage. If you take insulin, you may need some at mealtime to help lower your blood sugar after you eat. But even between meals, you need insulin in small amounts to help keep blood sugar stable. This is where long-acting insulin comes in. If you have diabetes, either your pancreas can’t produce enough (or any) insulin, or your cells can’t use it efficiently. To control your blood sugar, you need to replace or supplement the normal function of your pancreas with regular insulin injections. Insulin comes in many types. Each type differs in three ways: onset: how quickly it starts working to lower your blood sugar peak: when its effects on your blood sugar are strongest duration: how long it lowers your blood sugar According to the U.S. Food and Drug Administration (FDA), the five types of insulin are: Rapid-acting insulin: This type starts to work just 15 minutes after you take it. It peaks within 30 to 90 minutes, and its effects last for three to five hours. Short-acting insulin: This type takes about 30 to 60 minutes to become active in your bloodstream. It peaks in two to four hours, and its effects can last for five to eight hours. It is sometimes called regular-acting insulin. Intermediate-acting insulin: The intermediate type takes one to three hours to start working. It peaks in eight hours and works for 12 to 16 hours. Long-acting insulin: This type takes the longest amount of time to start working. The insulin can take up to 4 hours to get into your bloodstream. Pre-mixed: This is a combination of two different types of insulin: one that controls blood sugar at meals and another that controls blood sugar between meals. Lo Continue reading >>

Short And Long-acting Insulin Therapy

Short And Long-acting Insulin Therapy

HOW DOES IT WORK? Type 1 Diabetes, formerly known as “Juvenile Onset Diabetes,” is an autoimmune disorder that often develops at younger ages, however can occur at adulthood as well. It is believed that the immune system of the Type 1 Diabetic attacks the cells in the Pancreas called Beta Cells, which are responsible for producing insulin. Insulin is a hormone that helps regulate levels of blood sugar (glucose) in the bloodstream. Symptoms of Type 1 Diabetes can include excessive hunger, thirst and urination, weight loss, blurred vision and tingling in the hands and feet. For people who do not have Diabetes, insulin is produced at a normal, constant levels on a consistent basis, with surges of extra insulin released after meals are ingested. Without the Beta Cells in the Pancreas producing insulin, there is no way for the blood glucose to be controlled in a Type 1 Diabetic without proper medical intervention. Uncontrolled Blood Glucose levels can be life-threatening and need to be managed as quickly as possible by a physician. What is the ideal goal for proper medical treatment and management of Type 1 Diabetes? Research has proven that a combination of a diet that incorporates low-glycemic index foods, a regimen of long and short acting insulins given throughout the day, and strict monitoring of blood glucose levels gives the patient the best chance for preventing both elevated blood sugar levels and small and large blood vessel damage that can eventually affect the kidneys, eyes, cardiovascular system, nervous system and many other organs of the body. What is the difference between short and long acing insulins? Short acting insulins are used prior to meals and have a quicker onset of action (from approximately 5 min to an hour), peak at 1-4 hours and last from 4- Continue reading >>

Rapid-acting Versus Long-acting Insulin: What’s The Difference?

Rapid-acting Versus Long-acting Insulin: What’s The Difference?

For people who need to take insulin, there are a couple of different types—long-acting, short-acting, rapid-acting, intermediate-acting, etc. That’s a lot of options! One question I see most often is the difference between rapid-acting and long-acting insulins. So, let’s get into it. What is rapid-acting insulin? Rapid-acting, or meal-time insulin, is a type of insulin that’s usually taken before, during, or after a meal to lower your blood sugar levels associated with meals. How long does it take rapid-acting insulin to begin working? The onset of action varies between rapid-acting insulin products, but can begin working in as little as 5 minutes, or could take as long as 30 minutes, depending on the insulin. The following are the typical onset of action times for each individual rapid-acting insulin products. What is long-acting insulin? Long-acting, or basal insulin, is a type of insulin that gives you a slow steady release of insulin that helps control your blood sugar between meals, and overnight. How long does long-acting insulin last? The duration of action varies between long-acting products but should last anywhere between 22-24 hours. The following are the typical duration of action times for each individual long-acting insulin product: Do I need more than one insulin? Maybe. It’s up to your doctor to determine the best medication regimen for you. Some type 2 diabetes patients may only need to use a long-acting insulin to get their blood sugar control on track; whereas others may need a combination of meal-time and long-acting insulin to best control their blood sugar. If you are using an insulin pump, you will only need to use a rapid or short-acting insulin. The pump is able to give you a slow and steady amount of insulin to cover you all day like Continue reading >>

Insulin: Types

Insulin: Types

Last week, we started to take a closer look at insulin, a hormone that helps to lower blood sugar levels and a hormone that everyone needs. Insulin works much like a key, unlocking receptors that are located on cells, allowing glucose to enter and be used for energy. When the pancreas works as it should, insulin helps to regulate, or balance out, blood sugar levels. If there is more sugar in the blood than the body currently needs, the sugar gets stored in the liver as glycogen (or, if glycogen stores are full, as fat). Then, when the body needs more sugar, say, for physical activity, the liver will release glucose to provide additional fuel for the body. Types of insulin If you have Type 1 diabetes, you very likely take two types of insulin: rapid-acting or short-acting, also known as mealtime or bolus insulin, and longer-acting, also known as basal insulin. People who have Type 2 diabetes may take just one type or both types. Rapid-acting insulin. This type of insulin starts to work about 15 minutes after you inject it. It will peak about 1 hour later, but it keeps working for 2 to 4 hours. Rapid-acting insulin is generally taken right before eating a meal to “cover” the carbohydrate consumed at that meal. Rapid-acting insulin is generally the only type of insulin used in an insulin pump (longer-acting insulins are never used in a pump). Examples: aspart (brand name NovoLog), lispro (Humalog), glulisine (Apidra) Short-acting insulin. Also a type of mealtime insulin, short-acting insulin is taken about 30 minutes before a meal. It starts to work about 30 minutes after injecting, peaks 2–5 hours later, and lasts up to 12 hours. With the newer rapid-acting insulins now available that offer more flexibility, short-acting insulin isn’t used as much as it used to be Continue reading >>

Different Types Of Insulin: What To Use And When?

Different Types Of Insulin: What To Use And When?

What’s the difference between the different types of insulin? Long-acting, short-acting, premixed, learn more about all three. You may have a lot of questions as you begin insulin therapy. What are the different types of insulin available? Which should I be using and when? Insulins differ based on 3 key factors: 1 how quickly they work when they peak how long they last (duration) This table compares these factors in the types of insulin available:2 Type Onset (How quickly it starts working) Onset (What it is most effective) Duration (How long it works) Timing of injection (When should it be given) Bolus insulins Rapid acting analogues Apidra/Humalog/NovoRapid 10-15 min 1-2 hours 3-5 hours Given with 1 or more meals per day. To be given 0-15 minutes before or after meals. Short-acting Humulin-R/Toronto 30 min 2-3 hours 6.5 hours Given with one or more meals per day. Should be injected 30-45 minutes before the start of the meal. Basal insulins Intermediate-acting Humulin-N/NPH 1-3 hours 5-8 hours Up to 18 hours Often started once daily at bedtime. May be given once or twice daily. Not given at any time specific to meals. Long-acting analogues Lantus Levemir 90 min Not applicable Lantus: Up to 24 hours Levemir: 16-24 hours Often started once daily at bedtime. Insulin detemir (Levemir) may be given once or twice daily. Not given at any time specific to meals. Premixed insulins Premixed regular insulin Humulin 30/70 and Novolin ge 30/70, 40/60, 50/50 Varies according to types of insulin Contains a fixed ratio of insulin (% of rapid-acting or short-acting insulin to % of intermediate-acting insulin): See above for information about peak actions based on insulin contained Given with one or more meals per day. Should be injected 30-45 minutes before the start of the meal. Pre Continue reading >>

Basal Insulins (intermediate And Long-acting)

Basal Insulins (intermediate And Long-acting)

Who? Intermediate- and long-acting (basal) insulins are recommended for patients with type 1, type 2, or gestational diabetes. They may also be used in other types of diabetes (i.e. steroid-induced). Persons with type 1 diabetes generally use intermediate-acting insulin or long-acting insulin in conjunction with regular or rapid acting insulin. Persons with type 2 diabetes may use intermediate or long-acting insulins in conjunction with regular or rapid acting insulins or with oral medications. What? Injections given under the skin. Not suitable for insulin pumps. These medications can be injected with a traditional syringe and needle, or with a disposable pen that has been prefilled with insulin. Most patients tend to prefer pens though while convenient, they can be more expensive. The most common type of intermediate-acting insulin is: NPH (marketed as Humulin N and the Humulin N Pen) NPH (marketed as Novolin N and the Novolin N FlexPen) Long-acting insulins are marketed as different brands. The common ones are: Glargine (marketed as Lantus and the Solo Star Pen) Detemir (marketed as Levemir and the FlexPen) Degludec (marketed as Tresiba and the FlexTouch Pen) Where? These medicines are injected into the tissue under the skin and are slowly released into the body. These insulins allow glucose from the bloodstream to enter the cells in the body so that glucose can be used as energy. They also reduce glucose release into the bloodstream. When? NPH is usually injected twice a day. It begins working 1-3 hours after injection, and is most effective between 4-10 hours of injection. It generally keeps working for 10-16 hours. Detemir can be used once or twice a day. It begins working a few hours after injection and generally keeps working for anywhere from 20-24 hours. Glarg 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

For people who need to take external or supplemental insulin (insulin your body did not produce but that was instead made by a pharmaceutical company), there are several different types and kinds of insulin. The insulin you take will depend on your personal needs. Different types of insulin work differently in different people. The University of California, San Francisco explains that insulin “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.” Here’s a chart of how the types of insulin work to replicate the normal pancreatic delivery of insulin and how they are typically used. Type of Insulin Brand (Generic) Onset Peak Duration Rapid-Acting Apidra (glulisine), Humalog (lispro), Novolog (aspart) 15 minutes 1 or 2 hours 2 to 4 hours Regular- or Short-Acting Humulin R, Novolin R (human recombinant) 30 minutes 2 to 3 hours 3 to 6 hours Intermediate-Acting Humulin N, Novolin N (insulin isophane)) 2 to 4 hours 4 to 12 hours 12 to 18 hours Long-Acting or Basal Insulin Lantus (glargine), Levemir (detemir), Basaglar (glargine) 2 to 4 hours lower peak 24 hours Ultra Long-Acting Toujeo (glargine), Tresiba (degludec) 6 hours small peak 36 hours Inhaled Insulin Afrezza (insulin human) 15 minutes 30 minutes 3 hours Rapid-acting insulin analogs (Insulin Aspart, insulin Lyspro, Insulin Glulisine): Usually taken as a bolus before a meal to cover the blood glucose elevation from eating or to correct for high blood glucose. This type of insulin is often used with longer-acting insulin, which is used to cover the body’s metabolic need for insulin. Short-acting synth 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 >>

Types Of Insulin

Types Of Insulin

Topic Overview Insulin is used to treat people who have diabetes. Each type of insulin acts over a specific amount of time. The amount of time can be affected by exercise, diet, illness, some medicines, stress, the dose, how you take it, or where you inject it. Insulin strength is usually U-100 (or 100 units of insulin in one millilitre of fluid). Short-acting (regular) insulin is also available in U-500. This is five times more concentrated than U-100 regular insulin. Long-acting insulin (glargine) is also available in U-300. This is three times more concentrated than U-100 long-acting insulin. Be sure to check the concentration of your insulin so you take the right amount. Insulin is made by different companies. Make sure you use the same type of insulin consistently. Types of insulinfootnote 1 Type Examples Appearance When it starts to work (onset) The time of greatest effect (peak) How long it lasts (duration) Rapid-acting Apidra (insulin glulisine) Clear 10-15 minutes 1-1.5 hours 3-5 hours Humalog (insulin lispro) Clear 10-15 minutes 1-2 hours 3.5-4.75 hours NovoRapid (insulin aspart) Clear 10-15 minutes 1-1.5 hours 3-5 hours Short-acting Humulin R, Novolin ge Toronto (insulin regular) Clear 30 minutes 2-3 hours 6.5 hours Intermediate-acting Humulin N, Novolin ge NPH(insulin NPH) Cloudy 1-3 hours 5-8 hours Up to 18 hours Long-acting Lantus (insulin glargine) Clear 1.5 hours Does not apply Up to 24 hours Levemir (insulin detemir) Clear 1.5 hours Does not apply 16 to 24 hours Toujeo (insulin glargine U-300) Clear Up to 6 hours Does not apply Up to 30 hours Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal. Rapid-acting insulin acts most like insulin that is produced by Continue reading >>

Insulin Types

Insulin Types

Types of Insulin Insulin types are discussed in the table below. [1] Table 1. Insulin Types (Open Table in a new window) Insulin Type Onset Peak Duration Ultra short acting: insulin lispro, insulin aspart, insulin glulisine Usually taken before a meal to cover the blood glucose elevation from eating Used with longer-acting insulin 12-30 min 0.5-3 hr 3-5 hr Short acting: regular insulin Usually taken about 30 minutes before a meal to cover blood glucose elevation from eating Used with longer-acting insulin 30 min 2.5-5 hr 4-24 hr Intermediate acting: insulin NPH Covers the blood glucose elevations when rapid-acting insulins stop working Often combined with rapid- or short-acting insulin and usually taken twice a day 1-2 hr 4-12 hr 14-24 hr Long acting: insulin glargine, ultralente insulin, insulin detemir Often combined, when needed, with rapid- or short-acting insulin Lowers blood glucose levels when rapid-acting insulins stop working Taken once or twice a day 3-4 hr No defined peak ≥24 hr Continue reading >>

Short-acting Insulins

Short-acting Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Onset: 30 minutes Peak: 2.5 - 5 hours Duration: 4 - 12 hours Solution: Clear Comments: Best if administered 30 minutes before a meal. Mixing NPH: If Regular insulin is mixed with NPH human insulin, the Regular insulin should be drawn into the syringe first. Aspart - Novolog ®: Compatible - but NO support clinically for such a mixture. Draw up Novolog first before drawing up Regular Insulin. Lispro - Humalog ®: Compatible - but NO support clinically for such a mixture. Draw up Humalog first before drawing up Regular Insulin. Mixtures should not be administered intravenously. When mixing insulin in a syringe, draw up the quickest acting insulin first (e.g. draw up Humalog or Novolog before drawing up Regular Insulin, or draw up Regular insulin before Novolin N (NPH) or Lente insulin. CLINICAL PHARMACOLOGY Insulin is a polypeptide hormone that controls the storage and metabolism of carbohydrates, proteins, and fats. This activity occurs primarily in the liver, in muscle, and in adipose tissues after binding of the insulin molecules to receptor sites on cellular plasma membranes. Insulin promotes uptake of carbohydrates, proteins, and fats in most tissues. Also, insulin influences carbohydrate, protein, and fat metabolism by stimulating protein and free fatty acid synthesis, and by inhibiting release of free fatty acid from adipose cells. Insulin increases active glucose transport through muscle and adipose cellular membranes, and promotes conversion of intracellular glucose and free fatty acid to the appropriate storage forms (glycogen and triglyceride, respectively). Although the liver does not require active glucose transport, insulin increases hepatic gl Continue reading >>

Long-acting Insulins

Long-acting Insulins

Tue, 12/14/2010 - 14:43 -- Richard Morris When To Bring Your Background To The Foreground By Ruth Roberts, M.A. and John Walsh, P.A., C.D.E. Copyright 1997 by Diabetes Services, Inc. Diabetes control is the place where two worlds collide--the world of the known and the world of the unknown. You know certain things affect your blood sugars--what you eat, how much insulin you take, when you take it, and the exercise you do. When you take charge of these areas, you often have good blood sugar readings. But sometimes, out of nowhere, your blood sugars lose their track and start running out of control. As far as you are aware, you're doing the same things as before. You run through your usual troubleshooting questions. But one question many people don't get to is, "Is it time to adjust my long-acting insulin?" Long-acting insulins, whether a dose or doses of L, UL, or NPH or the basal rate in the pump, are typically given to control the blood sugar when you are not eating. Fuel as glucose or fat is released into the blood stream around the clock to keep the body running. So a long-acting insulin or a basal insulin has to be in the blood stream around the clock to assist the movement of glucose into cells. Long-acting insulin is a background insulin--often out of sight and out of mind. Usually, that's okay. It's job is usually less than dramatic, not responding to the turmoil, crises and carbohydrates of life like Regular or Humalog. It's usually the last thing you adjust to solve a problem. But there are times when adjusting the long-acting or basal insulin has to be considered. To control blood sugars with flexible insulin therapy, you want to know how to set up and test the short and long-acting insulins or the boluses and basals on a pump. Although you won't end up chang 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 >>

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 >>

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