Types of Insulin

There are three main groups of insulins: Fast-acting, Intermediate-acting and Long-acting insulin.

Fast-acting insulin:

Rapid Acting Insulin Analogs (Insulin Aspart, insulin Lyspro, Insulin Glulisine) which have an onset of action of 5 to 15 minutes, peak effect in 1 to 2 hours and duration of action that lasts 4-6 hours. With all doses, large and small, the onset of action and the time to peak effect is similar. The duration of insulin action is, however, affected by the dose – so a few units may last 4 hours or less, while 25 or 30 units may last 5 to 6 hours. As a general rule, assume that these insulins have duration of action of 4 hours.

Regular Human Insulin which has an onset of action of 1/2 hour to 1 hour, peak effect in 2 to 4 hours, and duration of action of 6 to 8 hours. The larger the dose of regular the faster the onset of action, but the longer the time to peak effect and the longer the duration of the effect.




Intermediate-acting insulin:

NPH Human Insulin which has an onset of insulin effect of 1 to 2 hours, a peak effect of 4 to 6 hours, and duration of action of more than 12 hours. Very small doses will have an earlier peak effect and shorter duration of action, while higher doses will have a longer time to peak effect and prolonged duration.

Pre-Mixed Insulin which is NPH pre-mixed with either regular human insulin or a rapid- acting insulin analog. The insulin action profile is a combination of the short and intermediate acting insulins.

Long-acting insulin:

Long acting insulin analogs (Insulin Glargine, Insulin Detemir) which have an onset of insulin effect in 1 1/2-2 hours. The insulin effect plateaus over the next few hours and is followed by a relatively flat duration of action that lasts 12-24 hours for insulin detemir and 24 hours for insulin glargine.

Reference: Diabetes Education Onlline