Millions of diabetics require the use of subcutaneous insulin injections to regulate their blood sugar. Chronic exposure to elevated blood sugars is a major risk factor for complications that include stroke, heart disease, eye disease, kidney disease and neuropathies. There are many types of insulin, each with unique properties that include onset of action. Subcutaneous insulin regimens are typically customized to meet a diabetic's individual needs.
Rapid & Short-Acting Insulins
Rapid- and short-acting insulins are designed to mimic peak insulin secretion that occurs in response to elevated glucose levels following the ingestion of a meal. Insulin Lispro and Aspart are considered rapid-acting insulins and typically have an onset of action within 15 minutes and duration of 3 to 5 hours. Regular insulin is also short-acting and typically has an onset of action within 60 minutes and duration of 5 to 8 hours.
Intermediate-Acting Insulin
NPH insulin is considered intermediate-acting insulin that has an onset of action within 3 hours and duration of action lasting 12 to 16 hours. Since NPH insulin has an extended duration when compared to rapid and short-acting insulins, it provides some basal insulin coverage throughout the day.
Long-Acting Insulin
Long-Acting insulins include Insulin Glargine and Detemir. Both of these types of insulin provide basal insulin coverage throughout the day. They have a typical onset of action within 1 hour and can last up to 26 hours. However, they usually do not produce the peak insulin effect that is seen with the shorter-acting insulins and have fewer incidences of hypoglycemia, or excessively low blood sugars.
Significance
Many diabetics will require an insulin regimen that includes both longer-acting insulins that provide basal coverage and shorter-acting insulins that can produce the peak effect that is normally seen following consumption of a meal. Hypoglycemia is a possible side effect of all insulin types, and blood glucose monitoring is often required of patients on insulin therapy. Patients with questions regarding diabetes and insulin therapy should speak with a physician.
