Your Guide to Understanding Insulin Types and Choosing the Right One

Insulin is a hormone produced by the pancreas, a small organ located behind the stomach. It regulates blood sugar levels, ensuring that cells have the energy they need to function properly. When the body doesn't produce enough insulin or doesn't use it effectively, blood sugar levels rise, leading to type 1 or type 2 diabetes.

Insulin therapy plays a crucial role in managing diabetes. It helps keep blood sugar levels within a healthy range, preventing serious complications such as heart disease, stroke, kidney damage, and blindness. There are several types of insulin available, each with unique characteristics and durations of action.

Types of Insulin

Rapid-Acting Insulin

• Onset: Works within 15-30 minutes
• Peak: Reaches peak effect 1-2 hours after injection
• Duration: Lasts for 3-4 hours
• Examples: Humalog, NovoLog, Apidra

Short-Acting Insulin

• Onset: Works within 30-60 minutes
• Peak: Reaches peak effect 2-4 hours after injection
• Duration: Lasts for 5-8 hours
• Examples: Regular insulin (Humulin R, Novolin R), Actrapid, Velosulin

Intermediate-Acting Insulin

• Onset: Works within 1-2 hours
• Peak: Reaches peak effect 4-12 hours after injection
• Duration: Lasts for 12-18 hours
• Examples: NPH (Humulin N, Novolin N), Lente, Protaphane

Long-Acting Insulin

• Onset: Works within 2-4 hours
• Peak: Reaches peak effect 6-12 hours after injection
• Duration: Lasts for 24-36 hours
• Examples: Glargine (Lantus, Basaglar), Detemir (Levemir), Toujeo

Combination Insulins

• Onset: Varies depending on the specific combination
• Peak: Varies depending on the specific combination
• Duration: Varies depending on the specific combination
• Examples: Humalog Mix, NovoLog Mix, Toujeo Max

Choosing the Right Insulin

The type of insulin that's right for you will depend on your individual needs. Your doctor will consider factors such as your age, weight, activity level, and the severity of your diabetes.

Rapid-acting insulin is often used to cover meals or correct high blood sugar levels. Short-acting insulin is also used to cover meals, but it has a longer duration of action than rapid-acting insulin. Intermediate-acting insulin is typically used twice a day to provide basal insulin, which helps keep blood sugar levels stable between meals. Long-acting insulin is also used to provide basal insulin, but it has a longer duration of action than intermediate-acting insulin. Combination insulins contain a mix of rapid-acting and long-acting insulin, which can help simplify your dosing regimen.

How to Use Insulin

Insulin is typically injected under the skin. The most common injection sites are the abdomen, thighs, buttocks, and upper arms. Your doctor will teach you how to inject insulin correctly and how to monitor your blood sugar levels.

It's important to use insulin exactly as prescribed by your doctor. Skipping or changing doses can lead to high blood sugar levels, which can be dangerous. If you have any questions or concerns about using insulin, talk to your doctor.

Storage and Handling

Insulin should be stored in the refrigerator at a temperature between 36°F and 46°F (2°C and 8°C). Do not freeze insulin.

Once opened, some types of insulin, such as rapid-acting and short-acting insulin, can be kept at room temperature for up to 28 days. Other types of insulin, such as intermediate-acting and long-acting insulin, should be stored in the refrigerator after opening.

Possible Side Effects of Insulin

Insulin can cause side effects, including:

• Hypoglycemia (low blood sugar)
• Weight gain
• Allergic reactions
• Lipodystrophy (lumps or indentations at the injection site)

If you experience any side effects from insulin, talk to your doctor.

Other Considerations

In addition to insulin, there are other medications that can be used to manage diabetes. These include oral medications, such as metformin and sulfonylureas, and other injectable medications, such as glucagon-like peptide-1 (GLP-1) agonists and sodium-glucose co-transporter 2 (SGLT2) inhibitors.

Your doctor will work with you to determine the best treatment plan for your individual needs.

Stories for Insight

Story 1:

The Insulin Pump Debacle

A woman with type 1 diabetes was having trouble controlling her blood sugar levels with multiple daily injections of insulin. Her doctor recommended that she try an insulin pump. The woman was hesitant at first, but she eventually agreed to give it a try.

The woman loved the insulin pump initially. It gave her more freedom and flexibility in managing her diabetes. However, after a few months, she began to experience problems with the pump. It would malfunction frequently, and she had to call the company for help multiple times.

Finally, the woman had enough. She went back to using multiple daily injections of insulin. She realized that the insulin pump was not right for her and that she preferred the simplicity and reliability of injections.

What we learn: Insulin pumps can be a great option for some people with diabetes, but they are not right for everyone. It's important to weigh the pros and cons of insulin pumps before making a decision.

Story 2:

The Insulin Allergy

A man with type 2 diabetes was taking insulin to help control his blood sugar levels. One day, he developed a severe allergic reaction to the insulin. He broke out in hives and had difficulty breathing.

The man was rushed to the hospital, where he was treated with epinephrine and antihistamines. He was discharged from the hospital the next day, but he was advised to stop taking the insulin that he had been using.

The man's doctor prescribed a different type of insulin, and he has not had any problems since.

What we learn: It's important to be aware of the potential side effects of insulin, including allergic reactions. If you experience any side effects from insulin, talk to your doctor immediately.

Story 3:

The Insulin Mix-Up

A woman with diabetes was taking two different types of insulin: a rapid-acting insulin to cover meals and a long-acting insulin to provide basal insulin. One day, she accidentally mixed up the two insulins.

The woman took the long-acting insulin before breakfast, and she took the rapid-acting insulin at bedtime. This caused her blood sugar levels to drop dangerously low overnight.

The woman woke up in the morning feeling dizzy and nauseous. She called her doctor, who told her to check her blood sugar levels. When she checked her blood sugar, it was only 40 mg/dL.

The woman was immediately taken to the hospital, where she was treated with glucose. She was discharged from the hospital later that day, but she was advised to be more careful when taking her insulin.

What we learn: It's important to pay close attention to the type of insulin you are taking and to be careful when mixing different types of insulin.

Frequently Asked Questions

1. How often should I check my blood sugar levels?

The frequency of blood sugar monitoring will vary depending on your individual needs. Your doctor will recommend a blood sugar monitoring schedule that is right for you.

2. How do I inject insulin?

Your doctor will teach you how to inject insulin correctly. In general, insulin is injected under the skin at a 45-degree angle.

3. What should I do if I have a hypoglycemic reaction?

If you have a hypoglycemic reaction, eat or drink something that contains sugar immediately. This will help raise your blood sugar levels.

4. What should I do if I have an allergic reaction to insulin?

If you have an allergic reaction to insulin, stop using it and call your doctor immediately.

5. How long does insulin last?

The duration of insulin will vary depending on the type of insulin you are taking. Rapid-acting insulin lasts for 3-4 hours, short-acting insulin lasts for 5-8 hours, intermediate-acting insulin lasts for 12-18 hours, and long-acting insulin lasts for 24-36 hours.

6. Can I take insulin if I am pregnant or breastfeeding?

Yes, you can take insulin if you are pregnant or breastfeeding. However, it is important to talk to your doctor about the best type of insulin for you and how to adjust your dose.

7. What are the different types of insulin pens?

There are several different types of insulin pens available, including:

• Pre-filled pens: These pens come pre-filled with insulin, so you do not need to load them.
• Disposable pens: These pens are disposable and can be used for multiple injections.
• Reusable pens: These pens can be reused and loaded with different types of insulin.

8. What are the different types of insulin pumps?