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Questions about diabetes

Learn About Different Types of Insulin

What are the different types of insulin?
There are several types of insulin. Rapid- or short-acting insulin is usually taken before meals. Intermediate- or long-acting insulin is usually taken at supper or bedtime. Some types of premixed insulin provide rapid-acting and intermediate-acting insulin in a single dose. This type of insulin is usually taken before breakfast, before the evening meal, or at both times. Talk with your healthcare provider or diabetes-care team to determine which insulin type is right for you.
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What is a rapid-acting insulin analog?
A rapid-acting insulin analog is a modified form of human insulin. This modification allows the insulin to be absorbed and work faster. As a result, it starts working within minutes, allowing you to take your insulin and eat right away. Rapid-acting insulin analogs are also considered to act similar to the way insulin is released after meals in people without diabetes, which is a significant goal of insulin therapy.
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What are the advantages of a rapid-acting insulin analog?
A rapid-acting insulin analog has several advantages over other types of insulin.
  • It can be injected within 15 minutes of starting a meal, making it more convenient.
  • It doesn't last in the body as long as other types of insulin. Rapid-acting insulin analogs are also considered to act similar to the way insulin is released after meals in people without diabetes, which is a significant goal of insulin therapy. Rapid-acting insulin can improve blood glucose control after meals.
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How is insulin supplied?
Some insulin analogs are available in prefilled disposable pens. Most insulin is available in 3-mL cartridges and 10-mL vials.
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Is a prescription necessary for insulin and supplies?
Prescriptions are not needed to get some of the older types of insulin, but they are needed for the more modern types of insulin analogs. Depending on the laws in your state, you may also need prescriptions for needles and syringes.
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Mixing insulin can be difficult. Is there an easier way?
Premixed insulin analogs provide both rapid-acting and intermediate-acting insulin in a single preparation. Talk to your healthcare provider to see if a premixed insulin analog may work for you. Any change in insulin should be made carefully and only under medical supervision.
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Can a person switch from Regular insulin to rapid-acting insulin?
If you have achieved glycemic control with Regular human insulin, you may decide to switch to a rapid-acting insulin analog for increased convenience and flexibility. You may find that your dosage of a rapid-acting insulin analog will be the same. It's important to note that any change in insulin must be done under strict medical supervision, and each person's dosage and injection schedule is individualized.
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Can rapid-acting insulin analogs be mixed with other insulin?
Yes, with some other types of insulin. They cannot, however, be mixed with long-acting insulin analogs. Talk to your healthcare provider about taking a Rapid-acting insulin with another type of insulin. Any change in treatment therapy should be made cautiously and only under medical supervision.
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What is basal insulin?
In people without diabetes, the pancreas continuously releases a small, steady "basal" flow of insulin to keep blood glucose in a normal range overnight and between meals. A long-acting insulin analog can be used to mimic this basal insulin.
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What is bolus insulin?
When you eat, the pancreas normally releases a short "burst" or "bolus" of insulin to handle the increased glucose in your blood after a meal. Blood glucose is usually highest about an hour after a meal. High glucose levels signal the body to release more insulin into the bloodstream to help the glucose get into the cells where it can be used as energy. This natural bolus of insulin can be mimicked (copied) by using an injection of a rapid-acting insulin analog before each meal.
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Why would a person who has been taking diabetes pills for a while now need insulin? Does this mean he or she has type 1 diabetes? Why would he or she need to inject insulin when others only have to take pills?
As type 2 diabetes progresses, the body's ability to make enough insulin naturally dwindles. Over time, even two or three types of diabetes pills may not be enough to manage blood glucose levels, and insulin becomes necessary. This doesn't mean the person with type 2 diabetes has done anything wrong or has type 1 diabetes. It just means that diabetes has progressed to a point where diabetes pills alone are no longer sufficient in controlling the disease. Most people with type 2 diabetes will need to eventually take insulin to help manage their diabetes.
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What are some sample insulin therapy plans?
Your healthcare provider will help you develop an insulin therapy plan that is right for you. Your plan will be based on your lifestyle, eating habits, and exercise habits. Some examples of insulin plans include:
2 Injections of a premixed insulin analog - The rapid-acting insulin analog part of the premix starts working right away. You can eat as soon as you take your insulin. The intermediate-acting part provides longer-term insulin coverage. This plan gives the advantage of providing insulin coverage at mealtime and in-between time.
2 injections of a premixed insulin analog
1 injection of a long-acting insulin analog - this plan is often used by people with type 2 diabetes. The injection is usually taken at bedtime or at dinner to provide up to 24-hour insulin coverage and to prevent high fasting blood glucose in the morning.
1 injection of a long-acting insulin analog
Intensive insulin therapy - this plan can give you more flexibility when it comes to meals and activity level. It usually means taking a long-acting insulin analog and a rapid-acting insulin analog. An example of a 4-injection plan would be 3 injections of a rapid-acting insulin analog before meals and 1 injection of a long-acting insulin analog at bedtime. This plan is intended to mimic your body's natural flow of insulin release.
Three injections of a rapid-acting insulin analog and one injection of a long-acting insulin analog.
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What is intensive insulin therapy?
Intensive insulin therapy usually means having an insulin plan that includes taking a long-acting insulin with a rapid-acting insulin. The goal of intensive insulin therapy is to keep your blood glucose as close to normal as possible. It can help your body meet your need for insulin like your body did before you had diabetes. Intensive insulin therapy can help you better manage your blood glucose, add more freedom and flexibility to your life, and may help you reduce your risk of diabetes-related complications. To use intensive insulin therapy, you may need to take insulin and use your blood glucose meter when you are away from home. Fortunately, insulin delivery systems are available that offer a convenient alternative to the sometimes inconvenient vial and syringe.
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