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Diabetes: Types of Insulin

There are many forms of insulin. They are classified 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

The FDA approved the inhaled insulin drug Exubera in 2006. But in October 2007 the drug company Pfizer said it was halting sales of the drug because of financial reasons.

What Type of Insulin Is Best Suited For Me?

Your doctor will work with you to prescribe the type of insulin that is best for you. Deciding what type of insulin might be best for you will depend on many factors, including:

Your body's individualized response to insulin (how long it takes insulin to be absorbed in the body and remain active in the body varies slightly from individual to individual).
Your own lifestyle choices -- for instance, the type of food you eat, if/how much alcohol you drink, or how much exercise you get – are all factors that influence your body's processing of insulin.
How willing you are to give yourself multiple injections per day.
How frequently you are willing to check your blood sugar level.
Your age.
Your blood sugar management goals.

The following chart lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood glucose), peak (the time period when the insulin is the most effective in lowering blood glucose) and duration (how long insulin continues to lower blood glucose). These three factors may vary, depending on your body's response. The final column provides 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 Glucose Management
Rapid-Acting
Humalog or lispro	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 used with longer-acting insulin.
Novolog or aspart	10-20 min.	40-50 min.	3-5 hours
Apidra or glulisine	20-30 min.	30-90 min.	1-2½ hours
Short-Acting
Regular (R) humulin or novolin	30 min. -1 hour	2-5 hours	5-8 hours	Short-acting insulin covers insulin needs for meals eaten within 30-60 minutes
Velosulin (for use in the insulin pump)	30 min.-1 hour	2-3 hours	2-3 hours
Intermediate-Acting
NPH (N)	1-2 hours	4-12 hours	18-24 hours	Intermediate-acting insulin covers insulin needs for about half the day or overnight. This type of insulin is often combined with rapid- or short-acting insulin.
Lente (L)	1-2½ hours	3-10 hours	18-24 hours
Long-Acting
Ultralente (U)	30 min.-3 hours	10-20 hours	20-36 hours	Long-acting insulin covers insulin needs for about 1 full day. This type of insulin is often combined, when needed, with rapid- or short-acting insulin.
Lantus	1-1½ hour	No peak time; insulin is delivered at a steady level	20-24 hours
Levemir or detemir(FDA approved June 2005)	1-2 hours	6-8 hours	Up to 24 hours
Pre-Mixed*
Humulin 70/30	30 min.	2-4 hours	14-24 hours	These products are generally taken twice a day before mealtime.
Novolin 70/30	30 min.	2-12 hours	Up to 24 hours
Novolog 70/30	10-20 min.	1-4 hours	Up to 24 hours
Humulin 50/50	30 min.	2-5 hours	18-24 hours
Humalog mix 75/25	15 min.	30 min.-2½ hours	16-20 hours
*Premixed insulins are a combination of specific proportions of intermediate-acting and short-acting insulin in one bottle or insulin pen (the numbers following the brand name indicate the percentage of each type of insulin).