Insulin has been available since 1925. Initially, they were extracted from pork and beef pancreas. In the 1980s, due to the technological advancements the companies were able to produce human insulin synthetically. They replaced beef and pork and now insulin analogues are replacing human insulin.
Characteristics of Insulin
Beta cells make the hormonal insulin inside the pancreas. After each meal, beta cells release insulin to store or use glucose as per the body needs. In Type 1 diabetes, the beta cells are destroyed due to which the pancreas stops making glucose. Hence, insulin shots are helpful to use glucose from meals. In Type 2 diabetes, the beta cells are present, but the body does not respond to it. Hence, insulin helps to fulfil that purpose.
The different types of Insulin are categorised on how quickly they act, reach maximum effect and eventually wear off from the body. All insulins are dissolved in liquids. The insulin concentration peaks at U100 in the USA. This means it has 100 units of insulin per ml. of liquid. U-500 insulin is also available for patients who are extremely insulin resistant. U-40 has been phased out from most of the countries, but it can still be found in many countries. In many countries additional concentrations are available.
Insulin cannot be taken as a pill because it will be broken down like protein with food. It should be injected into the fat under the skin to reach the blood. In some cases, it can lead to allergies. Take the advice of your doctor if you have an allergic reaction after taking insulin.
7 types of insulin that actually work
An individual might have to take more than one type of insulin and it changes with time.
Rapid Acting Insulin
Brands used: Humalog – Lispro, Novolog – Aspart, Apidra – Glulisine
This kind of insulin is taken just before the meal to control the spikes in the blood sugar. This type can be used in addition to longer-acting insulin. It works in 15 minutes, peaks between 30 to 90 minutes and stays for 3 to 5 hours. Doctors say that one can take a few minutes before the meal as well.
Short- acting insulin
Brands used: Humulin R, Novolin R
This kind of insulin covers the insulin needs during meals. This can be taken 30 minutes to an hour before the meal to control blood sugar. It peaks after 2 to 4 hours and effect stays for 5 to 8 hours. The advantage of this insulin is you can take it at breakfast and supper and still have control because it lasts longer.
Brands used: Humulin N (NPH), Novolin N (NPH)
This kind of insulin can control blood sugar for 12 hours or longer so can be used overnight. It starts to work within an hour, peaks between 4 to 12 hours. This all depends on the brand one is using. Intermediate-acting insulin offers baseline insulin coverage and can be used with short or rapid acting insulin.
Brands used: Lantus (glargine), Levemir (detemir)
It lasts for 20-26 hours with no peak and has an onset of 1 hour. An individual can take it during bedtime. The long-acting insulin provides 24-hour coverage and is successful in controlling Type 2 diabetes with one shot.
Brands used: Humulin 70/30, Humulin 50/50, Novolin 70/30, Humalog mix 50/50, Humalog mix 75/25
It combines intermediate and short-acting insulin. It can be taken twice a day before meals, 10 to 30 minutes prior. It takes effect in 5 to 60 minutes and the peak time varies. The effect lasts anytime between 10 to 16 hours. Many do not fit into the pre-mixed insulin requirements often. Premixed insulins combine specific amounts of intermediate and short-acting insulin in insulin pen or bottle. The numbers mentioned in the brand name above show the percentage of the type of insulin.
Ultra long Acting
Brands used: Insulin degludec (Tresiba)
This kind of insulin has the longest effect which lasts for 42 hours. It has no peak onset. Inject one dose daily to provide base insulin levels. It can be combined with short-acting insulin to cover meals.
Brand used: Afrezza
In the USA, an inhaled insulin product called Afrezza became available during 2015. It is known to be rapid-acting inhaled insulin, which can be taken during the beginning of the meal for Type 1 and Type 2 diabetes. Please remember, Afrezza is not a substitute for long-acting insulin. It begins working within 15 minutes, peaks around 30 minutes and out of the system in 180 minutes.
Another major point to take care is the route of delivery. It means if it should be given under the skin or given intravenously. Insulin dosage is generally injected into the fatty tissue just under the skin most of the times. There are many ways in which insulin can be taken. It can either be with an injector pen, needle or insulin pump. Whatever may be the method, it is a lifesaver. It lowers toxic blood sugar, prevents blindness, nerve and kidney damage and other complications. Never skip a dosage of insulin as you are likely to have problems later in life. Velosulin is the most preferred brand used for an insulin pump. Insulin must be stored in refrigerator alternatively; vial or pen can be kept at room temperature. All insulins have an expiry date and the unused ones should be discarded.
The doctor works out the plan of the dose of insulin to be taken depending upon the vital statistics like weight, height, diet, age and overall health. After the doctor makes the plan, you can adjust depending on how the glucose level responds. How to do it? Simple. If the blood sugar level is too high after breakfast, you know the next time a higher dosage will be required.
Figuring out the right dosage can be an exercise of trial and error. Work closely with the diabetes treatment team to monitor your glucose levels. The injection can be inserted from the abdomen, back of the arm, thighs or hips. Although taking it on the abdomen is highly recommended as it will act quickly.