Insulin is a hormone produced in the pancreas which regulates the amount of glucose in the blood. Insulin helps keep your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia) The cells in your body need sugar for energy. However, sugar cannot go into most of your cells directly. After a meal when your blood sugar rises, cells in your pancreas are signaled to release insulin into your bloodstream. Insulin then attaches to its receptors and opens a specific pathway through which sugar can enter into the cells. Insulin is often described as a key which unlocks the cell to allow sugar to enter into the cell and be used for energy.

 

Insulin can be broadly classified as basal and bolus insulin:

 

Basal Insulin: Drop by drop of insulin released by our pancreas slowly for 24 hours is the basal insulin. Basal insulin is also called as background insulin. Its role is to control blood glucose levels during periods of fasting.

When fasting the body steadily releases glucose into the blood to supply our body with energy. Basal insulin helps to keep this glucose under control and allow the cells to uptake the glucose.

Bolus Insulin: When we have a meal our blood glucose rises. To control this glucose our pancreas to release more insulin which is called bolus insulin.

For clinical use biosynthetic human insulin is used and is manufactured by recombinant DNA technology. Several analogs of human insulin which are closely related to human insulin structure are available to mimic the human pancreas.

Various types of Insulin used for treatment purpose include:

  • Rapid-acting Insulin
  • Regular or Short-acting insulin
  • Intermediate-acting insulin
  • Long-acting insulin

Each type of Insulin works at a different speed. Most people need 2 or more types of insulins to reach their targets. Each Insulin has a time action profile which consists of onset, peak action, and duration of action.

  • The Onset is how soon the insulin starts to lower blood glucose after being injected.
  • The Peak is the time insulin is working at its maximum or hardest to lower the blood glucose.
  • The duration is how long the insulin works in your body or continues to lower the blood glucose.

 

So this time action profile of insulin should match with your food intake and blood glucose. Hence if you are taking insulin whose onset is 30mins, you are advised to inject it 30 mins before you have your food, similarly, if you are taking rapid-acting insulin it starts to work right after you take it, so you can have your food immediately.

 

Insulin Onset Peak Duration
Rapid-acting Insulin Analogs:

Insulin Aspart

Insulin Lispro

Insulin Glulisine

5 – 15 mins

5 – 15 mins

5 – 15 mins

30 – 90 mins

30 – 90 mins

30 – 90 mins

3 – 5 hours

3 – 5 hours

3 – 5 hours

Short-acting regular Insulin 30 – 60 mins 2 – 3 hours 5 – 8 hours
Intermediate-acting Insulin:

NPH

Lente

2 – 4 hours

3 – 4 hours

4 – 10 hours

4 – 12 hours

10 – 16 hours

12 – 18 hours

Long Acting Insulin:

Insulin Ultralente

Insulin Glargine

Insulin Detemir

6 – 10 hours

2 – 4 hours

2 – 4 hours

10 – 16 hours

Peakless

6- 14 hours

18 – 24 hours

20 – 24 hours

16 – 20 hours

Insulin Mixtures:

30/70 Human mix

25/75 Lispro Analog Mix

30/70 Aspart Analog Mix

50/50 Lispro Analog Mix

50/50 Human Mix

30 – 60 mins

5 – 15 mins

5 – 15 mins

5 – 15 mins

30 – 60 mins

Dual

Dual

Dual

Dual

Dual

10 – 16 hours

10 – 16 hours

10 – 16 hours

10 – 16 hours

10 – 16 hours

The action profile of insulin should always match your food timings and blood sugar peaks.

If the peak action time of insulin does not match your blood sugar peak; in spite of taking insulin, your sugar will not be under control and will result in episodes of hyperglycemia and hypoglycemia. Always clarify from your health care team as to when should you eat after insulin injection.

 

Related:

Insulin Basics

Things to remember while using insulin

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