Insulin


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Editors
Leonor Corsino, MD, MHS, FACE
Yen Dang, PharmD
Silvio Inzucchi, MD
Sean T. Vasaitis, MD
Guillermo Umpierrez, MD


Additional Resources
Affordable Insulin Project
Mayo Clinic
NIDDK (NIH)

What are the different types of insulin?

Different types of insulin are classified by how fast they start to work and how long they continue to work in the body. 

Mealtime (or “bolus”) insulin. Used before meals to control the rise of blood glucose levels after eating.

  • Rapid-acting: lispro, aspart, glulisine, regular human inhaled 
  • Short-acting: human regular insulin

Basal insulin. Controls your blood glucose levels between meals and throughout the night. This is usually used once or twice daily. It can be used alone or in combination with oral medicines or rapid-acting insulin.

  • Intermediate-acting: human NPH
  • Long-acting: glargine biosimilar, detemir, and degludec 

Pre-mixed insulin. Combination of bolus and basal insulins that controls blood glucose levels after and between meals. These are usually used twice daily before breakfast and dinner. They can be used alone or in combination with oral medicines.

The type of insulin your doctor prescribes will depend on the type of diabetes you have, your lifestyle (when and what you eat, how much you exercise), your age, your body’s response to insulin. It also depends on how often you are able or willing to check your blood glucose and give yourself injections.

People with type 1 diabetes often need more than one type of insulin. Most people with type 2 diabetes who use insulin just use basal (long-acting) insulin initially.

What are insulin analogs?

In recent years, scientists have developed new products called insulin analogs. These have been genetically engineered to better match the insulin produced by your pancreas.

Insulin analogs make it easier to control blood glucose. By controlling and preventing hyperglycemia (high blood glucose) and hypoglycemia (low blood glucose), they may reduce the risk of diabetic health problems and improve your quality of life. Like traditional insulins, insulin analogs are injected with a syringe, an insulin pen, or an insulin pump. Insulin analogs include long-acting, basal insulins (for example glargine and determir) and rapid-acting, bolus insulins (for example, lispro, aspart, and glulisine).

Some insulin analogs have not yet been approved for use during pregnancy. If you are or plan to become pregnant, talk with your doctor about the best insulin for you.

How can you take care of yourself and your diabetes?

If you have diabetes, you should maintain a healthy lifestyle and learn as much as you can about your condition. Follow your doctor’s recommendations for treatment and regularly monitor your blood glucose to avoid high or low blood glucose. You can manage your diabetes with diet, exercise, and medicines (if needed).

Questions to ask your doctor, if you are taking insulin 

  • What type of diabetes do I have?
  • What kind of medicine do I need for my diabetes?
  • What are the risks and benefits of the medicine?
  • Do I need to take insulin? What type? How often?
  • How often should I check my blood sugars?
  • How often will I need check-ups?
  • Should I see a diabetes educator?
  • Should I see an endocrinologist for my care?
Edited: January 2019