What is Insulin?
Insulin is a hormone made in the pancreas. It helps sugar from food get into your body’s cells to be used for energy. Insulin also stops the liver from making too much sugar and prevents the breakdown of fat, which can release ketones into the blood. Knowing about different types of insulin and how they work is very important.
WHY ARE INSULIN SHOTS NEEDED?
- People with type 1 diabetes don’t make insulin in their pancreas.
- Insulin can’t be taken as a pill because stomach acid would destroy it.
- People with type 2 diabetes may need insulin shots if their blood sugar levels are very high.
THE FIVE TYPES OF INSULIN:
- Rapid-acting/short-lasting insulin (ex. Humalog, Admelog, NovoLog, Apidra) and Regular insulin:
- Humalog, NovoLog, and Apidra act faster than Regular insulin.
- They are clear and start working in about 15 minutes, peak at around 90 minutes, and last for 3-4 hours.
- Ultra-rapid-acting insulin (ex. Fiasp, Lyumjev)
- Fiasp and Lyumjev start working even faster than rapid-acting insulins
- They still peak around 90 minutes, and last for 3-4 hours
- Long-lasting insulin (Lantus®, Basaglar, Levemir®):
- These insulins last about 24 hours with a flat, steady action.
- They are clear and should be injected into a pinch of fat, often in the buttocks or stomach.
- Ultra-long-lasting insulin (Tresiba® [called Degludec in some countries]):
- This insulin lasts up to 72 hours but is usually taken once daily.
- It has a very steady effect, reducing the risk of nighttime low blood sugars.
- Intermediate-lasting insulin (NPH):
- NPH insulin is cloudy and must be mixed before use.
- It peaks 3-8 hours after injection and lasts 12-15 hours.
- NPH is generally not used any longer with access to newer insulins, due to its peak, requiring multiple injections, and risk for nighttime low blood sugars.
Important Insulin Storage Tips:
- Insulin must not freeze or get too hot (over 90°F/32°C) because it will lose its effectiveness.
- Once opened, insulin can be kept at room temperature for approximately 30 days. (Read the manufacturer’s label for more specific times).
- If kept in the refrigerator and unopened, insulin will remain effective until the expiration date on the box.
HOW AND WHEN EACH INSULIN USED?
Most people with type 1 diabetes take multiple insulin shots each day. They often use a combination of long-lasting insulin once a day and rapid-acting insulin before meals.
RAPID-ACTING and ULTRA-RAPID-ACTING INSULINS:
Humalog, Admelog, NovoLog, Apidra, Lyumjev, or Fiasp
- These insulins help control the blood sugar spike with eating.
- Take rapid-acting insulin around 10-15 minutes before meals to match the insulin’s peak action with the peak absorption of sugars from food.
- For very young children with unpredictable appetites, it may be given after meals.
LONG-ACTING INSULINS:
Lantus, Basaglar, Levemir, or Tresiba
- These insulins provide steady, 24-hour blood sugar control.
- They should not be mixed with other insulins and given in the same injection.
- These insulins should be given at the same time each day
- They are also known as basal insulin.
- Levemir or Lantus might be taken twice a day if needed.
INTERMEDIATE-ACTING INSULIN (NPH):
- NPH insulin peaks in 3-8 hours and lasts 12-15 hours.
- It’s usually taken twice daily, mixed with rapid-acting insulin.
- NPH taken at dinner or bedtime can cause nighttime low blood sugars.
Understanding insulin and how to use it is a big part of managing type 1 diabetes. Knowing the different types and when to use them helps keep blood sugar levels stable and reduces the risk of complications.