This is five times more concentrated than U regular insulin. Long-acting insulin glargine is also available in U This is three times more concentrated than U long-acting insulin. Be sure to check the concentration of your insulin so you take the right amount. Insulin is made by different companies. Make sure you use the same type of insulin consistently.
Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal.
Rapid-acting insulin acts most like insulin that is produced by the human pancreas. It quickly drops the blood sugar level and works for a short time.
If a rapid-acting insulin is used instead of a short-acting insulin at the start of dinner, it may prevent severe drops in blood sugar level in the middle of the night. Short-acting insulins take effect and wear off more quickly than long-acting insulins.
A short-acting insulin is often used 30—60 minutes before a meal so that it has time to work. These liquid insulins are clear and do not settle out when the bottle vial sits for a while.
This patient could benefit from the substitution of insulin lispro for regular human insulin to decrease postprandial blood glucose excursions. The patient who uses insulin lispro can expect fewer episodes of hypoglycemia if the exercise is undertaken 2.
Information from Bohannon NJ. Benefits of lispro insulin: control of postprandial glucose levels is within reach. Postgrad Med ; 2 —6,79— Primary care physicians should consider including mealtime insulin lispro in insulin regimens. The disadvantages of insulin lispro therapy are the increased risk of hypoglycemia if meal ingestion or absorption gastroparesis is delayed and the increased overall cost of therapy. In addition, insulin lispro is available by prescription only.
Nonetheless, a short-acting insulin analog such as insulin lispro should provide increased convenience and flexibility to patients who are currently receiving regular human insulin.
Furthermore, the characteristics of insulin lispro may help patients achieve improved long-term glycemic control and may reduce the incidence of hypoglycemic episodes.
Insulin analogs may be an important tool for helping patients with diabetes mellitus achieve their target glucose goals. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. NOBLE, pharm. She earned a doctorate in pharmacy from the University of Mississippi. She earned her master's degree in education from Jackson Miss. State University. Address correspondence to Sara L.
Noble, Pharm. State St. Reprints are not available from the authors. Noble has served as a co-investigator for Merck Research Laboratories and Abbott Laboratories, and as a member of the speaker's bureau of CibaGeneva Pharmaceuticals Novartis.
Insulin therapy in the era of insulin analogs. Pharmacist ;HS35—HS The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized, prospective 6-year study.
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Endocrinol Metab Clin North Am. Betz JL. Fast-acting human insulin analogs: a promising innovation in diabetes care. Diabetes Educ. A rapidly absorbed analogue of human insulin. Pharmacokinetics, pharmacodynamics and glucose counterregulation following subcutaneous injection of the monomeric insulin analogue [Lys B28 , Pro B29 ] in IDDM.
US Pharmacist. Physicians' desk reference. Clin Pharmacol Ther. Heinemann L. Do insulin-treated diabetic patients use an injection-meal-interval in daily life? Diabet Med. Trautmann ME. Horm Metab Res. Improved postprandial metabolic control after subcutaneous injection of a short-acting insulin analog in IDDM of short duration with residual pancreatic beta-cell function.
Improvement of glycemic control with the rapidly absorbed lispro analog in type 1 diabetes. Rapid-acting insulin acts most like insulin that is produced by the human pancreas. It quickly drops the blood sugar level and works for a short time. If a rapid-acting insulin is used instead of a short-acting insulin at the start of dinner, it may prevent severe drops in blood sugar level in the middle of the night. Short-acting insulins take effect and wear off more quickly than long-acting insulins.
A short-acting insulin is often used 30 minutes before a meal so that it has time to work. These liquid insulins are clear and do not settle out when the bottle vial sits for a while. Intermediate-acting insulins contain added substances buffers that make them work over a long time and that may make them look cloudy. When these types of insulin sit for even a few minutes, the buffered insulin settles to the bottom of the vial.
Mixtures of insulin can sometimes be combined in the same syringe, for example, intermediate-acting and rapid- or short-acting insulin. Not all insulins can be mixed together. For convenience, there are premixed rapid- and intermediate-acting insulin. The insulin will start to work as quickly as the fastest-acting insulin in the combination. It will peak when each type of insulin typically peaks, and it will last as long as the longest-acting insulin. Examples include:.
Author: Healthwise Staff. Medical Review: E. Rapid Acting Insulin Analogs Insulin Aspart, insulin Lyspro, Insulin Glulisine which have an onset of action of 5 to 15 minutes, peak effect in 1 to 2 hours and duration of action that lasts hours.
With all doses, large and small, the onset of action and the time to peak effect is similar, The duration of insulin action is, however, affected by the dose — so a few units may last 4 hours or less, while 25 or 30 units may last 5 to 6 hours. As a general rule, assume that these insulins have duration of action of 4 hours. The larger the dose of regular the faster the onset of action, but the longer the time to peak effect and the longer the duration of the effect.
NPH Human Insulin which has an onset of insulin effect of 1 to 2 hours, a peak effect of 4 to 6 hours, and duration of action of more than 12 hours. Very small doses will have an earlier peak effect and shorter duration of action, while higher doses will have a longer time to peak effect and prolonged duration.
Pre-Mixed Insulin which is NPH pre-mixed with either regular human insulin or a rapid- acting insulin analog.
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