General Practice 2022

Types of insulin: what they are, what they are for and how to apply

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Types of insulin: what they are, what they are for and how to apply
Types of insulin: what they are, what they are for and how to apply

Insulin is a hormone naturally produced by the body to control blood glucose levels, but when it is not produced in sufficient quantity or when its function is impaired, as in diabetes, it may be necessary to use synthetic insulin and injectable.

There are several types of synthetic insulin, which mimic the action of the natural hormone at every moment of the day, and which can be applied through daily injections into the skin with syringes, pens or small specialized pumps.

Synthetic insulin helps to normalize blood glucose levels and allows the diabetic to maintain a he althy life and avoid the complications of diabetes. However, its use should only be started when indicated by a general practitioner or endocrinologist, as the type of insulin to be used, as well as its amounts, vary according to the needs of each person.

The main types of insulin vary according to the time of action and when they should be applied:

1. Long-acting or slow-acting insulin

It can be known as Detemir, Deglutega or Glargina, for example, and lasts for a whole day. This type of insulin is used to maintain a constant amount of insulin in the blood, which mimics basal and minimal insulin, throughout the day.

Currently, there are ultra-low insulins, which act for up to 2 days, which can reduce the number of bites and improve the diabetic's quality of life.

2. Intermediate-acting insulin

This type of insulin can be known as NPH, Lenta or NPL and it works for about half the day, between 12 to 24 hours. It can also mimic the basal effect of natural insulin, but it should be applied 1 to 3 times a day, depending on the amount needed for each person and the doctor's advice.

3. Rapid-acting insulin

Also known as regular insulin, it is an insulin that should be applied about 30 minutes before the main meals, usually 3 times a day, and that helps to keep glucose levels stable after eating food.

The most well-known trade names for this type of insulin are Humulin R or Novolin R.

4. Ultra-rapid-acting insulin

It is the type of insulin that has the most immediate effect and, therefore, must be applied immediately before eating or, in some cases, right after eating, mimicking the action of insulin that is produced when we eat to avoid blood sugar levels to get high.

The main commercial names are Lispro (Humalog), Aspart (Novorapid, FIASP) or Glulisina (Apidra).

Characteristics of each type of insulin

The characteristics that differentiate the main types of insulin are:

Insulin type Start of action Peak action Duration Insulin Color How much to take
Ultra-Fast Action 5 to 15 min 1 to 2 hours 3 to 5 hours Transparent Right before meals
Quick Action 30 min 2 to 3 hours 5 to 6 hours Transparent 30 min before meals
Slow Action 90 min No peak 24 to 30 hours Transparent / Milky (NPH) Usually once a day

The onset of insulin action corresponds to the time it takes for insulin to start taking effect after administration and the peak of action is the time when insulin reaches its maximum action.

Some diabetics may need rapid-acting, ultra-rapid and intermediate-acting insulin preparations, called pre-mixed insulin, such as Humulin 70/30 or Humalog Mix, for example, to control the disease and, it is usually used to facilitate its use and reduce the number of stings, especially by elderly people or those with difficulty preparing insulin due to motor or vision problems. The onset of action, duration and peak depend on the insulins that make up the mixture, and it is usually used 2 to 3 times a day.

In addition to insulin injections applied with a specialized pen or syringe, you can also use the insulin pump, which is an electronic device that is connected to the body and releases insulin for 24 hours, allowing for better control blood sugar levels and diabetes, and can be used for individuals of all ages, usually in type 1 diabetes.Learn more about how to use and where to find your insulin pump.

How to apply insulin

For any type of insulin to take effect, it is essential to apply it correctly, and for that it is necessary:

  1. Make a small fold in the skin,before giving the injection, so that it is absorbed in the subcutaneous region;
  2. Introduce the needle perpendicular to the skin and apply the medication;
  3. Vary the injection sites, between the arm, thigh and belly and even in these places it is important to rotate, to avoid bruising and lipohypertrophy.

Furthermore, it is important to store insulin, keeping it in the fridge until it is opened and after the package is opened it must be kept protected from the sun and heat and must not be used for more than 1 month. Better understand the details of how to apply insulin.

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