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Types of Insulin Preparations

Insulin is a peptide hormone secreted by cell clusters in the pancreas that form the endocrine part of that organ. Insulin works by regulating the absorption and storage of glycogen (blood glucose) in the cells of the liver, fat tissue and muscle, and by accelerating the oxidation of sugar in cells. Some people suffer from conditions like diabetes or insulinoma in which they cannot produce this hormone naturally and must rely on synthetic insulin preparations.

  1. Categories

    • Insulin types usually fall into one of four categories based on their commonly reported actions: short-acting insulin, rapid-acting analogs, intermediate-acting insulin and long-acting analogs. Doctors typically base their choice of insulin on the time course desired for the level of the illness under treatment. Factors that contribute to the choice of insulin include length of time to the onset of medication and the effective duration of medication.

    Regular Human Insulin

    • Regular human insulin is a short-acting preparation that the FDA (Food and Drug Administration) has approved to treat type 1 and type 2 diabetes and for hyperglycemia (abnormally high blood sugar) experienced during pregnancy. Regular human insulin is most often administered subcutaneously as with other insulins, but it is the only preparation that also may be administered intramuscularly and intravenously. This insulin acts within 15 to 30 minutes and lasts from one to 12 hours.

    Rapid-Acting Analogs

    • Rapid-acting analogs include the medications insulin aspart, insulin glulisine and insulin lispro. These types of insulin work by attempting to duplicate the phase-2 prandial insulin release (the insulin nondiabetics naturally release during meals). Rapid-acting analogs are structurally different from regular human insulin, but deliver similar biological actions. They are usually administered by subcutaneous injection or by use in insulin pump therapies. They take effect in 15 to 30 minutes and can last for up to six hours.

    Intermediate-Acting Insulin

    • NPH (neutral protamine Hagedorn) insulin, or Isophane insulin suspension, was developed by adding neutral protamine (nuclear proteins) to regular human insulin in order to decrease the amount of injections required to control food-related blood sugar levels. This type of insulin is administered by subcutaneous injection or by a prefilled pen device. NPH insulin begins to work in two to four hours and is most effective for 10 to 16 hours. Its maximum duration is 14 to 18 hours.

    Long-Acting Analogs

    • Insulin glargine and insulin detemir are long-acting analog insulin preparations that work in much the same way as other insulin. The main difference between this and other types is the length of time to onset and the duration of action, which has been extended in the long-acting type. Long-acting insulin is typically administered by subcutaneous injection. The length of time to onset is three to four hours and the maximum duration is 20 to 24 hours.

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