Table 11.

Summary of available human and analog insulins and their pharmacokinetics

Type of insulina	Onset of action	Peak	Duration of action	Frequency of dosing
Human insulin
Regular	0.5–1 h	2–4 h	6–8 h	Meal time (preferred in DGp, poorly controlled diabetes mellitus, enteral nutrition)
NPH (isophane)	2–4 h	4–8 h	12–16 h	Basal insulin, given twice a day
U 500 regular (concentrated)	2–4 h	4–8 h	12–16 h	Basal/bolus 2–3 × day or  pump
Analog insulin
Prandial/meal time/rapid acting
Lispro	5–15 min	1 h	2–4 h	Meal time
Aspart	5–15 min	1–3 h	3.5–5 h
Glulisine	5–15 min	1 h	4–5 h	Meal time(may be administered within 20 min after a meal)
Aspart (fast acting)	< 15 min	1.5–2.22 h	5–7 h
Basal/long acting analog
Glargine (U100)	3–4 h	Flat/12 h	10.8–24 h	Once or twice a day Duration dose dependent (generic available)
Detemir U100	1–4 h	Flat	10–18 h	Twice a day Duration dose dependent
Degludec (u-100)	90 min	Flat peak	24–42 h	Once a day
Concentrated insulinsb
U-200 degludec	90 min	Flat	24–42 h	Basal
U-300 glargine	6 h	Flat	24 h
U-500 regular	~ 15 min	4–8 h	≤ 21 h	Basal/bolus Inject 30 min before meal
U-200 lispro	~ 15 min	30–90 min	4–5 h	Prandial

^aPremix insulins and inhaled insulins are not discussed here since their role in patients with DGp is unclear

^bConcentrated insulins may be helpful in insulin-resistant patients with DGp (type 2 diabetes mellitus)