Table 11.
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)