Different insulin types are grouped together by how the insulin works in regards to length of duration, peak, and how fast the onset is. Duration will tell how long the insulin will be able to lower the blood sugar, peak will tell the time when the insulin is the most effective in the body, and onset will describe the length of time before the insulin will begin lowering the blood sugar. Rapid-acting, short-acting, intermediate-acting, long-acting, and pre-mixed are the main different insulin types.
Exactly how quickly insulin begins to work and how long it lasts depend on brand, so it's important for anyone using insulin to read the information provided with it when changing to a new prescription or different insulin types. Rapid-acting insulins, like Humalog® and Novolog®, will onset between 10 and 30 minutes, peak in 30 to 90 minutes, and last up to 5 hours. Short-acting insulins, like Novolin® or Humulin® will onset between 30 minutes and 1 hour, peak at 2 to 5 hours, and have duration of 2 to 8 hours. Rapid-acting and short-acting insulins are also called "mealtime" or "borus" insulin.
Intermediate-acting insulins, like NPH and Lente®, will onset between 1 and 2 1/2 hours, peak in 3 to 12 hours, and have duration of 18 to 24 hours. The long-acting brands, like Lantus®, and Ultralente® and onset between 30 minutes and 3 hours, peak in 6 to 20 hours, and have duration of 20 to 36 hours. There is no peak with Lantus®, however; its action is continual. Intermediate-acting and long-acting insulins are also called "background" or "basal" insulin.
Pre-mixed varieties are usually a 50/50 mix or 70/30 mix of short-acting and intermediate-acting insulin. Their onset is 10 minutes to 30 minutes, peak in 1 to 12 hours, and have duration of up to 24 hours. The mix of insulin in these varieties can be beneficial for users who only need a simple treatment plan. It is important to remember that different insulin types will work differently in every individual.
While short-acting insulin is taken at multiple times in the day, intermediate- and long-acting ones are generally taken once a day. Basal insulin is used to keep an even blood sugar range with one shot a day, while short-acting is used to counteract meals throughout the day. While this is more shots a day for the diabetic, it can help keep the blood sugar at a more even range.
Diabetes treatment with insulin can take many forms. The vast majority of the diabetic population relies on the insulin injection, whether via syringe or an insulin pen. The most advanced systems are insulin pumps, which can deliver the appropriate dose of insulin continuously under the skin through a catheter, decreasing the chance of error. In 2006, a trial of inhaled insulin was attempted, but was pulled from the market a year later for financial reasons.