Available insulins^[1]

Type	Onset (hours)	Peak (hours)	Duration (hours)	Comments
Ultra-rapid-acting
Faster aspart Insulin lispro-aabc	0.1 to 0.2	1 to 3	3 to 5	Duration of action may be shorter.
Rapid-acting
Lispro/aspart/glulisine	0.15 to 0.35	1 to 3	3 to 5
Short-acting
Regular	0.5 to 1	2 to 4	5 to 8	Longer duration of action if larger dose.
Intermediate-acting
NPH	2 to 4	4 to 12	12 to 24	Peak and duration quite variable.
NPL	Approximately 2	6	15	Activity profile similar to NPH; can be mixed with insulin lispro. Not available in the United States.
Basal long-acting
Glargine*	2 to 4	8 to 12 (not pronounced)	22 to 24	Half-life is shorter in some patients, requiring division of the daily dose into 2 injections per day. Cannot be mixed with other insulins, because this alters pharmacokinetics.
Detemir	1 to 2	4 to 7 (not pronounced)	20 to 24	Duration of action is dose dependent. At higher doses (≥0.8 units/kg), mean duration of action is longer and less variable (22 to 23 hours). At lower doses, mean duration of action is shorter and twice-daily injections are often needed. Cannot be mixed with other insulins, because this alters pharmacokinetics.
Glargine U300	2 to 6	None	30 to 36	Cannot be mixed with other insulins, because this alters pharmacokinetics.
Degludec	0.5 to 1.5	None	>42	Less day-to-day variation in glucose-lowering effect at steady state (after 2 to 3 days' use) relative to glargine U100 and detemir. Can be mixed with insulin aspart; coformulation with aspart available in some countries.

The numbers indicated above are approximations and are influenced by many factors including (but not limited to) presence and type of antibodies to the specific insulin, site of injection, and mass action effect. Premixed insulins are not generally recommended but are sometimes useful to reduce the number of injections in selected patients; mixes consist of NPH and regular (70:30 mix) or NPH and Lispro (75:25 mix), as well as other concentrations. Other new insulins are presently in clinical trials. No inhaled insulin preparation is currently available, but both orally absorbed and inhaled insulin preparations are being developed.

NPH: neutral protamine hagedorn; NPL: neutral protamine lispro.

* Certain biosimilar insulins for lispro, aspart, and glargine are approved for children in some countries, including the United States, Canada, and Europe. The US Food and Drug Administration uses the term "similar" rather than "biosimilar" for technical reasons^[2].

References:

Cengiz E, Danne T, Ahmad T, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Insulin treatment in children and adolescents with diabetes. Pediatr Diabetes 2022; 23:1277.
In brief: Another insulin lispro (Admelog) for diabetes. Med Lett Drugs Ther 2018; 60:e109.

Graphic 61880 Version 12.0

خرید پکیج

Available insulins[1]

Available insulins^[1]