In the recent years, diabetes is becoming a global epidemic disease. With the enormous number of oral therapy like anti-diabetic drugs available, yet the selection of treatment depends on the factors like age and situation of the person. Regular diet and exercises is the primary step that can help achieve healthier blood sugar levels. Injectable medication is also one among the option that helps in controlling the blood sugar level. Then comes final option of injecting insulin when the above options of oral treatment do not help better in controlling the blood sugar levels. The way how the insulin works is important to understand for a diabetic patient. Having a thorough understanding of what is the root cause of the diseases (few exceptions), helps in achieving a better treatment.
What is Insulin?
Insulin is an anabolic hormone of the body that is secreted by the pancreas. It helps in regulating blood sugar level from reaching too high or too low. The role of Intermediate acting insulin is to keep the glucose level in the blood stream in the normal range. This glucose, actually referred as sugar is used up by the cells in the form of energy source. When the insulin secretion gets too little, glucose can no longer be moved into the cells thereby leading to the lack of energy. In addition, insulin has other metabolic effects like affecting the breakdown of protein and fat. The right time to start the insulin therapy is a major concern as it greatly depends on the patient’s acceptance to adhere to the therapy. Insulin therapy is categorized based on the factors like how fast they react, how long they last in the body, how concentrated they are in terms of number of units per ml and the route they are injected.
Different Types of Insulin
This insulin action may vary from person to person and it cannot be said to be the same on all the days. Since the situation is unique, it is wise to consult a physician to get a right medication. The three broad classes of insulin and their average duration of action are given below.
Rapid-acting Insulin or Regular Insulin
This type of insulin starts its action in 5 to 15 minutes and it reaches its peak activity in 1 to 2 hours. The duration of action lasts up to 4 hours on an average, based on the dosage, say number of units. The timing of dosage is 5 to 15 minutes before or immediately after meals.
Novorapid, Humalog and Apidra are Rapid-acting insulin drugs.
Intermediate-acting or NPH Insulin
As the name NPH stands for Neutral Protamine Hagedorn, this type of insulin is made with a protein and the onset of action is 1hour to 1.5 hour which relatively much slower compared to other types, but it benefits in lasting for longer duration 16 to 20 hours on an average. It helps in regulating the blood sugar level overnight. It is also referred as cloudy insulin. You can read more about intermediate acting insulin. The timing of insulin is to be given pre-breakfast/pre-bed. It is more effective for treating type2 diabetes. It has an increased risk of hypoglycemia. NPH insulin is administrated under the skin and it requires at least once or twice a day.
Insulated and Humulin are Intermediate-acting insulin drugs.
For those who are not willing to go on NPH twice day, Long-lasting insulin comes a choice of insulin therapy. It profile is similar to basal insulin that stops sugar output from the liver. The onset of insulin effect in 1 t0 1.5 hours and it lasts 12-24 hours that is for an entire day. Timing of dosage has to be given on the same time every day at any time of the day. Due to its flexible characteristic, this type of insulin is often preferred over other types, provided by the physician’s advice.
Glargine and Detemir are Long-lasting insulin drugs.
Apart from these three broad classes of insulin, other type of insulin is Pre-mixed insulin. It contains a fixed proportion of rapid and intermediate insulin. This starts its action in 30 minutes and can last up to 18 hours on an average. The timing of dosage to be given is 30-60 minutes before meals.
Mixtard (30*) and Humulin (30/70*) are Pre-mixed human insulin drugs