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NPH insulin is cloudy and has an onset of 1–3 hours. Its peak is 6–8 hours and its duration is up to 24 hours. [9]It has an intermediate duration of action, meaning longer than that of regular and rapid-acting insulin, and shorter than long acting insulins (ultralente, glargine or detemir).
Prandial insulin is usually administered no more than 15–30 minutes prior to a meal using a rapid-acting insulin or a regular insulin. In some patients, a combination insulin may be used that contains both NPH (long acting) insulin and a rapid/regular insulin to provide both a basal insulin and prandial insulin. [36]
This is an ultralong-acting insulin analogue developed by Novo Nordisk, which markets it under the brand name Tresiba. It is administered once daily and has a duration of action that lasts up to 40 hours (compared to 18 to 26 hours provided by other marketed long-acting insulins such as insulin glargine and insulin detemir).
Ultralente insulin was a long-acting form of insulin. It has an onset of 4 to 6 hours, a peak of 14 to 24 hours, and a duration of 28 to 36 hours. [ 1 ] Ultralente insulin, along with lente insulin , were discontinued in the US by manufacturers in the mid-2000s.
The long-acting insulin class, which includes insulin glargine, do not appear much better than neutral protamine Hagedorn (NPH) insulin, [13] but do have a greater cost, making them, as of 2010, not cost effective for the treatment of type 2 diabetes. [14]
Prior to the late 1940s, insulin products were derived from pork or beef sources, and then used virtually unaltered as "short-acting" insulin products. It was known by 1950 that the addition of protamine or zinc could alter the duration of action of these insulin products, and in 1952, K. Hallas-Møller at Novo Nordisk produced the first ...
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