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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]
- Intermediate acting (i.e NPH insulin) with onset in 2 hours and duration of about 14 hrs. - Long acting (i.e. detemir) with onset in 1 hr. and duration of about 24 hrs. - Premixed which are usually combinations of short and long acting insulin. Insulin is usually taken several times per day in patients who require it to control their diabetes ...
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.
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).
Fast acting insulins do not require the injection-to-meal interval previously recommended for human insulin and animal insulins. The other type is long acting insulin; the first of these was Lantus (insulin glargine). These have a steady effect for an extended period from 18 to 24 hours.
An insulin pump can be programmed to infuse a steady amount of rapid-acting insulin under the skin. This steady infusion is termed the basal rate and is designed to supply the background insulin needs. Each time the patient eats, he or she must press a button on the pump to deliver a specified dose of insulin to cover that meal.
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]