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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]
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.
- 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 ...
ATC code A10 Drugs used in diabetes is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products.
Many people reported problems when being switched to intermediate acting insulins in the 1980s, using NPH formulations of porcine/bovine insulins. Basal (long-acting) insulin analogs were subsequently developed and introduced into clinical practice to achieve more predictable absorption profiles and clinical efficacy. [12] [13] [14]
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.
Insulin degludec is an ultra-long acting insulin that, unlike insulin glargine, is active at a physiologic pH.The addition of hexadecanedioic acid via an amide linkage to lysine at the B29 position allows for the formation of multi-hexamers in subcutaneous tissues. [16]
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