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The long acting insulin is given once (usually glargine, Lantus) or twice (usually detemir, Levemir) daily to provide a base, or basal insulin level. Rapid acting (RA) insulin is given before meals and snacks. A similar profile can be provided using an insulin pump where rapid acting insulin is given as the basal and premeal bolus insulin.
Insulin glargine sold under the brand name Lantus among others is a long-acting modified form of medical insulin, used in the management of type I and type II diabetes. [7] It is injected just under the skin . [ 7 ]
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]
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.
Examples of intermediate-acting insulins (peak 4–10 hours) are: Isophane insulin, neutral protamine Hagedorn (NPH) (Humulin N, Novolin N) Insulin zinc (Lente) Examples of long-acting insulins (duration 24 hours, often without peak) are: Extended insulin zinc insulin (Ultralente) Insulin glargine (Lantus) Insulin detemir (Levemir)
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). [5] [6]
Insulin detemir, sold under the brand name Levemir among others, is a long-acting modified form of medical insulin used to treat both type 1 and type 2 diabetes. [6] It is used by injection under the skin . [ 6 ]
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