Everything you need to know about insulin

Insulin can be a crucial part of diabetes treatment, but patients may not know all the ins and outs of using the medication effectively.

Fortunately, the American Diabetes Association (ADA) has a lot of information and tips about using insulin.

First, there are different types of insulin depending on how quickly they work, when they peak, and how long they last. Insulin is also available in different strengths, and all insulin made in the United States is produced in a laboratory, the ADA noted.

Whether someone needs to take insulin, and how much, varies per patient and the type of diabetes a patient has.

In people with type 1 diabetes, the pancreas no longer produces insulin at all. The beta cells are destroyed and these patients require insulin injections.

With type 2 diabetes, people produce insulin, but their body does not respond well to it. Some people with type 2 diabetes need insulin.

Why should insulin be given in injections? When taken in pill form, it is broken down during digestion, so it must be injected into the fat under your skin. In rare cases, insulin can cause an allergic reaction at the injection site. Contact your doctor if you think you are experiencing a reaction, the ADA advised.

Depending on a patient’s needs, different types of insulin are available:

• Rapid-acting insulin starts working about 15 minutes after injection, peaks about one to two hours after injection and lasts two to four hours
• Regular or short-acting insulin usually reaches the bloodstream within 30 minutes after injection, peaks two to three hours after injection and acts for three to six hours
• Intermediate-acting insulin generally begins working about two to four hours after injection, peaks four to 12 hours later, and is effective for about 12 to 18 hours
• Long-acting insulin reaches the bloodstream several hours after injection and tends to lower glucose levels for up to 24 hours
• Ultra long-lasting works in six hours, does not peak and lasts about 36 hours or more

Premixed insulin may be helpful for people with poor vision or dexterity and it is useful for people whose diabetes has been stabilized, the ADA added.

In 2015, an inhaled insulin product was mentioned Afrezza became available in the United States. Afrezza works quickly at the beginning of each meal and can be used by adults with type 1 or type 2 diabetes. However, it is not a replacement for long-acting insulin, the ADA noted. Afrezza should be used in combination with injectable long-acting insulin in patients with type 1 diabetes and in type 2 patients using long-acting insulin.

It starts working within 12 to 15 minutes, peaks after 30 minutes and is gone from your system within 180 minutes.

Aside from differences in how quickly insulin works and how long it lasts, there are different strengths of the drug, the ADA noted.

The most commonly used strength in the United States is U-100, which means it contains 100 units of insulin per milliliter of fluid, although U-500 insulin is available for patients who are extremely insulin resistant.

If you are traveling outside the United States, make sure your insulin strength matches the correct size syringe.

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