Insulin – Pick the right one for yourself

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Diabetes is marked by increased sugar levels in the body and is of two types – insulin dependent and non-insulin dependent. Insulin is a hormone produced by the pancreas, and in some people, there is reduced or no insulin production. This prevents sugar from entering the muscles and tissues where they are needed for energy, thereby spiking up the sugar levels. This is also known as Type 1 diabetes and often runs in families. 

Insulin

When diagnosed with Type 1 diabetes, insulin supplementation via injections is the only form of therapy. There are various modes of insulin that are available in the market. However, what works for one person to regulate sugar levels may not work for another individual. The doctor sometimes has to use the hit and trial method to find the right type of insulin, with the ultimate goal being maintaining optimal sugar level.

Read on to know about the various types of insulin and factors that will help the doctor determine the best insulin for a person.

Types of Insulin

There are five types of insulin depending on their rate of action, i.e. how fast they are able to bring your blood sugar under control. There are three important aspects that determine this – onset, peak, and duration. Onset is the time when the effect of the insulin is seen once it is administered as an injection. Peak is when the best blood sugar control is seen after giving an insulin injection. Duration is the length of the time that the insulin’s effect will be seen in the body.

Rapid Acting

This insulin takes effect in as quickly as 10 minutes with Novolog to 30 minutes with Humalog. These are often taken with a meal to help in sugar control, and a long-acting insulin is also used along with it for prolonged sugar level control. The peak effect is reached between 30 minutes and 90 minutes in these and the effect stays anywhere from half an hour to five hours. These may also be used in medical emergencies to bring down elevated sugar levels.

Short Acting

These are taken immediately with a meal and are used to control sugar. They take effect within 30 minutes, reach peak in up to 3 hours, and can remain active from 3 to 5 hours. These are often taken along with a meal within 30 to 60 minutes.

Intermediate Acting

These can take care of sugar levels over almost 15 to 20 hours and are used when one injection is required to control sugar levels for a prolonged time. They take effect within an hour and can stay active depending on the dosage for up to 20 hours. When someone is traveling and cannot take regular multiple injections, these may be used. They can be clubbed with short or rapid acting types if required.

Long-Acting

These are used when sugar control is required for longer periods, from 24 up to 42 hours. There is no peak time in these insulin products, and there is a steady dose that gets delivered to ensure sugar levels are controlled throughout. They take effect in about 2 hours, and something like Tresiba can stay active up to 2 full days.

Premixed

These are insulin pens which contain a mix of intermediate and short-acting insulins. The names indicate the ratio of intermediate and short acting – for instance, Humulin 70/30, Novolog 70/30. They take effect in as fast as 10 minutes to 30 minutes max and can stay effective for a full day.

While insulin is generally used in Type 1 diabetes, where they must have up to 5 injections a day, poorly controlled Type 2 diabetics are also sometimes put on insulin to improve sugar level control. 

Factors Determining the Type of Insulin to be Used

The insulin injection dose will not remain constant throughout, like some other medications. It will constantly change depending on various factors and is determined by regular sugar control recording and monitoring to identify patterns. Listed below are some of the key factors that determine insulin dosage.

  1. Food habits: The sugar content in the food, based on which more or less insulin would be required.
  2. Activity levels: More active a person, lesser the amount of insulin required.
  3. Rate of insulin absorption and duration of action: This varies from person to person, even for the same type of insulin
  4. Ability and feasibility to take injections: For someone who has a busy outside life, giving multiple injections may be cumbersome, and they might prefer one longer-acting insulin.

Based on all these factors, it will take a while to identify which insulin works best for any individual.

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