Welcome to Johns Hopkins Health Alerts!

"Johns Hopkins Health Alerts is an excellent site and I have recommended it to several of my friends. Thanks again, and keep up the good work!"
  • - D. Ambrosio

This free public service from Johns Hopkins Medicine helps keep you up to date on the latest breakthroughs for the most common medical conditions which prevent healthy aging.

Get the latest news sent straight to your inbox for FREE. Check all the boxes below for the topics that interest you.
We value your privacy and will never rent your email address

Johns Hopkins Health Alert

Insulin: You’ve Got Choices

Comments (0)

Approximately 40% of people with type 2 diabetes eventually require some type of insulin treatment to control their blood glucose, either because their diabetes gets worse or it no longer responds to oral drugs. Many people with type 2 diabetes take insulin in combination with metformin, a thiazolidinedione, or a sulfonylurea.

Insulin was once obtained exclusively from pig or cow pancreas. Today, regular and intermediate-acting insulins are referred to as human insulins, because they are manufactured to be identical to the insulin produced by the human pancreas. Rapid- and long-acting insulins are chemically modified forms of human insulin.

There are four main types of insulin:

  • Rapid-acting insulin.
    Insulin aspart (Novolog), insulin lispro (Humalog), and insulin glulisine (Apidra) are called insulin analogues, because their chemical structure is a modified form of human insulin that is designed to work more quickly and peak faster than regular insulin. These manufactured insulins work with time-actions that are close to the natural insulin functions in the body. Consequently, they may be effective in preventing high blood glucose (hyperglycemia) after meals and are less likely to produce hypoglycemia later on.
  • Regular or short-acting insulin.
    This type of insulin is manufactured to be the same as the insulin produced in the human body. Popular brands have an "R" (for regular) in their names, for example, Humulin R and Novolin R.

    Regular insulin is typically injected 30 to 60 minutes before meals and usually reaches the bloodstream within 30 minutes, in time to cover the rise in blood glucose that begins after food is eaten. Insulin action peaks two to three hours after injection and the effects generally last about three to six hours.

  • Intermediate-acting insulin.
    This type of human insulin called NPH insulin contains protamine, which makes the solution cloudy and slows the absorption of insulin. NPH insulins have an "N" in their names, for example, Humulin N and Novolin N.

    After injection, intermediate-acting insulins reach the bloodstream within two to four hours and show peak action in four to 10 hours. Duration of action is from 10 to 16 hours. Intermediate-acting insulin is often used in combination with regular or rapid-acting insulin.

  • Long-acting insulin.
    Both insulin glargine (Lantus) and insulin detemir (Levemir) are long-acting insulin analogues. They are often used alone in people with type 2 diabetes, or in combination with a more quick-acting insulin. Lantus is a clear solution in the vial, but it precipitates in the skin after injection, which greatly slows absorption and makes it very long acting, usually 20 to 24 hours. Levemir also is absorbed slowly, because it binds to the protein albumin in the skin. Its effects last about 14 to 18 hours.

Posted in Diabetes on September 2, 2010

Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer

Notify Me

Would you like us to inform you when we post new Diabetes Health Alerts?

Post a Comment


Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.

Post a Comment

Already a subscriber?


Forgot your password?

New to Johns Hopkins Health Alerts?

Register to submit your comments.

(example: yourname@domain.com)

Customer Service

Registered Users Log-in:

Forgot Password?

Become a Registered User!
It's fast and FREE!
The Benefits of Being a Registered User

Johns Hopkins Diabetes Bestsellers

Johns Hopkins White Papers

    2014 Diabetes White Paper

    The Diabetes White Paper teaches you how to manage Type 1 and Type 2 diabetes and avoid complications, such as nerve damage, heart disease, kidney failure, and retinopathy. This comprehensive report explains the basics of how your body metabolizes glucose and reviews the latest medications and tools for monitoring your blood glucose. Includes diagrams, glossary, and recent research. 96 pages.

    Read more or order now

Related Titles:

  • 2014 Vision White Paper
    Written by Dr. Susan B. Bressler, professor of ophthalmology at the acclaimed Wilmer Eye Institute, and a team of top Johns Hopkins doctors, this comprehensive report is essential reading for anyone affected by a vision disorder, including low vision, cataracts, glaucoma, age related macular degeneration, and diabetic retinopathy. 88 pages.
    Read more or order now
  • 2014 Heart Attack Prevention White Paper
    While heart attack remains the leading cause of death in America, Johns Hopkins specialists have identified a number of steps that can dramatically lower your risk. The Heart Attack Prevention White Paper contains potentially lifesaving strategies for the millions of people with high cholesterol, hypertension (high blood pressure), weight control issues, a sedentary lifestyle, and other known risk factors for heart attack. 88 pages.
    Read more or order now
  • 2014 Coronary Heart Disease White Paper
    The Coronary Heart Disease White Paper reports on the latest life-saving advances for your heart health, to help you prevent or treat coronary heart disease. Topics include preventing first heart attacks; heart attack recovery and its effects on your overall lifestyle and health; preventing a second heart attack; angina; cardiac arrhythmias; and congestive heart failure. 96 pages.
    Read more or order now
  • 2014 Hypertension & Stroke White Paper
    High blood pressure, or hypertension, gives few warning signs before it erupts with major complications, such as a stroke. Fortunately, in most cases the condition can be easily detected during a regular check up and can usually be controlled with a combination of diet, exercise, and medication. In the Hypertension & Stroke White Paper, experts at Johns Hopkins explain what you can do to manage high blood pressure in order to prevent stroke, and much more important information. 96 pages.
    Read more or order now

Health Topic Pages

  • Health Alert
  • Special Report

What is this?