Different insulin regimens
There are a few different insulin regimes that people on insulin therapy can follow. These include:
- Multiple daily injection insulin regimens / basal-bolus therapy
This regime includes an injection of bolus insulin (fast-acting) e.g. Humalog or Novorapid at each meal and basal insulin (long-acting) which is usually taken once or twice a day. Those who are on this regimen are able to adjust their bolus insulin at each meal time. The amount of bolus insulin taken is directly related to the amount of carbohydrates consumed.
Most people with type 1 will be on a basal-bolus or multiple daily injection regime.
- Twice daily mixed insulin regimen
Insulin used twice daily may contain a mixture of shorter and intermediate-acting insulin e.g. Humulin M3; Novomix 30 and is taken twice a day at breakfast and evening meal. Individuals who are on this regimen, are unable to adjust their insulin, but carbohydrate counting principles can be applied to maintain similar amounts at meals.
This is a brief guide to the types of insulin and how long each type of insulin lasts over a 24-hour period. Please note, insulins in each group can vary in their effect and duration of action. Visit the manufactures website for specific information about your insulin.
The fastest-acting insulin, usually taken immediately before meals or as a correction dose. Starts working in 5–10 minutes and lasts 2–5 hours.
Examples include insulin aspart (Novorapid®), insulin lispro (Humalog®), insulin glulisine (Apidra®), insulin aspart (FiAsp®).
Short-acting insulin is usually taken about 30 minutes before meals or just after eating. Starts working in 30 minutes to 1 hour and lasts up to 8 hours.
Examples include human soluble insulin (Actrapid®, Humulin® S and Insuman Rapid®).
Usually taken once or twice a day. Starts working within 2 hours and lasts 8–14 hours.
Examples include isophane insulin (Insuman® Basal, Insulatard® and Humulin® I)
Usually taken once or twice a day. Starts working within 2 hours and lasts up to 18–24 hours.
Examples include insulin detemir (Levemir®), insulin glargine (Abasaglar®, Lantus®, Toujeo®) and insulin degludec (Tresiba®).
These insulins are a mixture of shorter-acting and longer-acting insulins and come in different preparations. Usually taken twice or three times daily, between 15–30 minutes before or just after food. Starts working within 30 minutes (depending on short-acting insulin).
Examples include biphasic insulin aspart (Novomix® 30), biphasic insulin lispro (Humalog® Mix 25, Humalog® Mix 50), soluble and isophane insulin (Humulin® M3, Insuman® Comb 15, Insuman® Comb 25, Insuman® Comb 50).