Type | Onset (hours) | Peak (hours) | Duration (hours) | Comments |
Ultra-rapid-acting | ||||
Faster aspart Insulin lispro-aabc | 0.1 to 0.2 | 1 to 3 | 3 to 5 | Duration of action may be shorter. |
Rapid-acting | ||||
Lispro*/aspart*/glulisine | 0.15 to 0.35 | 1 to 3 | 3 to 5 | |
Short-acting | ||||
Regular | 0.5 to 1 | 2 to 4 | 5 to 8 | Longer duration of action if larger dose. |
Intermediate-acting | ||||
NPH | 2 to 4 | 4 to 12 | 12 to 24 | Peak and duration quite variable. |
NPL | Approximately 2 | 6 | 15 | Activity profile similar to NPH; can be mixed with insulin lispro. Not available in the United States. |
Basal long-acting | ||||
Glargine* | 2 to 4 | 8 to 12 (not pronounced) | 22 to 24 | Half-life is shorter in some patients, requiring division of the daily dose into 2 injections per day. Cannot be mixed with other insulins, because this alters pharmacokinetics. |
Detemir | 1 to 2 | 4 to 7 (not pronounced) | 20 to 24 | Duration of action is dose dependent. At higher doses (≥0.8 units/kg), mean duration of action is longer and less variable (22 to 23 hours). At lower doses, mean duration of action is shorter and twice-daily injections are often needed. Cannot be mixed with other insulins, because this alters pharmacokinetics. |
Glargine U300 | 2 to 6 | None | 30 to 36 | Cannot be mixed with other insulins, because this alters pharmacokinetics. |
Degludec | 0.5 to 1.5 | None | >42 | Less day-to-day variation in glucose-lowering effect at steady state (after 2 to 3 days' use) relative to glargine U100 and detemir. Can be mixed with insulin aspart; coformulation with aspart available in some countries. |
NPH: neutral protamine hagedorn; NPL: neutral protamine lispro.
* Certain biosimilar insulins for lispro, aspart, and glargine are approved for children in some countries, including the United States, Canada, and Europe. The US Food and Drug Administration uses the term "similar" rather than "biosimilar" for technical reasons[2].Do you want to add Medilib to your home screen?