Diabetic Living USA – July 2019

What are the diff erent

insulin types all about?

—Confused By My Options

Dear Confused,

Th e goal of insulin therapy is to keep

blood sugar as close to your target range

as possible. Diff erent forms of insulin just

provide fl exibility. Th ere are fi ve types,

named for how quickly they begin to

work and for how long they lower blood

sugar: rapid-acting, short-acting, interme-

diate-acting, long-acting, and premixed.

Th ese types fall into two main categories

based on their functionality: basal and

bolus formulations. (See chart, right.)

Basal insulin is taken regardless of

food intake. It acts slowly and steadily

to help shutt le glucose from the blood-

stream into cells, especially between

meals. Long- and intermediate-acting

forms help satisfy basal insulin needs.

Intermediate-acting insulins are typically

prescribed to be injected twice daily.

Long-acting forms are injected once per

day to cover up to a 24-hour period.

Bolus insulin is used when you are

eating or need to correct an elevated

blood sugar. Bolus insulins are all rapid-

or short-acting. Th ey reduce blood sugar

very quickly and stop acting within a mat-

ter of hours. Aside from Afreeza, which

is inhaled, these types of insulin can be

injected or used in a pump.

Premixed insulins usually combine

a bolus and a basal insulin in the same

product, so they may require less injec-

tions. But fi nding the right dose can be

challenging.

Insulin is the most eff ective treat-

ment for diabetes, but one size does

not fi t all. Speak with your doctor or

diabetes educator about the best choice

for you.

TOBY SMITHSON, M.S., RDN, CDE,

has been living with type 1 diabetes

and using insulinfor over 50

years, although her insulin regimen has

evolved over time. Currently she uses

rapid-acting insulin in a pump for a

more fl exible routine.

Common Insulin Types

The generic name is on

the left with the corresponding

brand name(s) on the right.

BOLUS

RAPID-ACTING

SHORT-ACTING

Aspart

Glulisine

Lispro

Inhaled

Regular

Human Regular

Humulin R,

Novolin R

Fiasp,

Novolog

Apidra

Humalog,

Admelog

Afreeza

BASAL

LONG-ACTING

INTERMEDIATE-ACTING

Degludec

Detemir

Glargine

Human NPH

Humulin N,

Novolin N

Tresiba

Levemir

Lantus, Toujeo,

Basaglar

PREMIXED

PREMIXED PRODUCTS

PREMIXED / GLP-1 RECEPTOR

AGONIST PRODUCTS

Lispro 75 ⁄ 25 ,

50 ⁄ 50

NPH/Regular

70 ⁄ 30

Degludec/

Liraglutide

Glargine/

Lixisenatide

Xultophy

Soliqua

Humalog Mix

75 ⁄ 25 , 50 ⁄ 50

Humulin 70 ⁄ 30 ,

Novolin 70 ⁄ 30

Aspart 70 ⁄ 30 Novolog Mix 70 ⁄ 30

Ask Toby

THE PUMP

Tandem Diabetes

Care t:slim X

THE

SOFTWARE

Control IQ

technology

THE CGM

Dexcom G

THE

VISION

PHOTO COURTESY TANDEM DIABETES CARE

THE

DIFFERENCE

The pump and software
use the CGM sensor
values to predict glucose
levels and adjust insulin
delivery to prevent highs
and lows.

THE GOAL

Better time in range and
improved A1C. Studies
in the pipeline are
promising ... stay tuned!

Here’s how the t:slim X
can be paired with smart
software and a CGM to
create an innovative hy-
brid closed-loop system.