Insulin regimens

Question 1

Rapid-acting insulin: time and examples

Answer 1

Onset: 5 mins
Peak: 1 hour
Duration: 3-5 hours

• novorapid
• humalog
• apidra

Question 2

Short-acting insulins: time and examples

Answer 2

Onset: 30 minutes
Peak: 3 hours
Duration: 6-8 hours

• Actrapid
• Humulin S
• Insuman Rapid

Question 3

Intermediate-acting insulins: time and examples

Answer 3

Onset: 2 hours
Peak: 5-8 hours
Duration: 12-18 hours

• Insulatard
• Humulin I
• Insuman Basal

Question 4

Long-acting insulins: time and examples

Answer 4

Onset: 1-2 hours
Peak: flat profile
Duration: up to 24 hours

• Lantus : given once daily
• Levemir: given once or twice daily
• Degludec (lasts over 40 hours)

Question 5

Combinations insulins: what are they and examples

Answer 5

These containing a rapid acting and an intermediate acting insulin. In brackets in the proportion of rapid to intermediate acting insulin

Humalog 25 (25:75)
Humalog 50 (50:50)
Novomix 30 (30:70)

Question 6

Basal-bolus regimens

Answer 6

Rapid/short acting insulins may be used for this acts as a ‘bolus’ insulin before meals

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intermediate/long-acting ‘basal’ insulin once or twice daily

Question 7

By manufacturing process

Answer 7

porcine: extracted and purified from pig pancreas

human sequence insulin: either produced by enzyme modification of porcine insulin (emp) or biosynthetically by recombinant DNA using bacteria (crb, prb) or yeast (pyr)

analogues