Type 2 diabetes and type 1 diabetes can be well controlled through diet, oral medication, and insulin. All diabetics with type 1 diabetes need to take insulin as their bodies do not produce the hormone. Not all patients with type 2 diabetes need insulin, but those who do have many options. There are several types of insulin that vary by onset (how long they take to work), peak (how long they take to take full effect), and duration (how long the insulin remains in the body). Long-acting insulin is often taken daily and combined with other forms to control blood sugar.
How Insulin Works
When you eat food, your pancreas is alerted to release insulin, a hormone that moves glucose out of the body and into the muscles, fat, and liver for storage or energy. People with diabetes either cannot produce enough insulin or cannot use it efficiently. Replacing it with injections can help your body use glucose properly.
Types of Insulin
There are a few broad types of insulin:
- Rapid acting is usually taken after a meal to protect against rising blood glucose from food. This form is combined with long acting insulins. It begins working in 15 minutes and peaks around 30-90 minutes later, lasting no more than 3-5 hours.
- Short acting is often taken around 30 minutes before a meal to guard against rising blood glucose levels. It is also used in combination with long acting medication. Short acting medication like Novolin R takes effect after 30-60 minutes and peaks after 2 hours. The effects can last for 5-8 hours.
- Intermediate acting protects against glucose elevations when a rapid acting insulin fails. It’s often taken twice a day with a rapid acting medication. Intermediate medication like Novolin N and Humulin L start to work within 1-4 hours and peak after 4 to 12 hours.
- Long acting is taken once or twice a day in combination with rapid or short acting medication. Long acting insulins help keep blood glucose levels normal throughout the day.
Insulins are also available pre-mixed. Common pre-mixed brands include Humulin 50/50, Humulin 70/30, Novolin 70/30, Humalog mix 75/25, and NovoLog 70/30. Pre-mixed insulins combine short and intermediate acting insulins and they can be taken twice a day before meals. Pre-mixed formulas usually take effect within 15 to 60 minutes and last for up to 16 hours.
How Long Acting Insulin Works
If you take the hormone injection during meals, it will help lower blood sugar levels immediately after eating. Still, even between meals, you need the hormone in small levels to keep your blood sugar levels normal. This is why long acting medication is important.
Long acting forms of the hormone take the longest amount of time to begin working. It may take up to 4 hours for these insulins to take effect, and the effect will not peak like other forms of the hormone. Long acting insulins like Lantus and Levemir mimic the normal action of the hormone produced by your pancreas.
How to Take Long Acting Insulin
Most long acting insulins are taken once a day by injection to keep blood glucose levels stable. You will need to use a pen device or needle to inject the medication. It’s important to inject the medication at the same time each day to avoid stacking your doses or lags in the effect.
While most diabetics on insulin take a long acting form of the medication, it’s usually combined with a rapid or short acting form that can be taken before or after meals to prevent spikes in blood sugar.
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