Insulin therapy
Short acting Very rapid acting insulin Intermediate acting insulin Long acting insulin Premixed Biphasic
insulin
soluble insulin insulin lispro isophane insulin ultralente a mixture of short acting and
Examples insulin aspart (i.e.NPH) and Lente insulin glargine intermediate acting insulin
Insulin detemir
Insulin degludec Mixtard 30/70 - soluble +
isophane (ratio 3:7)
Subcutaneous s/c injection. -Ultra rapid Only by subcutaneous route. Only for S/C injection Only by S/C route.
Route and
methods of absorption
administration.
Can be given IV in diabetic Can be given IV Tendency nocturnal Used in twice daily insulin
emergencies hypoglycemia regimen
IM route – only in hyperglycaemic IM route – only in Typically 1/2 to 2/3 of the
emergencies if facilities for IV hyperglycaemic emergencies if daily dose may be given in
infusions are not available. facilities for IV infusions are the morning before
not available. breakfast and 1/2 to 1/3
before the evening
30 minutes before meals Immediately before, during or When mixed in syringe with
even after the meal Isophane insulin draw
soluble insulin first
• Should not be mixed in a
syringe with long acting
analogue insulins and
protamine insulin
suspensions
Duration of action Peak at 2hrs glargine - 20-24 hrs
4-6 hrs NPH-20-24 hrs
6-10 hrs
Indications to use Diabetic emergencies Diabetic energencies To treat Type 1 DM Type 1 DM Type 1 DM
Type I DM(Twice a day Type 1 DM Type II- when blood sugar
regimen of premixed biphasic control is not adequate Type II- when blood sugar
insulin can be given) with oral therapy control is not adequate with
oral therapy
In hyperkalaemea
Short acting Very rapid acting insulin Intermediate acting insulin Long acting insulin Premixed Biphasic
insulin
soluble insulin insulin lispro isophane insulin ultralente a mixture of short acting and
Examples insulin aspart (i.e.NPH) and Lente insulin glargine intermediate acting insulin
Insulin detemir
Insulin degludec Mixtard 30/70 - soluble +
isophane (ratio 3:7)
Subcutaneous s/c injection. -Ultra rapid Only by subcutaneous route. Only for S/C injection Only by S/C route.
Route and
methods of absorption
administration.
Can be given IV in diabetic Can be given IV Tendency nocturnal Used in twice daily insulin
emergencies hypoglycemia regimen
IM route – only in hyperglycaemic IM route – only in Typically 1/2 to 2/3 of the
emergencies if facilities for IV hyperglycaemic emergencies if daily dose may be given in
infusions are not available. facilities for IV infusions are the morning before
not available. breakfast and 1/2 to 1/3
before the evening
30 minutes before meals Immediately before, during or When mixed in syringe with
even after the meal Isophane insulin draw
soluble insulin first
• Should not be mixed in a
syringe with long acting
analogue insulins and
protamine insulin
suspensions
Duration of action Peak at 2hrs glargine - 20-24 hrs
4-6 hrs NPH-20-24 hrs
6-10 hrs
Indications to use Diabetic emergencies Diabetic energencies To treat Type 1 DM Type 1 DM Type 1 DM
Type I DM(Twice a day Type 1 DM Type II- when blood sugar
regimen of premixed biphasic control is not adequate Type II- when blood sugar
insulin can be given) with oral therapy control is not adequate with
oral therapy
In hyperkalaemea
