types of insulin
Types of Insulin
Medical preparations of insulin (from the major diabetes supply companies – Eli Lilly, Novo Nordisk, and Sanofi Aventis – or from any other) are never just 'insulin in water'. Clinical insulins are specially prepared mixtures of insulin plus other substances. These delay absorption of the insulin, adjust the pH of the solution to reduce reactions at the injection site, and so on.
Slight variations of the human insulin molecule are called insulin analogs, so named because they are not technically insulin, rather they are analogs which retain the hormone's glucose management functionality. They have absorption and activity characteristics not currently possible with subcutaneously injected insulin proper. They are either absorbed rapidly in an attempt to mimic real beta cell insulin (as with Lilly's lispro, Novo Nordisk's aspart and Sanofi Aventis' glulisine), or steadily absorbed after injection instead of having a 'peak' followed by a more or less rapid decline in insulin action (as with Novo Nordisk's version Insulin detemir and Sanofi Aventis's Insulin glargine), all while retaining insulin's glucose-lowering action in the human body. However, a number of meta-analyses, including those done by the Cochrane Collaboration in the United Kingdom in 2002, Germany's Institute for Quality and Cost Effectiveness in the Health Care Sector released in 2007, and the Canadian Agency for Drugs and Technology in Health (CADTH), also released in 2007 have proven unequivocally that any claims of superiority for insulin analogs over regular insulin are unsupported by clinical evidence.
Choosing insulin type and dosage/timing should be done by an experienced medical professional working with the diabetic patient.
The commonly used types of insulin are:
* Rapid-acting, are presently insulin analogs, such as the insulin analog aspart or lispro – begins to work within 5 to 15 minutes and is active for 3 to 4 hours. Newer varieties are in now in Phase II clinical trials which are designed to work rapidly, but retain the same genetic structure as regular human insulin.
* Short-acting, such as regular insulin – starts working within 30 minutes and is active about 5 to 8 hours.
* Intermediate-acting, such as NPH, or lente insulin – starts working in 1 to 3 hours and is active 16 to 24 hours.
* Long-acting, such as ultralente insulin – starts working in 4 to 6 hours, and is active 24 to 28 hours.
* Insulin glargine and Insulin detemir – both insulin analogs which start working within 1 to 2 hours and continue to be active, without major peaks or dips, for about 24 hours, although this varies in many individuals.
* A mixture of NPH and regular insulin – starts working in 30 minutes and is active 16 to 24 hours. There are several variations with different proportions of the mixed insulins.
Yeast-based
In late 2003, Wockhardt commenced manufacture of a yeast-based insulin costing $3.25 in India claiming it eliminates the risk of contracting diseases such as BSE and CJD associated with insulin derived from pigs and cattle. However, the company continues to manufacture insulin derived from pigs in the United Kingdom.
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