Types of insulin

Any types of insulin help treat diabetes. Each type varies in how quickly and how long it controls blood sugar. You may need to take more than one kind of insulin. Factors that help determine which types of insulin you need and how much you need include:

• The type of diabetes you have.
• Your blood sugar levels.
• How much your blood sugar levels change during the day.
• Your lifestyle.

The main types of insulin therapy include:

• Long-acting, ultralong-acting or intermediate-acting insulins. When you're not eating, your liver releases glucose so your body has energy. Long-, ultralong- or intermediate-acting insulin prevents blood sugar levels from rising without eating.

  Examples of these insulins are glargine (Lantus, Basaglar, others), detemir (Levemir), degludec (Tresiba) and NPH (Humulin N, Novolin N, others). Intermediate-acting insulin lasts about 12 to 18 hours. Long-acting insulin works for about 24 hours. And ultralong-acting insulin lasts about 36 hours or longer.

• Rapid-acting or short-acting insulins. These insulins are ideal for use before meals. If taken with a meal, they can help bring blood sugar back down to the baseline. They also blunt the sugar spikes after you eat. They start to work much faster than long-acting or intermediate-acting insulins do. Sometimes, rapid-acting insulins begin working in as few as 5 to 15 minutes. But they work for a much shorter time. Rapid-acting insulin lasts about 2 to 3 hours. Short-acting insulin lasts about 3 to 6 hours.

  Examples of these insulins include ultrafast-acting aspart (Fiasp) and lispro (Lyumjev); rapid-acting aspart (NovoLog), glulisine (Apidra) and lispro (Humalog, Admelog); and short-acting, regular (Humulin R, Novolin R).

Sometimes, insulin-makers combine two types of insulin. This is called pre-mixed insulin. It can be helpful for people who have trouble using more than one type of insulin. Pre-mixed insulin often starts to work in 5 to 60 minutes. It can keep working for 10 to 16 hours.

Be aware that different preparations of insulin vary in terms of when they start working and how long they last. Be sure to read the instructions that come with your insulin. And follow any directions from your health care team.