Insulin Types & Insulin Action
All people with type 1 diabetes are “insulin dependent” – i.e. must take insulin by injection (syringe or pump infusion). Insulin cannot be taken by mouth because stomach acids will destroy it. Insulin helps sugar get into the body’s cells. Insulin also helps children grow.
Brands of Insulin
Your child will be taking human insulin. It does not come from humans but is made in a laboratory. It is like the insulin our body makes. There are three companies that make insulin:
- Eli Lilly (Humulin N® and Humalog®)
- Novo Nordisk (Novolin ge NPH®, NovoRapid®, Fiasp® and Levemir®)
- Sanofi Aventis (Lantus®, Apidra®)
There are many types of insulin. They are differentiated by their :
- Onset (the length of time it takes to start working after injection/infusion);
- Peak (the time at which insulin action is strongest); and
- Duration (how long the insulin lasts).
- Onset: starts to work in approximately 15 minutes
- Peak: strongest action at 1 hour
- Duration: lasts approximately 3-5 hours
- Examples: Humalog® (insulin lispro), NovoRapid® (insulin aspart), Fiasp® (insulin aspart), Apidra® (insulin glulisine)
Note: “Rapid”-acting insulin may not act as rapidly as the name seems to suggest. It’s important to remember that rapid-acting insulin takes at least 15 minutes to even start having an effect, and it takes about an hour to peak. This has important implications for timing of insulin with food intake.
With a goal to have rapid insulin live up to its name, insulin manufacturers continue to work on bigger, better, faster versions. With a quicker onset and shorter tail, Fiasp® is the most recent player to come to market in Canada, and currently the fastest acting insulin available here (though it’s not approved for used with kids – your child’s doctor may be willing to write an off-label prescription for it if they believe the potential benefits outweigh the risks).
(or Regular insulin; an earlier generation of insulin, not commonly used today)
- Onset: starts to work in about 30 minutes
- Peak: strongest action at 2-4 hours
- Duration: lasts approximately 4-6 hours
- Examples: Humilin R®, Novolin Toronto®
- Onset: starts to work in 2-4 hours
- Peak: strongest action at 6-10 hours
- Duration: lasts up to 18 hours
- Examples: Humulin N®, Novolin NPH®
- Onset: starts to work in 60-90 minutes
- Peak: none (provides a consistent concentration of insulin over the duration of insulin action)
- Duration: lasts 12-24 hours
- Examples: Lantus® (insulin glargine), Levemir® (insulin detemir)
The above information was adapted with permission from The Alberta Children’s Hospital Diabetes Clinic information handouts.
The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.
This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.