Insulin lowers your blood sugar when your own body is unable to, and for some people, this is the only way to prevent the problems that come with high blood sugar. Many people with diabetes use more than one type of insulin. This is because there are different types of insulin—some insulins work fast, some work slowly, and some work in-between. In addition to taking pills, your doctor might have you try taking an insulin shot before meals, or one at bedtime and in the morning. Maybe you will do all of the above. The only way to know what regimen is right for you is by taking your medications the same way every day, writing down your blood sugar readings, and reporting back to your doctor. Then he or she knows what changes to make to keep you feeling good.
If you are taking insulin or caring for someone who does, let’s talk about the four types of insulin that people with diabetes use: Rapid acting insulin, regular or ‘short-acting’ insulin, intermediate-acting insulin, and long-acting insulin.
Rapid-acting insulin is usually taken right before a meal, as it begins to work about 15 minutes after injection. It is most effective in about 1 hour, and works in the bloodstream for 2 to 4 hours. Apidra, Humalog, and Novolog are all rapid-acting insulin brands that might be used three to five times per day, depending on how many meals you eat.
Regular or Short-acting insulin is also used before meals, but usually takes effect within 30 minutes. It has its highest effect after 2-3 hours, and keeps working for up to 6-12 hours. Humulin R and Novolin R are both (think ‘R’ for ‘regular’) are both short-acting insulins.
Intermediate-acting insulin can cover for high blood sugars in between meals. They become effective in 2 to 4 hours, and are most effective in four to twelve hours. They can last for more than 12-16 hours in the bloodstream. This type of insulin is known as ‘NPH’; its two examples are Humulin N and Novolin N.
Long-acting insulin takes effect slowly and gently over the course of a 24-hour period. Lantus and Levemir are both long-acting insulins to keep your blood sugar steady for the full day, and when you are sleeping.
If your doctor has discussed insulin as a possibility for you in the future, you are well within the norm if you are fearful of the idea of starting daily injections. However, most people don’t consider the alternative to taking insulin or oral diabetes medications: blindness, kidney failure, sexual dysfunction, amputations and early death. Be realistic and do a cost-benefit analysis if your provider has broached the topic of insulin with you. Your provider’s office should be able to refer you to a nurse or diabetes educator to help you understand all of the in’s and out’s of using insulin as well as managing your diabetes with nutrition and exercise. Ask as many questions as you have. In all healthcare, but especially in the case of diabetes, knowledge is power.