Clinically Available Insulins 

Modern genetic engineering techniques enable specific amino acids in the molecule to be changed and the molecule subtly altered to form new preparations with advantageous properties for people with diabetes.

Classification of Clinically available Insulin Preparations -

  • Rapid Acting: Insulin lispro, Insulin Aspart
  • Short Acting: Regular Human insulin
  • Intermediate Acting: NPH Human 
  • Long Acting: Insulin Detemir, Insulin Degludec. 
Pharmacokinetics of Insulin preparations: 
  1. Administered via SQ injection and absorbed directly to the systemic circulation
  2. Majority of insulin degradation happens in the Liver and Kidney 
  3. Kidney is the main metabolism site 
  4. Do not enter the Hepatic portal system. 

CLASS

Onset of Action

DOA

Example

Rapid Acting

Inhaled

10 – 30 m

2-4 hrs

Afrezza

Oral

15 – 30 m

3 hrs

Lispro; Aspart

Short Acting

30 m – 1 hrs

15 – 30 m

Human Insulin (IV)

Intermediate Acting

2 – 4 hrs

12 – 18 Hrs

NPH Insulin

Long Acting

> 4 hrs

24 Hrs

Detemir

Ultra Long

> 5 – 6 Hrs

Upto 48 hrs

Degludec

Premixed Insulin

< 30 min

2 – 4 hrs

NPH : Regular (70:30)

Common Side effects:

  • Hypoglycemia
  • Injection site reaction 
  • Weight gain 
  • Headache 
  • Lipodystrophy 

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