types of insulin

How Many Types of Insulin Are Used to Manage Type 2 Diabetes?

Being diagnosed with type 2 diabetes can be overwhelming, especially if your Doctor has recommended you take insulin to manage your condition. But don’t worry, we’ve got you covered.

In this article you will learn:

Firstly, what does insulin do and when is it used?

Insulin is a hormone that is produced by the beta cells in our pancreas and plays a vital role in regulating blood sugar levels. When we consume food (mainly carbohydrates), our body breaks it down into glucose where it is released in the bloodstream. This triggers our pancreas to release insulin, to move the glucose into cells so it can be used for energy (1).

When the pancreas can no longer produce enough insulin to maintain healthy blood sugar levels, insulin therapy (aka manufactured insulin medication) is required. In the case of Type 1 Diabetes – an autoimmune condition where the immune system destroys the beta cells in the pancreas – daily insulin therapy is vital to maintaining sugar levels (2).

Type 2 diabetes on the other hand is different, as the pancreas can still make insulin, but it may not be enough to control sugar levels, or used effectively by the body. In some instances, lifestyle changes can be enough to manage the condition, however if the disease has progressed, your doctor may recommend you take Insulin to manage your sugar levels (2).

What are the 5 types of insulin?

There are 5 types of insulin that are currently prescribed and used to manage type 2 diabetes. Each type varies in how quickly and how long they can control your blood sugar levels. Your General Practitioner (GP) or Diabetes Educator will work with you to determine which type/s you will need, and how much is needed to manage your condition.

Here is a summary of the 5 types of insulin:

1. Fast-acting Insulin

  • This insulin is clear in appearance
  • It is known as a bolus insulin as it works quickly to lower your blood sugar levels
  • As it works within 1-20 minutes after its administered, you must eat immediately after. If you don’t, this can cause hypoglycemia
  • It peaks ~1 hour later, and lasts for 3-5 hours
  • This type of insulin can be used to correct a high blood sugar level in a “correction dose”

  • Examples: Novorapid® , Humalog® , Apidra® (3, 4, 5)

2. Short-acting Insulin

  • This insulin is clear in appearance
  • It works within 30 minutes after its administered, so you need to inject 30 minutes before eating
  • It peaks 2-4 hours later, and lasts for 6-8 hours

  • Examples: Actrapid® , Humulin® R, Hypurin® Neutral (3, 4, 5)

3. Intermediate-acting insulin

  • This insulin is cloudy in appearance
  • This type of insulin has zinc or protamine added to it, which delays its action
  • It works 1.5 hours after its administered
  • It peaks 4-12 hours later, and lasts for 16-24 hours

  • Examples: Protaphane®, Humulin®, Hypurin Isophane® (3, 4, 5)

4. Mixed insulin

  • This insulin is cloudy in appearance
  • Just like the name implies, its a mixture of insulins – either a fast or short-acting insulin with an intermediate-acting insulin. This makes it easier to inject one, rather than two insulins at once
  • It works 1.5 hours after its administered
  • It peaks 4-12 hours later, and lasts for 16-24 hours

  • Examples: Novomix® 30 & Humalog® Mix (fast acting types) and Mixtard® 30/70, Mixtard® 50/50 and Humulin® 30/70 (short acting types) (3, 4, 5)

5. Long-acting insulin

  • This insulin is clear in appearance
  • It’s also known as a basal or background insulin
  • It has no “peak” and can last for 18-36 hours
  • It peaks 4-12 hours later, and lasts for 16-24 hours

  • It doesn’t need to be injected with food like fast or short-acting insulins, and should be injected at the same time each day (3, 4, 5)

How are the different types of insulin administered?

All types of insulin can be injected and administered through the skin in several ways, for example through a:

  • Syringe – this delivers insulin through a needle and is designed to be used as a single use method. This is one of the most common ways to inject insulin, as it’s more affordable, and uses a smaller needle which may be more comfortable for some (3, 5)
  • Insulin pen – this also uses a needle and can be pre-filled with insulin to use as a single dose, or contain cartridges that are inserted within the pen. Pens can be more convenient to transport, but can carry a higher cost (3, 5)
  • Insulin pump – approximately the size of a cell phone, an insulin pump delivers insulin through a small plastic tube that is placed under the skin in the stomach, or back of the upper arm. It provides a basal dose of insulin each hour, and when you consume food, you calculate the dose and the pump delivers this into the bloodstream (3, 5)

What Insulin should I be taking to manage my type 2 diabetes?

When you first start taking insulin, your Doctor and Diabetes Educator will discuss your options and determine what types of insulin are most suitable, as well as how much, when and how (aka your method of administration). This is based on your condition and lifestyle too.

Things you should know about insulin

When starting to use different types of insulin, it’s important to know key information around storage, use and absorption.

Storage:

  • Do not freeze your insulin – keep unopened vials or pens in the fridge
  • Once opened, you can keep insulin at room temperature for 1 month. Then it must be disposed of

  • You can carry it in your bag when outside the home, however it’s important to not leave it in temperatures over 30° C or in direct sunlight as it can damage the medication (6)

Do not use Insulin if:

  • It’s past the expiry date or opened for longer than 1 month
  • If its’ been stored in temperatures over 30° C or frozen
  • Clear insulins (fast-acting, short-acting or long-acting) have turned cloudy

  • You notice lumps, flakes or deposits on the side of vials that don’t dissolve after gentle rotation (6)

Absorption of insulin can be accelerated in a number of ways, including:

  • Injecting into muscle or an exercised area like the thigh
  • In high temperature e.g. sauna or spa, or hot baths and showers

  • Massaging around the injection site (6)

On the other hand, absorption can be delayed by:

  • Injecting cold insulin straight from the fridge
  • Smoking

  • Injecting into scars or lumps due to over-use of the same injection site (6)

Looking for support?

Have you recently been diagnosed with type 2 diabetes and are looking for support? At Diabetes Wellness Australia, we offer individualised, evidence-based programs designed to help you manage and take control of your type 2 diabetes. Book your free assessment to speak to one of our friendly staff today to learn how we can help you.

How we reviewed this article

Diabetes Wellness Australia utilises a variety of credible and reliable sources to support and provide valuable insights into the topic being discussed. From academic journals to government reports, each reference has been carefully selected to add depth and richness of our articles.

  • (1) https://www.diabetesaustralia.com.au/about-diabetes/diabetes-in-australia/
  • (2) https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/
  • (3) https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-type-2-diabetes
  • (4) https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-prevention/art-20047639
  • (5) https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/preventing-diabetes-full-story/
How we reviewed this article

Miyagi utilises a variety of credible and reliable sources to support and provide valuable insights into the topic being discussed. From academic journals to government reports, each reference has been carefully selected to add depth and richness of our articles.

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