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Type of Insulin & Brand Names | Onset | Peak | Duration | Role in Blood Sugar Management |
Rapid-Acting | ||||
Lispro (Humalog) | 15-30 min. | 30-90 min | 3-5 hours | Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with longer-acting insulin. |
Aspart (Novolog) | 10-20 min. | 40-50 min. | 3-5 hours | |
Glulisine (Apidra) | 20-30 min. | 30-90 min. | 1-2 1/2 hours | |
Short-Acting | ||||
Regular (R) or novolin | 30 min.-1 hour | 2-5 hours | 5-8 hours | Short-acting insulin covers insulin needs for meals eaten within 30-60 minutes. |
Velosulin (for use in the insulin pump) | 30 min.-1 hour | 1-2 hours | 2-3 hours | |
Intermediate-Acting | ||||
NPH (N) | 1-2 hours | 4-12 hours | 18-24 hours | Intermediate-acting insulin covers insulin needs for about half the day or overnight. This type of insulin is often combined with a rapid- or short-acting type. |
Long-Acting | ||||
Insulin glargine (Basaglar, Lantus, Toujeo) | 1-1 1/2 hours | No peak time. Insulin is delivered at a steady level. | 20-24 hours | Long-acting insulin covers insulin needs for about one full day. This type is often combined, when needed, with rapid- or short-acting insulin. |
Insulin detemir (Levemir) | 1-2 hours | 6-8 hours | Up to 24 hours | |
Insulin degludec (Tresiba) | 30-90 min. | No peak time | 42 hours | |
Premixed* | ||||
Humulin 70/30 | 30 min. | 2-4 hours | 14-24 hours | These products are generally taken two or three times a day before mealtime. |
Novolin 70/30 | 30 min. | 2-12 hours | Up to 24 hours | |
Novolog 70/30 | 10-20 min. | 1-4 hours | Up to 24 hours | |
Humulin 50/50 | 30 min. | 2-5 hours | 18-24 hours | |
Humalog mix 75/25 | 15 min. | 30 min.-2 1/2 hours | 16-20 hours | |
*Premixed insulins combine specific amounts of
intermediate-acting and short-acting insulin in one bottle
or insulin pen. |
Follow your doctor's guidelines on when to take your insulin. The time span between your shot and meals may vary depending on the type you use.
In general, though, you should coordinate your injection with a meal. You want to time your shot so that the glucose from your food gets into your system at about the same time that the insulin starts to work. This will help your body use the glucose and avoid low blood sugar reactions. From the chart above, the "onset" column shows when the insulin will begin to work in your body. You want that to happen at the same time you're absorbing food. Good timing will help you avoid low blood sugar levels.
- Rapid acting insulins: About 15 minutes before mealtime
- Short-acting insulins: 30 to 60 minutes before a meal
- Intermediate-acting insulins: Up to 1 hour prior to a meal
- Premixed insulins: Depending on the product, between 10 minutes or 30 to 45 minutes before mealtime
Long-acting insulins aren’t tied to mealtimes. You’ll take detemir (Levemir) once or twice a day no matter when you eat. And you’ll take glargine (Basaglar, Lantus, Toujeo) once a day, always at the same time. Deglutec is taken once a day, and the time of day can be flexible. But some people do have to pair a long-acting insulin with a shorter-acting type or another medication that does have to be taken at mealtime.
Rapid-acting products can also be taken right after you eat, rather than 15 minutes before mealtime. You can take some of them at bedtime.
For more information about when to take insulin, read the "dosing and administration" section of the insulin product package insert that came with your insulin product, or talk with your doctor.
The major side effects include:
- Low blood sugar
- Weight gain when you first start using it
- Lumps or scars where you've had too many injections
- Rash at the site of injection or, rarely, over your entire body
With inhaled insulin, there's a chance that your lungs could tighten suddenly if you have asthma or the lung disease COPD.
Always have two bottles of each type you use on hand. You don't need to refrigerate vials of insulin that you're using. A good rule of thumb is that if the temperature is comfortable for you, the insulin is safe. You can store the bottle that you're using at room temperature (not higher than 80 F) for 30 days. You don't want it to get too hot or too cold, and keep it out of direct sunlight.
Keep your extra backup bottles in the refrigerator. The night before you're going to start using a new bottle, take it out and let it warm up. Don't let your insulin freeze.
Always look at your insulin inside the bottle before you draw it into the syringe. Rapid-acting, short-acting, and certain long-acting types should be clear. Other forms may look cloudy, but they shouldn't have clumps.
If you carry a bottle with you, be careful not to shake it. That makes air bubbles, which can change the amount of insulin you get when you withdraw it for an injection.
For insulin pens, check the package insert for storage instructions.
Check the directions on the package. You should keep a sealed package in the refrigerator until you're ready to start using it. If you don't, you must use it within 10 days.
You can refrigerate packages you've opened, but let a cartridge warm up to room temperature for 10 minutes before you use it.
There are many forms of insulin, which differ by how long it takes them to start working, reach their peak effectiveness, and stop working. Your doctor can help you determine which insulin or combination of the different types of insulin is right for you. There are also different ways to take insulin, so you can choose the option that you find convenient and easiest to use.
How many types of human insulin are there?
There are five general types of insulin made for treating diabetes. All types of insulin help cells use glucose for energy. The different types of insulin vary according to how rapidly they go to work and last in the body. The five main types of insulin are:
- Rapid-acting insulin is usually taken right before a meal and stays active for several hours.
- Short-acting insulin is usually taken before a meal, too, but takes somewhat longer to work.
- Intermediate-acting insulin works for about half a day.
- Long-acting insulin provides about a day’s worth of coverage.
- Premixed insulin is a combination of intermediate- and short-acting insulin.
How long does Novolog last?
Novolog (the brand name for insulin aspart) lasts 3 to 5 hours. Novolog is a rapid-acting insulin. It begins working in as little as 10 minutes and reaches peak effectiveness in 40 to 50 minutes.
Which insulin is best?
No form of insulin is best. Each category of insulin has unique properties that determine how long it takes to work, reach its peak effectiveness, and stop working. Using a combination of different types of insulin can help you control blood sugar.
Does type 2 diabetes require insulin?
People with type 2 diabetes who can’t control their blood sugar by making lifestyle changes and taking other diabetes treatments may need to use insulin. Some people with type 2 diabetes use insulin and other diabetes treatments.
Is Lantus a long-acting insulin?
Lantus is a long-acting insulin. Its effects last up to 1 day. There are other types of long-acting insulin's, including Basaglar and Toujeo.
Has your doctor prescribed insulin to help manage your type 1 or type 2 diabetes? You’ll want to know how and when to take it, what side effects could happen, and what other changes you may need to make.
Use this list of questions as a starting point when you talk with your doctor.
What type of insulin do I need?
Insulin comes in four basic forms:
- Rapid-acting insulin starts to work within 30 minutes after injection. Its effects only last 2 to 3 hours.
- Regular- or short-acting insulin takes about 30 minutes to work and lasts for about 3 to 6 hours.
- Intermediate-acting insulin takes up to 4 hours to work fully. It peaks anywhere from 4 to 12 hours, and its effects can last for about 12 to 18 hours.
- Long-acting insulin begins to work in about 2 hours and then lasts up to a full day, steadily without a real peak.
Your doctor can tell you which type will work best with your diabetes type and blood sugar level.
How should I give myself insulin?
You can inject or inhale it.
To inject insulin, you can use a syringe, pen, or pump. There is also a needle-free option called a jet injector. Pens are the easiest to use, pumps deliver insulin continuously, and syringes are the least expensive.
Find out how many times a day you'll need to inject, and how much insulin to inject in each dose. If you use an insulin pump, ask your doctor when you'll need to give yourself an extra amount of insulin (bolus).
If you have type 1 diabetes, you may need up to three or four injections daily. People with type 2 diabetes may need just one shot of insulin a day, possibly increasing to three or four injections.
There is also a rapid-acting inhaled insulin that you can use before meals only. If you have type 1 diabetes, you must also use long-acting insulin.
Talk with your doctor about the pros and cons of each method. The decision may come down to cost, so find out which method your insurance will cover. If you don't have insurance or your plan won't pay for the type of insulin delivery method you prefer, ask your doctor about programs that can help you cover the cost.
When should I take my insulin?
There isn’t one simple answer to this question. It depends on things such as:
- The type of insulin you use (fast-acting, premixed, etc.)
- How much and what type of food you eat
- How much exercise you get
- Other health conditions you have
- The type of insulin delivery system (such as shots, pump, or inhaler) you use
Your doctor may want you to take insulin a half-hour before meals, so it's available when sugar from food enters your bloodstream. Find out exactly when during the day you need to take each of your injections, and what to do if you forget to give yourself an injection.
If I inject insulin, does it need to be in a certain part of my body?
Most people inject it into their lower belly area, since it’s easy to reach. (Be sure to stay at least 2 inches from the belly button.) You can also inject insulin into your arms, thighs, or buttocks.
Ask your doctor or diabetes educator to show you the right way to inject, including how to keep your needle and skin clean to prevent infections. Also learn how to rotate the injection site so you don't develop hard, fatty deposits under the skin from repeated injections.
Does insulin affect other medicines I take?
Some drugs can intensify low blood sugars caused by insulin. Tell your doctor about all the medicines you take, even those you bought without a prescription.
What can I eat while taking insulin?
Ask your doctor for food recommendations to help your insulin work best. For instance, you’ll want to know how much to eat at each meal, which types of foods are best for you to eat, whether you need to have snacks, and when you should eat. If you drink alcohol, ask your doctor if that’s OK while you’re taking insulin, and what your limit should be.
What is my target blood sugar level?
Your doctor should tell you how often you need to check your blood sugar using your blood glucose meter. Find out your target blood sugar range before and after meals, as well as at bedtime. For most people with diabetes, the targets are:
- 70 to 130 milligrams per deciliter (mg/dL) before meals
- Less than 180 mg/dL 2 hours after a meal
Ask what to do if your blood sugar doesn’t stay within range, and how often you need to have your A1C level tested.
What side effects could I have from the insulin?
The most common side effects are low blood sugar and weight gain. Ask your doctor what others you might have, and what to do if you get them.
How should I store my insulin?
Most insulin makers recommend storing it in the refrigerator, but injecting cold insulin can be uncomfortable. Make sure it’s at room temperature before injecting. Ask your doctor whether to store your insulin in the fridge or at room temperature. Also find out how long your insulin will last, and how to tell if it has gone bad.
Can I reuse syringes?
Doing so can lower your costs, but it is not without risk. Ask your doctor if that’s safe for you, and how to keep your syringes clean so you don’t get an infection. If you throw out your syringes after each use, ask how to safely dispose of them.
- How do you feel while taking your insulin?
- Have you noticed any side effects?
- How are you responding to your insulin dose? Are you having any problems with high or low blood sugar?
- Have you had any trouble using your insulin syringe, pen, or pump?
- Do you know how to store and dispose of your used syringes or needles?
If you have any questions between doctor visits, write them down so you remember to ask them next time. Your doctor can check on your progress so that you can successfully manage your diabetes.
For those with diabetes, an insulin shot delivers medicine into the subcutaneous tissue -- the tissue between your skin and muscle. Subcutaneous tissue (also called "sub Q" tissue) is found throughout your body.
Please follow these steps when using an insulin syringe.
Note: these instructions are not for patients using an insulin pen or a non-needle injection system.
Gather Insulin Supplies
Select a clean, dry work area, and gather the following insulin supplies:
- Bottle of insulin
- Sterile insulin syringe (needle attached) with wrapper removed
- Two alcohol wipes (or cotton balls and a bottle of rubbing alcohol)
- One container for used equipment (such as a hard plastic or metal container with a screw-on or tightly secured lid or a commercial "sharps" container)
Wash hands with soap and warm water and dry them with a clean towel.
Prepare the Insulin and Syringe
- Remove the plastic cap from the insulin bottle.
- Roll the bottle of insulin between your hands two to three times to mix the insulin. Do not shake the bottle, as air bubbles can form and affect the amount of insulin withdrawn.
- Wipe off the rubber part on the top of the insulin bottle with an alcohol pad or cotton ball dampened with alcohol.
- Set the insulin bottle nearby on a flat surface.
- Remove the cap from the needle.
Note: If you've been prescribed two types of insulin to be taken at once (mixed dose), skip to the instructions in the next section.
- Draw the required number of units of air into the syringe by pulling the plunger back. You need to draw the same amount of air into the syringe as insulin you need to inject. Always measure from the top of the plunger.
- Insert the needle into the rubber stopper of the insulin bottle. Push the plunger down to inject air into the bottle (this allows the insulin to be drawn more easily). Leave the needle in the bottle.
- Turn the bottle and syringe upside-down. Be sure the insulin covers the needle.
- Pull back on the plunger to the required number of units (measure from the top of the plunger).
- Check the syringe for air bubbles. Air bubbles in the syringe will not harm you if they are injected, but they can reduce the amount of insulin in the syringe. To remove air bubbles, tap the syringe so the air bubbles rise to the top and push up on the plunger to remove the air bubbles. Recheck the dose and add more insulin to the syringe if necessary.
- Remove the needle from the insulin bottle. Carefully replace the cap on the needle.
How to Measure a Mixed Dose of Insulin
Your doctor may prescribe two types of insulin to be injected at once for diabetes. This mixed dose may provide better blood sugar control for some people.
Please follow these steps when injecting a mixed dose of insulin:
- Follow the preparation steps described above for both bottles of insulin.
- Draw the required number of units of air into the syringe by pulling the plunger back. Draw air into the syringe equal to the amount of cloudy (intermediate or long-acting) insulin needed. Always measure from the top of the plunger (the edge closest to the needle).
- Insert the needle into the rubber stopper of the cloudy insulin bottle. Push the plunger down to inject air into the bottle (this allows the insulin to be drawn more easily). Do not withdraw the insulin into the syringe at this time. Take the needle out of the bottle.
- Draw the required number of units of air into the syringe by pulling the plunger back. Draw air into the syringe equal to the amount of clear (short-acting) insulin needed. Always measure from the top of the plunger.
- Insert the needle into the rubber stopper of the clear insulin bottle. Push the plunger down to inject air into the bottle (this allows the insulin to be drawn more easily).
- Turn the bottle and syringe upside-down. Be sure the insulin covers the needle.
- Pull back on the plunger to the required number of units of clear insulin needed (measure from the top of the plunger, the edge closest to the needle).
- Check the syringe for air bubbles. Air bubbles in the syringe will not harm you if they are injected, but they can reduce the amount of insulin in the syringe. To remove air bubbles, tap the syringe so the air bubbles rise to the top and push up on the plunger to remove the air bubbles. Recheck the dose and add more insulin to the syringe if necessary.
- Remove the needle from the clear insulin bottle and insert it into the rubber stopper of the cloudy insulin bottle.
- Turn the bottle and syringe upside-down. Be sure the insulin covers the needle.
- Pull back on the plunger to the required number of total units of insulin needed (measure from the top of the plunger).
Important: This must be an exact measurement. If you withdraw too much cloudy insulin, the total dosage in the syringe must be discarded. Be careful not to push any of the clear insulin from the syringe into the cloudy insulin. If there are large air bubbles after mixing the insulin in the syringe, discard this dosage and start the procedure again. Do not push the insulin back into the bottle.
- Carefully replace the cap on the needle.
- You are now ready to inject the insulin. Follow the steps listed below.
Rotate Insulin Injection Sites
Because you will be injecting insulin on a regular basis for diabetes, you need to know where to inject it and how to rotate (move) your injection sites. By rotating your injection sites, you will make your injections easier, safer, and more comfortable. If the same injection site is used over and over again, you may develop hardened areas under the skin that keep the insulin from being used properly.
Important: Only use the sites on the front of your body for self-injection. Any of the sites may be used if someone else is giving you the injection.
Follow these guidelines:
- Ask your doctor, nurse, or health educator which sites you should use.
- Move the site of each injection. Inject at least 1 1/2 inches away from the last injection site.
- Try to use the same general injection area at the same time of each day (for example, use the abdomen for the injection before lunch). Note: The abdomen absorbs insulin the fastest, followed by the arms, thighs, and buttocks.
- Keep a record of which injection sites you have used.
Select and Clean the Injection Site
Choose an injection site for your insulin shot.
Do not inject near joints, the groin area, navel, the middle of the abdomen, or near scars.
Clean the injection site (about 2 inches of your skin) in a circular motion with an alcohol wipe or a cotton ball dampened with rubbing alcohol. Leave the alcohol wipe or cotton ball nearby.
Inject the Insulin
Using the hand you write with, hold the barrel of the syringe (with the needle end down) like a pen, being careful not to put your finger on the plunger.
- Remove the needle cap.
- With your other hand, gently pinch a two- to three-inch fold of skin on either side of the cleaned injection site.
- Insert the needle with a quick motion into the pinched skin at a 90-degree angle (straight up and down). The needle should be all the way into your skin.
- Push the plunger of the syringe until all of the insulin is out of the syringe.
- Quickly pull the needle out. Do not rub the injection site. You may or may not bleed after the injection. If you are bleeding, apply light pressure with the alcohol wipe. Cover the injection site with a bandage if necessary.
Dispose of the Syringe and Needle
Do not cap the needle. Drop the entire syringe and needle into your container for used "sharps" equipment. When the container is full, put the lid or cover on it and throw it away with the trash.
Do NOT put this container in the recycling bin. Some communities have specific disposal laws. Check with your local health department for specific disposal instructions in your community.
Ask your doctor these questions when you get a prescription for a medicine.
You may want to make copies of this list and fill it out for each of your medicines.
What are the names of my medicine?
Brand name: _______________________
Generic name: _____________________
What does my medicine do?
When should I start this medicine?
This medicine is prescribed by:_______________
How long will this medicine take to work?
What is the strength (for example, how many milligrams, written as mg)?
How much should I take for each dose?
How many times a day should I take my medicine?
At what times should I take my medicine?
Should I take it before, with, or after a meal?
Should I avoid any foods or medicines when I take it?
Should I avoid alcoholic beverages when I take it?
Are there any times when I should change the amount of medicine I take?
What should I do if I forget to take it?
If I'm sick and can't keep food down, should I still take my medicine?
Can my diabetes medicine cause low blood glucose?
What should I do if my blood glucose is too low?
What side effects can this medicine cause?
What should I do if I have side effects?
How should I store this medicine?
** Good Luck with your Diabetic Situation **
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