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Ultralente insulin was a long-acting form of insulin.It has an onset of 4 to 6 hours, a peak of 14 to 24 hours, and a duration of 28 to 36 hours. [1] Ultralente insulin, along with lente insulin, were discontinued in the US by manufacturers in the mid-2000s.
Insulin degludec has an onset of action of 30–90 minutes (similar to insulin glargine and insulin detemir). There is no peak in activity, due to the slow release into systemic circulation. The duration of action of insulin degludec is reported as being longer than 24 hours. [16] [14]
There are several types of insulin that are commonly used in medical practice, with varying times of onset and duration of action. [32] - Rapid acting (i.e. insulin lispro) with onset in 15 minutes and duration of about 4 hrs. - Short acting (i.e. regular insulin) with onset in 30 minutes and duration of about 6 hrs.
The differences mean that insulin degludec is absorbed more slowly by the body. [6] This means it has a long duration of action. [6] Meanwhile, insulin aspart is absorbed faster by the body than human insulin, and therefore it starts to work as soon as it is injected and has a short duration of action. [6]
NPH insulin is cloudy and has an onset of 1–3 hours. Its peak is 6–8 hours and its duration is up to 24 hours. [9]It has an intermediate duration of action, meaning longer than that of regular and rapid-acting insulin, and shorter than long acting insulins (ultralente, glargine or detemir).
Selecting an appropriate insulin preparation (typically on 'speed of onset and duration of action' grounds). Adjusting dosage and timing to fit food intake timing, amounts, and types. Adjusting dosage and timing to fit exercise undertaken. Adjusting dosage, type, and timing to fit other conditions, for instance the increased stress of illness.
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Insulin aspart can be used in an insulin pump and insulin pen for subcutaneous injection. Additionally, it can be used with an injection port such as the I-port. [25] Insulin aspart has a more rapid onset, and a shorter duration of activity than normal human insulin. [26] Insulin aspart can also be used with external insulin pumps. [13]