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Regular insulin, also known as neutral insulin and soluble insulin, is a type of short-acting medical insulin. [2] It is used to treat type 1 diabetes , type 2 diabetes , gestational diabetes , and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states . [ 5 ]
Prandial insulin is usually administered no more than 15–30 minutes prior to a meal using a rapid-acting insulin or a regular insulin. In some patients, a combination insulin may be used that contains both NPH (long acting) insulin and a rapid/regular insulin to provide both a basal insulin and prandial insulin. [36]
Examples of rapid-acting insulins (peak at ~1 hour) are: [citation needed] Insulin lispro (Humalog) Insulin aspart (Novolog) Insulin glulisine (Apidra) Examples of short-acting insulins (peak 2–4 hours) are: Regular insulin (Humulin R, Novolin R) Prompt insulin zinc (Semilente) Examples of intermediate-acting insulins (peak 4–10 hours) are:
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).
Insulin release from pancreas is pulsatile with a period of 3-6 minutes. [1] The insulin concentration in blood increases after meals and gradually returns to basal levels during the next 1–2 hours. However, the basal insulin level is not stable. It oscillates with a regular period of 3-6 min.
Conventional insulin therapy is characterized by: Insulin injections of a mixture of regular (or rapid) and intermediate acting insulin are performed two times a day, or to improve overnight glucose, mixed in the morning to cover breakfast and lunch, but with regular (or rapid) acting insulin alone for dinner and intermediate acting insulin at bedtime (instead of being mixed in at dinner).
The first biosynthetic insulin analog was developed for clinical use at mealtime (prandial insulin), Humalog (insulin lispro), [101] it is more rapidly absorbed after subcutaneous injection than regular insulin, with an effect 15 minutes after injection.
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.