It’s important that you use the right insulin and the right delivery method to suit you. Always consult your healthcare team making changes to your treatment regime.
There are many different types of insulin, and most people with type 1 in the UK combine the use of two insulins. This usually involves a ‘basal-bolus regime’ – combining a slow-acting and fast-acting insulin to try to balance blood glucose levels.
Slow-acting insulins (also known as long-acting, basal or background insulins) provide your body with the background insulin it needs throughout the day and night. They can last up to 24 hours.
Popular types of slow-acting insulin in the UK include:
- Insulin glargine (Lantus) – this takes effect after an hour and can last for 24 hours
- Insulin determir (Levemir) – this has a shorter effect than Lantus and so if often injected twice per day
- Insulin degludec (Tresiba) – this is often prescribed to reduce nocturnal hypoglycaemia in people over the age of 18
Rapid-acting insulins (also known as fast or short-acting, bolus or mealtime insulin) are usually taken just before a meal, snack or drink containing carbohydrates to minimise the rise in blood sugar which follows eating.
Types of rapid-acting insulin in the UK include:
- Insulin aspart (Novorapid) – takes effect approximately 10-20 minutes after injection
- Insulin aspart (Fiasp) – takes effect approximately 5 minutes after injection
- Insulin lispro (Humalog) – takes effect approximately 15-30 minutes after injection
- Insulin glulisine (Apidra) – takes effect approximately 10-20 minutes after injection
Novorapid, Fiasp, Apidra and Humalog all peak after approximately one hour, and cease to have any effect two to five hours after injection.
A note about Fiasp
Correct as of July 2017: Fiasp is a new rapid-acting insulin which was approved for use in the UK in 2017. It is available only for adults. Because it’s new, it is currently unclear who would benefit from switching to Fiasp. Local Fiasp availability and prescription will vary as not all hospitals and GP practices have added Fiasp to their lists of approved medicines for use yet.
Some people choose to use a ‘mix’ insulin, where fast and slow-acting insulins are mixed together in a single dosage. Whilst this usually involves fewer injections each day, it reduces the flexibility you have. People on mix insulins, such as Humalog Mix, usually have to eat fixed amounts of carbohydrates at fixed times, and can find unplanned exercise especially difficult.
Until the 1980s, insulin was taken from the pancreas of healthy animals and then stored for human use. Since the 1980s, most modern insulins are synthetic – they are developed in a laboratory rather than coming from animals. However, some people who used animal insulins have found it difficult to switch to synthetic insulins, and thus use older, animal based products, such as Hypurin.