What Are The Pros And Cons Of Various Types Of Insulins?

— -- Question:What are the pros and cons of various types of insulins?

Answer:I don't think we should think of insulin as having pros and cons, rather each insulin has its own function. For example, we have the 'mealtime' insulin, which covers the basal needs overnight and between meals. We have, really, two outstanding insulins for that: insulin glargine, which goes by the trade name Lantus; and insulin detemir, which goes by the trade name Levemir.

We also have 'mealtime' insulins and we have three of those: insulin lispro, which goes by the trade name Humalog; insulin aspart, which goes by the trade name Novolog; and insulin glulisine, which goes by the trade name Apedra. These are insulins which are injected just before eating, so there are not the large spikes (in blood sugar) that occur after eating a meal.

There are two other insulins that are older but still have an important niche in our insulin armamentarium. The first is NPH insulin, which we consider an intermediate insulin, although we usually use it as a 'basal' insulin. The other is 'regular' insulin, which is used quite a bit in intravenous solutions in the hospital, but we still use it on the outpatient basis for mealtime insulin. And both of these insulins, in addition to the newer rapid-acting insulins, can also be mixed with NPH insulin to be used as a pre-mixed insulin, as some people use this as a treatment for type 2 diabetes. The pre-mixed insulins are inappropriate for type 1 diabetes.

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