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Fig 4: Peak and Duration of Action of Short Acting Insulins



Short acting (Regular):- Short-acting (regular) insulin usually reaches the blood within 30 minutes after injection. It peaks 2 to 4 hours later and stays in the blood for about 4 to 8 hours (Fig.4).

Fig 5: Peak and Duration of Action of Intermediate Acting Insulins



Intermediate acting:- NPH and Lente (Fig.5): Intermediate-acting (NPH and lente) insulins reach the blood 2 to 6 hours after injection. They peak 4 to 14 hours later and stay in the blood for about 14 to 20 hours.

Intermediate-acting insulins include lente and NPH. Insulin preparations with a predetermined proportion of NPH mixed with regular, such as 70% NPH to 30% regular, or a 50/50 mix are called intermediate acting insulin.

Fig 6: Peak and Duration of Action of Long Acting Insulins



Long Acting: Ultralente (Fig.6): Long-acting (ultralente) insulin takes 6 to 14 hours to start working. It has no peak or a very small peak 10 to 16 hours after injection. It stays in the blood between 20 and 24 hours.

Fig 7: Peak and Duration of Action of Very Long Acting Insulins



Very long acting: Lantus (Fig.7): Lantus is newer insulin, which works for 24 hrs. The chemical structure of Lantus makes it to be released steadily and continuously in the body, mimicking almost the basal physiological secretion of Insulin. It is the only long acting insulin which is clear and cannot be mixed up with any other insulin.

Regular insulin, Lispro and Aspart are only clear insulins or solution of insulin. Regular insulin modified with addition of protamine and zinc (NPH) or zinc alone (Lente, Ultralente) to prolong duration of action of insulin are cloudy white suspensions. Lispro is an insulin analog identical to human insulin except for the reversal of two amino acids, lysine and proline, on the B chain.