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.
Insulin
Administration and Storage
Insulin vials should be preferably stored at 4-80C. If possible
they should be kept in the refrigerator, but not in the freezer
compartment. The insulin vial should be brought down to body temperature
by gently rubbing it between the palms before withdrawing the
insulin into the syringes.
If refrigeration facilities are unavailable, then the currently
used vial can be stored at room temperature away from heat and
direct sunlight. If vials have to be stored for longer periods,
a simple method is for the unopened vials to be stored in the
earthen pots, which contain drinking water and are found in most
homes where a refrigerator is not present.
Last
updated on 13-12-2002
