Insulin is the main medicine used to treat type 1 diabetes. Pramlintide may be used with it. Here are the basics about each of these medicines. Only common problems with them are listed.
Insulin
Insulin is injected 2 to 4 times during the day to replace the insulin that the pancreas cannot make. It is often given before meals, at snacks, and at bedtime. The amount of insulin must be balanced with the amount and type of food that is eaten and the amount of activity that is done. Making changes to a person's diet, exercise, or both without making changes to the insulin dose can cause blood glucose to drop too low or rise too high.
| Insulin Injection Sites |
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The main types of insulin are:
| Type of insulin | Onset* | Peak time* | Duration* | Notes on use |
|---|---|---|---|---|
| Rapid-acting Novolog (aspart) Humalog (lispro) Apidra (glulisine) Afrezza (technosphere, inhaled) | 10 to 30 minutes | 0.5 to 3 hours | 3 to 5 hours | Inject right away before a meal. |
| Regular or short-acting Novolin R Humulin R | 0.5 to 1 hour | 2 to 5 hours | 5 to 8 hours | |
|
Intermediate-acting (NPH ) |
1 to 2 hours | 3 to 12 hours | 18 to 24 hours | This is often used with short-acting insulin. |
|
Long-acting Insulin glargine (Lantus), Levemir (detemir) |
1 hour | n/a | 24 hours | This may not be mixed with other types of insulin. |
*Each person has a unique response to insulin. The times listed are approximate.
Premixed insulins are a mixture of short-acting and intermediate-acting. It is usually given twice per day with breakfast and dinner.
| Type of insulin | Onset | Peak time | Duration |
| Humulin (50/50) | 30 minutes | 2 to 5 hours | 18 to 24 hours |
| Humalog mix (75/25) | 15 minutes | 0.5 to 2.5 hours | 16 to 20 hours |
| Humulin (70/30) | 30 minutes | 2 to 4 hours | 14 to 24 hours |
| Novolin (70/30) | 30 minutes | 2 to 12 hours | up to 24 hours |
| Novolog Mix (70/30) | 10-20 minutes | 1 to 4 hours | up to 24 hours |
The table below shows types of insulin and common brand names.
| Type of insulin | Brand names |
|---|---|
| Rapid-acting |
Humalog (insulin lispro)
NovoLog (insulin aspart) Apidra (glulisine) *all require a prescription |
| Regular or short-acting |
Humulin R (regular)
Novolin R |
| Intermediate-acting |
Humulin N (NPH)
Novolin N (NPH) |
| Long-acting |
Levemir (detemir)
Lantus (insulin glargine) |
Here are methods to deliver insulin:
- Syringe and vial—used to inject insulin into the fat layer between the skin and the muscles
- Pena one-time-use pen that contains a dose of insulin is used to inject insulin
- Pump—uses a device the size of a pager that is worn on a belt or in a pocket to deliver a steady, measured dose of insulin through a tube that is inserted through the skin
Common name: pramlintide
Amylin is a hormone made by the same beta cells that make insulin. Pramlintide is chemically related to amylin. It lowers blood glucose when used with insulin. It is given to people who cannot manage blood glucose with insulin alone.
Pramlintide is injected right before meals. It can lower appetite and result in weight loss. This can be helpful to those who need to reach a healthy weight and those who have gained weight as a side effect of using insulin.
References
American Diabetes Association. Standards of medical care in diabetes—2019. Diabetes Care, 2019; 42 (Suppl 1): S1-193.
Diabetes mellitus type 1. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/diabetes-mellitus-type-1-39. Accessed May 5, 2022.
Insulin basics. American Diabetes Association website. Available at: https://www.diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-basics. Accessed May 6, 2022.
Type 1 diabetes. American Diabetes Association website. Available at: https://www.diabetes.org/diabetes/type-1. Accessed May 5, 2022.
Revision Information
- Reviewer: EBSCO Medical Review Board James P. Cornell, MD
- Review Date: 03/2022
- Update Date: 05/06/2022