If you have type 1 diabetes, your body can’t make its own insulin. The goal of treatment is to replace the insulin that your pancreas can’t make.
Insulin
Insulin is the most common type of medication used in type 1 diabetes treatment. There are more than 20 types sold in the United States.
It’s given as an infusion under the skin (with the help of an insulin pump) or as an injection.
There are multiple types of insulin. They vary based on how quickly they start working, how long they work, and whether they have a peak level of action.
The type of insulin you need depends on your body’s sensitivity to insulin and the severity of your insulin deficiency. These include the following:
Short-acting insulin:
Regular or “short-acting” insulin may reach the bloodstream 30 minutes after injection and peak 2-3 hours afterward. These injections also work up to 3-6 hours.
Types of regular insulin include:
- Humulin R U-100
- Novolin R FlexPen
- Novolin R ReliOn
- Novolin R FlexPen ReliOn
Rapid-acting insulin:
As the name suggests, rapid-acting insulin works within 15 minutes. The peak time is 1 to 2 hours after use, and the medication lasts between 2 and 4 hours.
The available types of rapid-acting insulin include:
- inhaled insulin (Afrezza)
- insulin aspart (Fiasp, Fiasp FlexTouch, Fiasp PenFill, NovoLog, NovoLog FlexPen, NovoLog FlexTouch, NovoLog PenFill, ReliOn NovoLog, ReliOn NovoLog FlexPen)
- insulin glulisine (Apidra, Apidra SoloStar), which is only available as a brand-name drug
- insulin lispro (Admelog, Admelog SoloStar, Humalog, Humalog KwikPen, Humalog Junior KwikPen)
- insulin lispro-aabc (Lyumjev, Lyumjev KwikPen)
Intermediate-acting insulin:
Intermediate-acting insulin works about 2-4 hours after use, with an average peak time of 12 hours. You can expect this type of insulin to last between 12 and 18 hours.
Examples include:
- insulin isophane (Humulin N U-100, Humulin N KwikPen, Novolin N, Novolin N FlexPen, Novolin N ReliOn, Novolin N FlexPen ReliOn)
Long-acting insulin:
Long-lasting insulin helps lower your blood glucose levels for up to 24 hours or longer, and it reaches your bloodstream more gradually.
The types of available long-acting insulin include:
- insulin degludec (Tresiba, Tresiba FlexTouch)
- insulin detemir (Levemir)
- insulin glargine (Basaglar KwikPen, Lantus, Lantus SoloStar, Toujeo SoloStar, Toujeo Max SoloStar)
- insulin glargine-yfgn (Semglee-yfgn)
- concentrated regular insulin (Humulin R U-500, Humulin R U-500 KwikPen)
Combination (premixed) insulins:
- insulin aspart protamine/insulin aspart 70/30 (NovoLog Mix 70/30, NovoLog Mix 70/30 FlexPen)
- insulin isophane/regular insulin 70/30 (Humulin 70/30, Humulin 70/30 KwikPen, Novolin 70/30, Novolin 70/30 FlexPen, Novolin 70/30 FlexPen ReliOn)
- insulin lispro protamine/insulin lispro 50/50 (Humalog Mix 50/50, Humalog Mix 50/50 KwikPen)
- insulin lispro protamine/insulin lispro 75/25 (Humalog Mix 75/25, Humalog Mix 75/25 KwikPen)
Amylinomimetic injectables
Pramlintide (SymlinPen) is an amylinomimetic. It’s an injectable medication that’s used before meals.
It works by delaying the time your stomach takes to empty itself. It also reduces the secretion of the hormone glucagon after meals. These actions lower your blood sugar.
Pramlintide reduces appetite, too.