🎯 Key Takeaways
- Five main types: Rapid-acting (10-15 min), short-acting (30 min), intermediate (1-2 hrs), long-acting (1-2 hrs), ultra-long (steady)
- Basal vs. bolus: Long-acting covers between meals; rapid-acting covers food - most people need both
- Timing matters: Understanding onset, peak, and duration prevents dangerous highs and lows
- Many options: Lantus, Tresiba, Humalog, NovoRapid - each has unique characteristics
- Biosimilars save money: Basaglar, Semglee offer same effectiveness at lower cost
Understanding the different types of insulin is essential for anyone managing diabetes with insulin therapy - yet the variety of options can feel overwhelming. From rapid-acting insulins that work in minutes to ultra-long-acting formulations lasting over 42 hours, each type serves a specific purpose in your treatment plan. In this comprehensive guide, you'll learn exactly how each insulin type works, when to use them, brand name options available in India, and how to match insulin therapy to your lifestyle for optimal blood sugar control.
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📑 In This Guide:
🎥 Watch: Insulin Types - Which One Do You Need?
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Get Free PDF →🔬 Insulin Basics: How It Works
Before diving into the different types of insulin, let's understand what insulin does and why so many insulin formulations exist. Understanding insulin types is the foundation for effective diabetes management.
Insulin: A hormone produced by the pancreas that allows glucose (sugar) from food to enter cells for energy. Without insulin, glucose builds up in the bloodstream causing high blood sugar. In diabetes, either the body doesn't produce enough insulin (Type 1) or can't use it effectively (Type 2), requiring external insulin therapy.
Why Different Types Exist
A healthy pancreas releases insulin in two patterns:
- Basal secretion: A steady, low-level release of insulin throughout the day and night (about 1 unit per hour)
- Bolus secretion: A burst of insulin released when you eat to handle the incoming glucose from food
Different insulin formulations are designed to mimic these natural patterns. Long-acting insulins replicate basal secretion, while rapid-acting insulins mimic the mealtime bolus response.
Key Terms to Understand
- Onset: How quickly the insulin starts working after injection
- Peak: When the insulin has its maximum effect on lowering blood sugar
- Duration: How long the insulin continues to work in your body
These three factors determine when to take each insulin type and how to prevent both hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar).
Complete Comparison of All Types of Insulin
This comprehensive table compares all major types of insulin available today, showing onset, peak, and duration for each category:
| Type | Examples | Onset | Peak | Duration | When Used |
|---|---|---|---|---|---|
| Rapid-Acting | Humalog, NovoRapid, Apidra, Fiasp | 10-15 min | 1-2 hours | 3-5 hours | Before meals |
| Short-Acting | Actrapid, Humulin R | 30 min | 2-4 hours | 5-8 hours | 30 min before meals |
| Intermediate | NPH (Humulin N, Novolin N) | 1-2 hours | 4-8 hours | 12-18 hours | Twice daily |
| Long-Acting | Lantus, Basaglar, Levemir | 1-2 hours | Minimal/None | 20-24 hours | Once daily |
| Ultra-Long | Tresiba (degludec) | 1-2 hours | None | 36-42 hours | Once daily (flexible) |
⚡ Rapid-Acting Insulin
Among all types of insulin, rapid-acting insulin is specifically designed to cover the glucose from meals. It's the "mealtime" or "bolus" insulin most people with Type 1 diabetes and many with Type 2 use. This is one of the most commonly prescribed types of insulin worldwide.
Characteristics
- Onset: 10-15 minutes (ultra-rapid versions: 2-5 minutes)
- Peak: 1-2 hours after injection
- Duration: 3-5 hours
- Appearance: Clear liquid
Brand Options
| Brand Name | Generic Name | Manufacturer | Notes |
|---|---|---|---|
| Humalog | Insulin lispro | Eli Lilly | Most prescribed rapid insulin |
| NovoRapid | Insulin aspart | Novo Nordisk | Called NovoLog in USA |
| Apidra | Insulin glulisine | Sanofi | Slightly faster than Humalog |
| Fiasp | Faster insulin aspart | Novo Nordisk | Ultra-rapid (2-5 min onset) |
| Lyumjev | Ultra rapid lispro | Eli Lilly | Ultra-rapid version of Humalog |
When and How to Use
- Standard rapid-acting: Take 10-15 minutes before eating
- Ultra-rapid (Fiasp, Lyumjev): Can take at the start of a meal or even up to 20 minutes after
- Dose calculation: Based on carbohydrate content (insulin-to-carb ratio) plus correction for current blood sugar
- Injection sites: Abdomen provides fastest absorption; rotate sites to prevent lipohypertrophy
Optimize your mealtime dosing: Track post-meal glucose patterns to fine-tune your insulin-to-carb ratios. Start tracking with My Health Gheware →
⏱️ Short-Acting (Regular) Insulin
Short-acting insulin, also called "Regular" insulin, was the original mealtime insulin before rapid-acting versions were developed. It's still used in some situations.
Characteristics
- Onset: 30-60 minutes
- Peak: 2-4 hours after injection
- Duration: 5-8 hours
- Appearance: Clear liquid
Brand Options
- Humulin R (Eli Lilly)
- Actrapid / Novolin R (Novo Nordisk)
When Regular Insulin is Still Used
- Cost considerations: Regular insulin is significantly cheaper than rapid-acting
- IV administration: Only Regular insulin can be given intravenously (in hospitals)
- Pre-mixed combinations: Combined with NPH in 70/30 formulations
- Older regimens: Some patients stable on Regular may continue
Important: Because Regular insulin takes 30 minutes to start working, you must inject 30 minutes before eating - not at the meal like rapid-acting. This timing requirement is why most people now prefer rapid-acting insulin.
🕐 Intermediate-Acting Insulin (NPH)
NPH (Neutral Protamine Hagedorn) insulin provides intermediate-duration coverage. Before modern long-acting insulins were developed, NPH was the standard "background" insulin.
Characteristics
- Onset: 1-2 hours
- Peak: 4-8 hours (pronounced peak - can cause hypoglycemia)
- Duration: 12-18 hours
- Appearance: Cloudy/milky (must be gently rolled to mix before use)
Brand Options
- Humulin N (Eli Lilly)
- Novolin N / Insulatard (Novo Nordisk)
NPH Advantages and Limitations
Advantages:
- Much cheaper than modern long-acting insulins
- Can be mixed with Regular or rapid-acting insulin in the same syringe
- Widely available globally
Limitations:
- Pronounced peak increases hypoglycemia risk
- Usually requires twice-daily dosing
- More variable absorption than modern insulins
- Must be mixed (rolled) before each injection
Clinical note: While NPH has largely been replaced by long-acting insulin analogs in developed countries, it remains the most commonly used background insulin in many parts of the world due to cost. The WHO includes NPH on its Essential Medicines List, recognizing insulin as a critical medication for global health.
🌙 Long-Acting Insulin
Long-acting insulin analogs represent one of the most important types of insulin for modern diabetes management. These insulins provide steady, "peakless" background insulin coverage for 20-24 hours, making them the standard for basal insulin therapy. Understanding this type of insulin is crucial for anyone using multiple daily injections.
Characteristics
- Onset: 1-2 hours
- Peak: Minimal or none (flat action profile)
- Duration: 20-24 hours (varies by specific insulin)
- Appearance: Clear liquid
Brand Options
| Brand Name | Generic Name | Duration | Notes |
|---|---|---|---|
| Lantus | Insulin glargine U-100 | ~24 hours | Original long-acting; most prescribed globally |
| Basaglar | Insulin glargine (biosimilar) | ~24 hours | Biosimilar to Lantus; more affordable |
| Semglee | Insulin glargine (biosimilar) | ~24 hours | Interchangeable biosimilar to Lantus |
| Toujeo | Insulin glargine U-300 | ~36 hours | Concentrated; flatter profile; less hypos |
| Levemir | Insulin detemir | 12-24 hours | Often requires twice-daily dosing |
Lantus vs. Levemir
Both are effective long-acting insulins, but they have key differences:
- Duration: Lantus typically lasts a full 24 hours; Levemir may require twice-daily dosing in some people
- Weight: Levemir is associated with slightly less weight gain in some studies
- Mixing: Neither should be mixed with other insulins
- Flexibility: Lantus should be taken at the same time daily; Levemir offers slightly more timing flexibility
See your basal insulin working: Track overnight glucose patterns to know if your long-acting insulin dose is right. Try My Health Gheware free →
📅 Ultra-Long-Acting Insulin
Ultra-long-acting insulins represent the newest generation of basal insulins, offering extended duration and exceptional flexibility.
Tresiba (Insulin Degludec)
- Onset: 1-2 hours
- Peak: None (truly flat profile)
- Duration: 36-42+ hours
- Appearance: Clear liquid
What Makes Tresiba Different
Ultra-stable levels: Tresiba forms "multi-hexamers" under the skin that slowly release insulin, providing the flattest, most consistent blood levels of any basal insulin.
Dosing flexibility: Because of its 42+ hour duration, Tresiba offers unmatched dosing flexibility. You can vary your injection time by up to 8 hours without affecting blood sugar control - ideal for shift workers, travelers, or anyone with an irregular schedule.
Reduced hypoglycemia: Clinical trials (SWITCH 1 and SWITCH 2) showed significantly lower rates of severe and nocturnal hypoglycemia compared to Lantus, making Tresiba particularly valuable for people prone to low blood sugar.
Cost Consideration
Tresiba is more expensive than Lantus/Basaglar. In India, expect to pay ₹2,000-3,500 per pen compared to ₹1,200-1,800 for Lantus. However, the reduced hypoglycemia risk and dosing flexibility may justify the cost for many patients.
🔄 Pre-Mixed Insulins
Pre-mixed insulins combine intermediate-acting (NPH) or long-acting insulin with rapid or short-acting insulin in a fixed ratio, reducing the number of injections needed.
Common Pre-Mixed Options
| Brand Name | Composition | Ratio Meaning |
|---|---|---|
| Humalog Mix 75/25 | 75% lispro protamine + 25% lispro | 75% intermediate + 25% rapid |
| NovoMix 30 | 70% aspart protamine + 30% aspart | 70% intermediate + 30% rapid |
| Humulin 70/30 | 70% NPH + 30% Regular | 70% intermediate + 30% short |
| Ryzodeg | 70% degludec + 30% aspart | 70% ultra-long + 30% rapid |
Who Benefits from Pre-Mixed Insulin
- People who prefer fewer injections: Typically twice daily instead of 4+ times
- Consistent meal patterns: Works best with regular meal timing and similar carb amounts
- Those new to insulin: Simpler regimen to start with
- Vision or dexterity issues: Fewer injections to manage
Limitations of Pre-Mixed Insulin
- Less flexibility: Can't adjust mealtime and background insulin independently
- Fixed ratios: May not match individual needs perfectly
- Timing requirements: Must eat at consistent times
- Hypoglycemia risk: If meals are skipped or delayed
But here's what most people miss: The DEVOTE trial published in NEJM showed that among all types of insulin, ultra-long-acting insulin degludec (Tresiba) reduced severe hypoglycemia by 40% vs. insulin glargine (Lantus)—while achieving identical HbA1c. For patients at high hypoglycemia risk, the "premium" insulin often pays for itself in avoided ER visits and lost work days. (DOI: 10.1056/NEJMoa1615692)
💉 Basal-Bolus Therapy Explained
Basal-bolus therapy is the gold standard for insulin treatment, most closely mimicking how a healthy pancreas works. The American Diabetes Association Standards of Care recommend this approach for all people with Type 1 diabetes and many with Type 2.
Basal-Bolus Regimen: A method of insulin delivery using two types of insulin - a long-acting "basal" insulin taken once or twice daily for background coverage, plus a rapid-acting "bolus" insulin taken before each meal to cover food. This typically means 4+ injections daily but provides the most flexible and precise blood sugar control.
How Basal-Bolus Works
Basal Insulin (40-50% of daily dose):
- Long-acting insulin (Lantus, Tresiba, Levemir) taken once or twice daily
- Controls blood sugar between meals and overnight
- Maintains steady glucose levels during fasting
- Dose usually stays consistent day-to-day
Bolus Insulin (50-60% of daily dose):
- Rapid-acting insulin (Humalog, NovoRapid) taken before meals
- Covers the glucose from carbohydrates eaten
- Dose varies based on carb content and current blood sugar
- Allows flexibility - eat more, take more; eat less, take less
Advantages of Basal-Bolus
- Maximum flexibility: Eat when you want, what you want (within reason)
- Precise control: Adjust mealtime doses for different meals
- Better HbA1c: Often achieves tighter glucose control
- Skip meals safely: Simply skip the bolus dose
- Correct highs: Take correction doses for elevated blood sugar
Who Uses Basal-Bolus
- All people with Type 1 diabetes: Essential for survival
- Many with Type 2 diabetes: When other treatments aren't enough
- Gestational diabetes: When blood sugar needs tight control during pregnancy
- Anyone wanting optimal control: Especially with variable schedules or meal patterns
Master your basal-bolus therapy: Track patterns, correlate meals with glucose response, and optimize your ratios. Start tracking with My Health Gheware →
🎯 Choosing the Right Insulin
Selecting the right type of insulin from the many available options involves multiple factors. With so many types of insulin to choose from - rapid-acting, long-acting, pre-mixed, and more - here's what influences the decision:
Factors Your Doctor Considers
- Diabetes type: Type 1 always needs basal-bolus; Type 2 may start with basal only
- Current HbA1c: Higher levels may need more intensive regimens
- Hypoglycemia risk: Newer insulins (Tresiba, rapid analogs) carry lower risk
- Lifestyle: Shift workers, travelers benefit from flexible insulins
- Meal patterns: Irregular eating favors basal-bolus over pre-mixed
- Injection frequency tolerance: Some prefer fewer injections
- Cost and insurance: Biosimilars and NPH offer affordable options
- Kidney function: Affects insulin clearance and dosing
- Age: Elderly patients may need simpler regimens
Insulin Cost Comparison (India)
| Insulin Type | Brand Example | Approx. Cost (per pen/vial) |
|---|---|---|
| Human Insulin (NPH/Regular) | Humulin N/R | ₹200-400 |
| Pre-Mixed | Humulin 70/30 | ₹300-500 |
| Rapid-Acting | Humalog/NovoRapid | ₹800-1,200 |
| Long-Acting | Lantus | ₹1,200-1,800 |
| Long-Acting Biosimilar | Basaglar | ₹900-1,400 |
| Ultra-Long-Acting | Tresiba | ₹2,000-3,500 |
Note: Prices vary by location, pharmacy, and pack size. Check current prices before purchasing.
❓ Frequently Asked Questions About Types of Insulin
Here are answers to common questions about the different types of insulin and how to use them effectively:
Q: Can I switch between insulin brands?
Yes, but it should be done under medical supervision. Switching between biosimilars (e.g., Lantus to Basaglar) usually requires no dose change. Switching between different insulin types (e.g., NPH to Lantus) requires careful dose adjustment as they work differently. Never switch insulins without consulting your healthcare provider.
Q: Why does insulin make me gain weight?
Insulin helps your body use glucose efficiently, which means fewer calories are lost in urine (as happened when blood sugar was high). Additionally, insulin promotes fat storage. Some people eat more to prevent hypoglycemia. Weight gain can be minimized by proper dosing to avoid excess insulin, carb counting, and regular exercise. Newer medications like GLP-1 agonists may help with weight when added to insulin therapy.
Q: What if I accidentally took too much insulin?
If you've taken too much insulin, immediately eat fast-acting carbohydrates (glucose tablets, juice, regular soda) and monitor your blood sugar frequently. If you can't eat or are unconscious, someone should give you glucagon if available and call emergency services. The severity depends on the insulin type - rapid-acting overdoses are most dangerous in the first few hours, while long-acting overdoses require monitoring for 24+ hours.
Q: Can insulin be taken as a pill instead of injection?
Not yet effectively. Insulin is a protein that would be digested in the stomach before reaching the bloodstream. Research into oral insulin continues, but current technology hasn't solved this challenge for routine use. Some oral insulin products are in late-stage development but aren't yet widely available. For now, injection (syringe, pen, or pump) remains the standard delivery method.
Q: How do insulin pumps change which insulin I need?
Insulin pumps only use rapid-acting insulin (Humalog, NovoRapid, or ultra-rapid like Fiasp). The pump delivers tiny amounts continuously for basal coverage and larger boluses for meals - all from one type of insulin. This eliminates the need for separate long-acting insulin. The pump's programming replicates the basal-bolus pattern electronically rather than using different insulin formulations.
📚 Related Articles
Now that you understand the different types of insulin, explore these related guides to complete your diabetes medication knowledge:
Complete guide to the most commonly prescribed diabetes medication
GLP-1 Medications: From Ozempic to Weight Loss and Diabetes ControlUnderstanding the revolutionary weight loss and diabetes medications
What is Time in Range? The #1 Metric for Diabetes ControlLearn the key glucose metric and how to improve it
Which type of insulin are you using—rapid-acting, long-acting, pre-mixed, or a combination? What has your experience been with different insulin types?
Your experience might help someone choosing their insulin regimen.
Last Reviewed: January 2026
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