Medicine & USMLE

Insulin Preparations

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Diabetes Drugs (Old)
  1. Insulin Preparations
  2. Metformin
  3. Glitazones / Thiazolidinediones
  4. First-Gen Sulfonylureas
  5. Second-Gen Sulfonylureas
  6. Meglitinides
  7. GLP-1 Analogs
  8. DPP-4 Inhibitors
  9. alpha-Glucosidase Inhibitors
  10. Pramlintide

Summary

Insulin is an anabolic peptide hormone used to treat diabetes, and its main function is to lower and control blood glucose levels.  It comes in a variety of different preparations, each of which is used in different clinical contexts. Lispro, Glulisine, and Aspart are rapid-acting insulin analogues and are used prior to eating to combat the post-prandial peak.  Regular insulin is short-acting and is used primarily in the context of diabetic ketoacidosis. NPH insulin is intermediate-acting but its use has declined in recent years with the advent of newer long-acting insulins.Glargine and detemir are long-acting insulin analogues and are primarily used to maintain blood glucose levels over a longer period of time. 

Key Points

  • Insulin preparations
    • Rapid-acting (1-hr peak)
      • Lispro
      • Aspart
      • Glulisine
    • Short-acting (2–3 hr peak)
      • Regular insulin
    • Intermediate-acting (4–10 hr peak)
      • NPH
        • NPH stands for neutral protamine Hagedorn, and the words refer to neutral pH (pH = 7), protamine (a protein), and Hans Christian Hagedorn (the original researcher)
    • Long-acting (no real peak)
      • Detemir
      • Glargine