Insulin: Types & Regimens

Key points

• Rapid-acting analogues (lispro, aspart): onset ~15 min, peak 1 h, duration 3–5 h — given with meals.
• Short-acting (soluble/Actrapid): onset 30 min, duration ~8 h — also used IV in DKA/sliding scales.
• Intermediate (isophane/NPH): peak 4–12 h; long-acting analogues (glargine, detemir) provide peakless basal cover ~24 h.
• Typical T1DM regimen: basal-bolus (long-acting basal + rapid-acting with meals).
• Only soluble (short-acting) insulin can be given intravenously.