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Table 2 Currently Available Insulin Formulations

From: Common crossroads in diabetes management

Insulin Formulation Coverage Duration of Action Dosing Special Considerations
NPH insulin [69] Basal 13 hours Twice daily Nocturnal hypoglycemia; morning hyperglycemia; intersubject variability
Insulin glargine [69,70] Basal 24 hours Once daily Less risk of hypoglycemia (overall and nocturnal) compared with NPH insulin; once-daily dosing
Insulin detemir [38,45,71] Basal 14 hours Once or twice daily Less nocturnal hypoglycemia and less weight gain compared with NPH insulin; most patients require twice-daily dosing
RHI [40] Prandial 6–8 hours 30 minutes premeal Limited mealtime flexibility
Insulin lispro [42,72] Prandial 3–4 hours Up to 15 minutes premeal or immediately postmeal Pregnancy category B rating
Insulin aspart [40,44] Prandial 3–4 hours Up to 15 minutes premeal or immediately postmeal Pregnancy category B rating.
Insulin glulisine [72,73] Prandial 3–4 hours Up to 15 minutes premeal or up to 20 minutes after start of meal Only rapid-acting agent evaluated in conjunction with a dosing algorithm
Premix (human)
70% NPH, 30% RHI
50% NPH, 50% RHI
Basal-prandial 16–24 hours Prebreakfast and presupper Short- and long-acting components in fixed ratio; difficult to titrate, increased risk of hypoglycemia
Premix (insulin analogs)
75% NPL, 25% lispro
50% NPL, 50% lispro
70% protamine aspart, 30% aspart
Basal-prandial 16–24 hours Prebreakfast and presupper Short- and long-acting components in fixed ratio; difficult to titrate, increased risk of hypoglycemia
  1. NPH = neutral protamine Hagedorn; NPL = neutral protamine lispro; RHI = regular human insulin.