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The best way to replace insulin: Learning to act like a pancreas

The goal of insulin therapy is always to deliver insulin as the pancreas would, if it could, or as closely as possible. That means we need to replace both basal insulin needs (about ½ to 1 unit of insulin per hour!) and meal insulin (depends of what you eat or drink) in constantly changing situations. A major challenge!!!

While there is no true artificial pancreas yet, we now have several major types of insulin preparations available to replace the body’s natural insulin, though none are perfect. Learn about what types of insulin are available first, then move on to Question 7 for examples of how to put the insulin types into the best combination for you.

There are 3 brand manufacturers of insulin – Eli Lilly, Novo Nordisk and Sanofi Aventis. Each company makes a version of each insulin (see the table below). The action times given in this table are approximate, insulin works differently in different people and even differently on different days in the same person.


Type of Insulin
Onset Maximum Absorption Duration
Rapid (Analogue) Meal insulin

OR

Pump insulin
10 – 15 min. 1 – 1.5 hrs. 4 – 5 hrs
Fast (traditional) 30 – 60 min. 2 – 4 hrs. 5 – 8 hrs
Intermediate: N/NPH
(traditional)
Basal insulin for MDI 1 – 3 hrs. 5 – 8 hrs. 18 hrs
Long Acting:
Glargine or Detemir
(analogue)
90 min.
22 - 24 hrs