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Action and Duration Times of Animal, GM ‘Human’ and Analogue Insulins

GM Vs animal insulin

Choices – The Evidence
Evidence from people with diabetes
A little bit of history
Facts
Action and duration times of animal and GM ‘human’ insulins
Hypoglycaemia and loss of warnings
‘Dead in Bed Syndrome’
The concerns of patients are justified
Availability of animal insulins in the UK
Changing your insulin
What to do if your consultant refuses to change your insulin
Availability of animal insulin if you admitted to hospital
Frequently asked questions
Allergic reactions to insulin

Action and duration times of animal and GM ‘human’ insulins

Table 1 shows the different insulins according to their origin and their length of action.

Table 1

insulin	Rapid	Short	Intermediate	Long
Analogue	Apidra Humalog NovoRapid			Lantus Levemir
Animal		Hypurin Bovine Neutral Hypurin Porcine Neutral	Hypurin Bovine Isophane, Hypurin Porcine Isophane	Hypurin Bovine lente Hypurin Bovine PZI
Human		Actrapid, Humulin S, Insuman Rapid	Humulin I, Insuman basal, Insulatard

Also available are pre-mixed insulins of rapid-acting or short-acting insulins with an intermediate-acting insulin. These are usually used where only two injections are day are required.
Table 2 shows the different pre-mixed insulins.

Insulin	Pre-mixed
Analogue	Humalog Mix 25 and Mix 50, NovoMix 30
Animal	Hypurin Porcine 30/70
Human	Humulin M3, Insuman Comb 15, 25 and 50, Mixtard 30

Table 3 shows the relative activity curves of animal, ‘human’ and analogue insulins. It must be noted that these times are a rough guide of peak activity and duration as the action peaks and duration of action will vary in different people.
Table 3

Insulin type	Onset	Peak [hours]	Effective duration [hours]	Maximum duration [hours]
ANIMAL
Regular [short]	0.5 – 2 hours	3 – 4	4- 6	6 – 8
NPH [intermediate]	4- 6 hours	8 – 14	16 – 20	20- 24
‘HUMAN’
Regular [short]	0.5 – 1 hour	2 – 3	3 – 6	6 – 10
NPH [Intermediate]	2- 4 hours	4 – 10	10 – 16	14 – 18
ANALOGUES
Rapid	Immediate	Immediate to about 1 hour	Tails off from peak over 3- 4 hours	About 4 hours
Lantus [long]	2 hours	None	24hours
Levemir [long]	2 hours	None	14 or more hours

Note: Long-acting beef insulins [Bovine lente and Bovine PZI] are available but they are not included in this table as they are rarely used.

Key facts about insulins and their actions:

The manufacturers’ profiles of the speed of onset, peak of action and duration of action are only a rough guide and may vary. Insulins act differently in different people.
The speed of action of injected insulin varies at different injection sites. For example, if Hypurin Porcine Neutral is injected above the umbilicus [tummy button] its speed of action is much quicker, and similar to a rapid-acting analogue, than if it is injected below the tummy button.
The depth of the injection also affects the speed of action and it is important to have the correct sized needle for the amount of fat at injection sites.