The Insulin that is commonly used now is human insulin. Human insulin is produced by recombinant DNA technology. It comes in vials of 40 units per ml and 100 units per ml. Short acting insulin does not contain zinc and an example is Human Actrapid insulin. Longer acting insulins contains zinc or protamine. Examples are Human Monotard insulin (with zinc) and Human Insulatard insulin (with protamine).

There are ready mixed combinations of short and long acting insulins in various fixed proportions. These are called biphasic insulins. Examples are Mixtard insulin 30:70, Mixtard insulin 50:50, and Humulin 30:70. The ratio refers to the proportion of short acting and long acting insulin respectively in the solution.

Biphasic insulins must always be given before food because they have a short acting component (prandial insulin) in them.

Long acting insulins, including biphasic insulins, should NEVER be given before lunch because of the risk of hypoglycemia during sleep. The peak action of long acting insulins like Monotard Insulin will occur around 8 to 10 hours after injection and their effect can last for 18 hours or more.

Insulin analogues are different from human insulins in their pharmacokinetics. They are produced by techniques in genetic engineering that alter their amino acid structure. They are also called insulin receptor ligands. The advantage of these insulin analogues is that they have a lesser tendency to produce hypoglycemia. Examples of long acting insulin analogues are Glargine and Detemir while the short acting ones are Lispro and Aspart.



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