If you or a loved one has just been diagnosed with diabetes, there are many things to consider. How will you cope with the changes in your day-to-day life? How will the diagnosis affect your family? What are the serious consequences for your health?
The last thing you want to be worrying about right now is learning about the different types of diabetes medications are available and which type is best for you. To help you out, we’ve prepared this guide to introduce you to the five main options for managing your blood sugar.
As the name suggests, rapid-acting insulin enters your bloodstream and starts working very quickly. Most of these medications will start lowering your blood sugar in 10 to 15 minutes, meaning you can take them at the same time as you eat a meal.
These medications generally show peak effectiveness between 45 and 90 minutes after taking the injection and will continue lowering your blood sugar anywhere from 90 minutes to five hours.
This is the type of insulin used in an insulin pump, which lets you take a dose whenever needed. Using a pump usually means you don’t have to stay on a set eating-and-dosing schedule, which can be inconvenient for many people.
Common forms of rapid-acting insulin include lispro (Humalog), aspart (NovoLog) and glulisine (Apidra).
If you can’t — or rather not — take your insulin at the same time as a meal, you can use a short-acting alternative and take it 30 to 60 minutes before eating so it starts working around your mealtime.
The peak effectiveness of short-acting insulin depends on the specific medication, but usually falls into a window of between two and five hours. It continues lowering your blood sugar for up to eight hours, depending on the medication.
The generic name of short-acting insulin is usually “regular,” meaning it’s just insulin. Brand names include Humulin R and Novolin R.
While rapid- and short-acting insulin medications lower your blood sugar over the course of a meal, intermediate-acting options will help keep it in the healthy range for about 12 hours.
This insulin shows its peak effectiveness between four and 12 hours, and will continue lowering your blood sugar throughout most of a day. Because the effect tapers off, these medications are often paired with rapid- or short-acting insulin to keep your blood sugar at a steady level.
NPH insulin is the main type of intermediate-acting insulin, and can be bought as Humulin N, Novolin NPH, and Novolin N, among others.
If you’re looking for a more convenient option, you may want to consider long-acting insulin. These are taken once a day and provide a steady release of insulin throughout the next 24 hours. They can be combined with rapid- or short-acting insulin to combat any blood sugar spikes.
Formulations vary, but most long-acting medications start taking effect in a couple hours and continue throughout the remainder of the day.
Insulin glargine (Lantus) and insulin detemir (Levemir) are both popular long-acting insulin medications.
This type of insulin medication combines an intermediate-acting and a rapid- or short-acting insulin into a single dose, and is usually taken two or three times each day around mealtimes. Because it contains fast-acting insulin, it starts to lower your blood sugar quickly, but the intermediate-acting medication also ensures your blood sugar is maintained throughout the day.
The proportion of intermediate- and rapid- or short-acting insulin is listed on the bottle or insulin pen, and is listed as intermediate/fast. For example, Humulin 70/30 is 70 percent intermediate-acting and 30 percent fast-acting.
Novolin 70/30, Novolog 70/30, Humulin 50/50, and Humalog 75/25 are all common pre-mixed medications.
How to Choose the Best Medication for Your Situation
The best way to find out about your insulin needs and which medications will suit your lifestyle is to talk to your doctor. The severity of your diabetes, your diet and your activity level will all be considered when choosing a treatment plan.
If you have a preference for the type of insulin you’d like to take, let your doctor know and he or she can work with you to find an option suitable to both your needs and your lifestyle.
It’s also a good idea to take into account how easy it is to get the type of medication that you’re on. For example, if you have Medicare, you may be able to get an external insulin pump covered as durable medical equipment. Some people on Medicare part D can get the insulin and any syringes needed covered as well.
If you don’t have Medicare, you have other options, such as state-based patient assistance programs. You can even procure your medications yourself (for example, it’s easy to buy most medications online).
There are hundreds of different diabetes medications out there, and each one differs. But if you understand the differences between these five types, you’ll feel less overwhelmed when it’s time to talk to your doctor about the next steps in your treatment program — giving you more time to think about the things that really matter.