CONTENTS

Serial no. Content

1 Insulin

2 Types of Insulin

3 Methods of Taking Insulin

4 Treatment and Side affects

5 Conclusion

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Insulin:
Insulin is a hormone that helps regulate blood sugar levels by
moving glucose from the blood into cells, where it can be used
for energy:
• How it works
When blood sugar levels rise after eating, the pancreas releases
insulin into the blood. Insulin then helps glucose enter cells in
the liver, fat, and muscles, where it can be used for energy or
stored for later use.
• Types of insulin
There are several types of insulin, each with a different onset,
duration, and peak effect. For example, rapid-acting insulin
analogs take effect in 5–15 minutes, while regular human insulin
takes 30 minutes to an hour to start working.
• How to take insulin
Insulin can be taken via syringes, insulin pens, insulin pumps, or
inhalers.
• Diabetes
In people with diabetes, the pancreas doesn't produce enough
insulin or the body doesn't respond normally to insulin. This
causes blood sugar levels to rise. Taking insulin can help keep
blood sugar levels within a healthy range and reduce the risk of
complications like blindness and limb loss.

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Taking insulin or other diabetes medicines is often part of
treating diabetes. In addition to making healthy food and
beverage choices, getting physical activity, getting enough sleep,
and managing stress, medicines can help you manage the
disease. Some other treatment options are also available.

What medicines might I take for diabetes?

The medicine you take depends on the type of diabetes you have
and how well the medicine controls your blood glucose levels,
also called blood sugar levels. Other factors, such as any other
health conditions you may have, medication costs, your
insurance coverage and copays, access to care, and your
lifestyle, may affect what diabetes medicine you take.

What type of diabetes do I have?

Type 1 diabetes
If you have type 1 diabetes, you must take insulin because
your pancreas does not make it. You will need to take insulin
several times during the day, including when you eat and drink,
to control your blood glucose level.
There are different ways to take insulin. You can use a needle
and syringe, an insulin pen, or an insulin pump. An artificial
pancreas—also called an automated insulin delivery system—
may be another option for some people.

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Type 2 diabetes
Some people with type 2 diabetes can control their blood
glucose level by making lifestyle changes. These lifestyle
changes include consuming healthy meals and beverages,
limiting calories if they have overweight or obesity, and getting
physical activity.
Many people with type 2 diabetes need to take diabetes
medicines as well. These medicines may include diabetes pills
or medicines you inject, such as insulin. Over time, you may
need more than one diabetes medicine to control your blood
glucose level. Even if you do not take insulin, you may need it at
special times, such as if you are pregnant or if you are in the
hospital for treatment.

Gestational diabetes
If you have gestational diabetes, you can manage your blood
glucose level by following a healthy eating plan and doing a
moderate-intensity physical activity, such as brisk walking for
150 minutes, each week. If consuming healthy food and
beverages and getting regular physical activity aren’t enough to
keep your blood glucose level in your target range, a doctor will
work with you and may recommend you take insulin. Insulin is
safe to take while you are pregnant.
No matter what type of diabetes you have, taking diabetes
medicines every day can feel like a burden sometimes. New
medications and improved delivery systems can help make it

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easier to manage your blood glucose levels. Talk with your
doctor to find out which medications and delivery systems will
work best for you and fit into your lifestyle.

What are the different types of insulin?

Several types of insulin are available. Each type starts to work at
a different speed, known as “onset,” and its effects last a
different length of time, known as “duration.” Most types of
insulin reach a peak, which is when they have the strongest
effect. After the peak, the effects of the insulin wear off over the
next few hours or so. Table 1 lists the different types of insulin,
how fast they start to work, when they peak, and how long they
last.

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Another type of insulin, called premixed insulin, is a
combination of insulins listed in Table 1. Premixed insulin starts
to work in 15 to 60 minutes and can last from 10 to 16 hours.
The peak time varies depending on which insulins are mixed.
Your doctor will work with you to review your medication
options. Talk with your doctor about your activity level, what
you eat and drink, how well you manage your blood glucose
levels, your age and lifestyle, and how long your body takes to
absorb insulin.
Follow your doctor’s advice on when and how to take your
insulin. If you're worried about the cost, talk with your doctor.
Some types of insulin cost more than others. You can also find
resources to get financial help for diabetes care.

What are the different ways to take insulin?

The way you take insulin may depend on your lifestyle,
insurance plan, and preferences. Talk with your doctor about the
options and which one is best for you. Most people with diabetes
take insulin using a needle and syringe, insulin pen, or insulin
pump. Inhalers and insulin jet injectors are less common ways to
take insulin. Artificial pancreas systems are now approved by
the U.S. Food and Drug Administration (FDA). Talk with your
doctor to see if an artificial pancreas is an option for you.

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Needle and syringe
You can give yourself insulin shots using a needle and syringe.
You draw up your dose of insulin from the vial—or bottle—
through the needle into the syringe. Insulin works fastest when
you inject it in your belly, but your doctor may recommend
alternating the spot where you inject it. Injecting insulin in the
same spot repeatedly could cause the tissue to harden, making it
harder to take shots in that area over time. Other spots you can
inject insulin include your thigh, buttocks, or upper arm, but it
may take longer for the insulin to work from those areas. Some
people with diabetes who take insulin need 2 to 4 shots a day to
reach their blood glucose targets. Others can take a single shot.
Injection aids can help you give yourself the shots.

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Pen
An insulin pen looks like a writing pen but has a needle for its
point. Some insulin pens come filled with insulin and are
disposable. Others have room for an insulin cartridge that you
insert and replace after use. Many people find insulin pens easier
to use, but they cost more than needles and syringes. You may
want to consider using an insulin pen if you find it hard to fill
the syringe while holding the vial or cannot read the markings
on the syringe. Different pen types have features that can help
with your injections. Some reusable pens have a memory
function, which can recall dose amounts and timing. Other types
of “connected” insulin pens can be programmed to calculate
insulin doses and provide downloadable data reports, which can
help you and your doctor adjust your insulin doses.

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Pump
An insulin pump is a small machine that gives you steady doses
of insulin throughout the day. You wear one type of pump
outside your body on a belt or in a pocket or pouch. The insulin
pump connects to a small plastic tube and a very small needle.
You insert the plastic tube with a needle under your skin, then
take out the needle. The plastic tube will stay inserted for several
days while attached to the insulin pump. The machine pumps
insulin through the tube into your body 24 hours a day and can
be programmed to give you more or less insulin based on your
needs. You can also give yourself doses of insulin through the
pump at mealtimes.
Another type of pump has no tubes. This pump attaches directly
to your skin with a self-adhesive pad and is controlled by a
hand-held device. The plastic tube and pump device are changed
every several days.

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Inhaler
Another way to take insulin is by breathing powdered insulin
into your mouth from an inhaler device. The insulin goes into
your lungs and moves quickly into your blood. You may want to
use an insulin inhaler to avoid using needles. Inhaled insulin is
only for adults with type 1 or type 2 diabetes. Taking insulin
with an inhaler is less common than using a needle and syringe.

Jet injector
A jet injector is a device that sends a fine spray of insulin into
the skin at high pressure instead of using a needle to deliver the
insulin. It is used less commonly than a needle and syringe or a
pen.

Artificial pancreas
An artificial pancreas is a system of three devices that work
together to mimic how a healthy pancreas controls blood
glucose in the body. A continuous glucose monitor
(CGM) tracks blood glucose levels every few minutes using a
small sensor inserted under the skin that is held in place with an
adhesive pad. The CGM wirelessly sends the information to a
program on a smartphone or an insulin infusion pump. The
program calculates how much insulin you need. The insulin
infusion pump will adjust how much insulin is given from
minute to minute to help keep your blood glucose level in your

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target range. An artificial pancreas is mainly used to help people
with type 1 diabetes.
What oral medicines treat type 2 diabetes?
You may need to take medicines to manage your type 2 diabetes,
in addition to consuming healthy foods and beverages and being
physically active. You can take many diabetes medicines by
mouth. These medicines are called oral medicines.
Most people with type 2 diabetes start with metformin pills.
Metformin also comes as a liquid. Metformin helps your liver
make less glucose and helps your body use insulin better. This
drug may help you lose a small amount of weight.
Other oral medicines act in different ways to lower blood
glucose levels. Combining two or three kinds of diabetes
medicines can lower blood glucose levels better than taking just
one medicine.

What other injectable medicines treat diabetes?

Type 1 diabetes
If you have type 1 diabetes, your doctor may recommend you
take other medicines, in addition to insulin, to help control your
blood glucose. Some of these medicines work to slow how fast
food and beverages move through your stomach. These
medicines also slow down how quickly and how high your
blood glucose levels rise after eating. Other medicines work to
block certain hormones in your digestive system that raise blood

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glucose levels after meals or help the kidneys to remove more
glucose from your blood.

Type 2 diabetes
Besides insulin, other types of injected medicines are available
that will keep your blood glucose level from rising too high after
you eat or drink. These medicines, known as glucagon-like
peptide-1 (GLP-1) receptor agonists,3 may make you feel less
hungry and help you lose some weight. GLP-1 medicines are not
substitutes for insulin.
What should I know about side effects of diabetes
medicines?
Side effects are problems that result from taking a medicine.
Some diabetes medicines can cause hypoglycemia, also called
low blood glucose, if you don’t balance your medicines with
food and activity.
Ask your doctor whether your diabetes medicine can cause
hypoglycemia or other side effects, such as upset stomach and
weight gain. Aim to take your diabetes medicines as your doctor
instructs you, to help prevent side effects and diabetes problems.
Do I have other treatment options for my diabetes?
If medicines and lifestyle changes are not enough to manage
your diabetes, there are other treatments that might help you.
These treatments include weight-loss (bariatric) surgery for
certain people with type 1 or type 2 diabetes, or pancreatic islet
transplantation for some people with type 1 diabetes.
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Weight-loss surgery
Weight-loss surgery are operations that help you lose weight by
making changes to your digestive system. Weight-loss surgery is
also called bariatric or metabolic surgery.
This type of surgery may help some people who have obesity
and type 2 diabetes lose a large amount of weight and bring their
blood glucose levels back to a healthy range. How long the
improved response lasts can vary by patient, type of weight-loss
surgery, and the amount of weight the person lost. Other factors
include how long a person had diabetes and whether the person
used insulin. Some people with type 2 diabetes may no longer
need to use diabetes medicines after weight-loss surgery.4
Researchers are studying whether weight-loss surgery can help
control blood glucose levels in people with type 1 diabetes who
have obesity.

Pancreatic islet transplantation

Pancreatic islet transplantation is a treatment for type 1 diabetes
in people who struggle to manage their blood glucose levels.
Pancreatic islets are clusters of cells in the pancreas that make
the hormone insulin. In type 1 diabetes, the body’s immune
system attacks these cells. A pancreatic islet transplantation
replaces destroyed islets with new islets from a deceased donor.
The new islets make and release insulin.

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Clinical Trials for Insulin, Medicines, & Other Diabetes
Treatments
The NIDDK conducts and supports clinical trials in many
diseases and conditions, including diabetes. The trials look to
find new ways to prevent, detect, or treat disease and improve
quality of life.
What are clinical trials for insulin, medicines, and other
diabetes treatments?
Clinical trials—and other types of clinical studies are part of
medical research and involve people like you. When you
volunteer to take part in a clinical study, you help health care
professionals and researchers learn more about disease and
improve health care for people in the future.
Find out if clinical trials are right for you
Researchers are studying many aspects of diabetes medicines,
including
• new types of insulin
• the most effective times to take diabetes medicines
• new types of monitoring devices and delivery systems
What clinical trials for insulin, medicines, and other diabetes
treatments are looking for participants?
You can view a filtered list of clinical studies on insulin,
medicines, and other diabetes treatments covered in this health
topic that are federally funded, open, and recruiting at
www.ClinicalTrials.gov. You can expand or narrow the list to
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include clinical studies from industry, universities, and
individuals; however, the National Institutes of Health does not
review these studies and cannot ensure they are safe. Always
talk with your health care provider before you participate in a
clinical study.
What does insulin do?
Insulin moves glucose from your blood into cells all over your
body. Glucose comes from both the food and drinks you
consume and your body’s natural release of stored glucose
(glycogen). Glucose is your body’s main — and preferred —
source of energy.
All of your body’s cells need energy. Think of insulin as the key
that opens the doors of the cells in your body. Once insulin
opens your cell doors, glucose can leave your bloodstream and
move into your cells where you use it for energy.
Without enough insulin, glucose can’t get into your cells and
instead builds up in your blood. This leads to high blood sugar
and diabetes. A total lack of insulin for a prolonged time leads to
a life-threatening complication called diabetes-related
ketoacidosis (DKA).
Does insulin lower or raise blood sugar?
Insulin lowers your blood sugar level. Glucagon (another
hormone) naturally raises it. Your body uses these two hormones
to balance out your blood sugar level to keep it in a healthy
range.

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If you have diabetes, too much (manufactured) insulin can lead
to low blood sugar (hypoglycemia). In this case, you may need
to consume sugar to raise your blood sugar level. There are
manufactured forms of glucagon available with a prescription
for emergency use to treat severe low blood sugar. Talk to your
healthcare provider or diabetes care and education specialist to
find out if glucagon should be included in your treatment plan.
Where is insulin produced?
Your pancreas produces insulin. More specifically, beta cells in
the islets of Langerhans in the pancreas make the hormone. This
is the endocrine function of your pancreas, meaning it releases
insulin directly into your bloodstream.
Your pancreas also has an exocrine function — it
releases enzymes into certain ducts to help with digestion.
What are the types of insulin for diabetes?
There are many different types of insulin. Most types
are injectable, either through a needle, pen or pump. There’s
also inhalable insulin. If you have diabetes, your provider will
work with you to prescribe the right type(s) for you and adjust
the dosage when your needs change.
The main types of insulin based on how fast they work and how
long they last include:
• Rapid-acting insulin: This kind of insulin begins to work
within five to 20 minutes and keeps working for three to
five hours. It peaks (is most effective) about an hour or two
after you inject it. Types of rapid-acting insulin

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 include insulin glulisine. Inhaled insulin is also considered
rapid-acting. You should take it before meals.
• Regular insulin (or short-acting insulin): This kind of
insulin includes Novolin R® and Humulin R®. They begin
working about 30 to 45 minutes after injection and wear off
after about five to eight hours. Regular insulin peaks about
two to four hours after injection.
• Intermediate-acting insulin: This type begins working in
about two hours and is most effective between four and 12
hours after injection. It wears off in 14 to 24 hours. Types
include isophane insulin (NPH).
• Long-lasting insulin: It takes about an hour for this type of
insulin to reach your bloodstream and start working. It
peaks between three and 14 hours after injection. It lasts up
to a day. Types include insulin glargine.
• Ultra long-acting insulin: Reaching the bloodstream in
about six hours, this type of insulin has the same level of
effectiveness for several hours (it doesn’t peak). It can last
up to two days. Types include insulin degludec.

What are the side effects of insulin?

The most common complication of insulin treatment is low
blood glucose levels (hypoglycemia) from taking too much
insulin for your needs.
Other possible side effects of insulin treatment, which are rare,
include:
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 • Skin reactions with injected insulin: Injecting insulin in
the same area frequently can cause fat deposits to form
under your skin, making your skin look lumpy. It can also
destroy fat, causing indentation of your skin. This issue is
called localized lipodystrophy. It can decrease the
absorption of injected insulin, so it’s important to
frequently rotate injection sites.
• Allergic reaction to insulin: Some people can develop
allergic reactions to certain types of insulin. It can cause
pain and burning, followed by skin discoloration, itchiness
and swelling around the injection site for several hours.
• Developing insulin antibodies: In very rare cases, your
body can produce antibodies to manufactured insulin
because it’s not exactly like natural insulin. These
antibodies may interfere with how well the manufactured
insulin works. And it may require you to take very large
doses of insulin.
What are the sites of injection for insulin?
You can inject several areas of your body with insulin. In
general, the areas where you typically have body fat (adipose
tissue) are the best sites. These include:
• Your belly — at least 2 inches (5 centimeters) away from
your belly button.
• The front or side of your thighs.
• The back of your upper arms.
• Your upper buttocks.
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CONCLUSION:
Human insulin and insulin analogs are the primary treatment for
type 1 and type 2 diabetes. Insulin therapy has evolved over
time, from animal pancreas extracts to recombinant human
insulin. Here are some things to know about insulin and diabetes
management:
Insulin types: Insulin comes in a variety of types, including
basal insulin, which is taken once a day to control blood sugar
levels. The dose of insulin can range from very low to very high,
depending on the individual's needs.
Insulin delivery: Insulin can be administered via pens, which
are generally more comfortable than syringes and
needles. Insulin pens can also be reusable, which can be more
durable and eliminate the need to refrigerate cartridges.
Insulin and other treatments: Insulin is often used in
combination with other treatments, such as oral
medications. This combination therapy can help reduce the risk
of weight gain.
Preventing diabetes:To help prevent type 2 diabetes, people
can:
• Maintain a healthy weight
• Be physically active
• Eat a healthy diet
• Avoid tobacco

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REFRENCE:
[1] Types of insulin. Centers for Disease Control and Prevention.
Updated March 25, 2021. Accessed January 24,
2022. www.cdc.gov/diabetes/basics/type-1-types-of-
insulin.html External link
[2] Wong EY, Kroon L. Ultra-rapid-acting insulins: how fast is
really needed? Clinical Diabetes. 2021;39(4):415–423.
doi:10.2337/cd20-0119
[3] Collins L, Costello RA. Glucagon-like Peptide-1 Receptor
Agonists. In: StatPearls [Internet]. StatPearls Publishing; 2021.
Updated June 25, 2021. Accessed April 21,
2022. www.ncbi.nlm.nih.gov/books/NBK551568
[4] Brethauer SA, Aminian A, Romero-Talamás H, et al. Can
diabetes be surgically cured? Long-term metabolic effects of
bariatric surgery in obese patients with type 2 diabetes mellitus
Annals of Surgery. 2013;258(4):628–636. doi:
10.1097/SLA.0b013e3182a5034b
[5] Vilarrasa N, San Jose P, Rubio MÁ, Lecube A. Obesity in
patients with type 1 diabetes: links, risks, and management
challenges. Diabetes, Metabolic Syndrome, and Obesity: Targets
and Therapy. 2021;14:2807–2827. doi:
10.2147/DMSO.S223618

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 THANK YOU !

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