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NPH insulin, also known as isophane insulin (INN) and by various trade names, is an intermediate-acting insulin given to help control the blood sugar level of people with diabetes. It is a neutral-pH suspension of crystalline zinc insulin combined with positively charged protamine (a fish protein). When injected subcutaneously, it has an intermediate duration of action, meaning longer than that of regular and rapid-acting insulin, and shorter than ultralente, glargine or detemir.
NPH stands for neutral protamine Hagedorn, and the words refer to neutral pH (pH = 7), protamine (a protein), and Hans Christian Hagedorn (an insulin researcher). NPH insulin was created in 1936 when Nordisk formulated "isophane" porcine insulin by adding neutral protamine to regular insulin.
All animal insulins made by Novo Nordisk were replaced by synthetic, recombinant 'human' insulin. Synthetic 'human' insulin is also complexed with protamine to form NPH.
NPH insulin is cloudy and has an onset of 1–4 hours. Its peak is 6–10 hours and its duration is about 10–16 hours.
NPH insulin may be combined with faster acting insulin to allow more accurate dosing and better blood sugar level control. When administered this way, the two insulin types will normally be combined in the same syringe. NPH and fast-acting insulin bind when mixed, so they should not be combined until it is time to inject. Patients are instructed on the proper procedure to prepare this type of injection to minimize the likelihood of combining two types of insulin in the same vial. The proper order for withdrawing NPH insulin and fast-acting insulin into the same syringe can be remembered by the mnemonic "clear before cloudy", or fast acting clear insulin first, followed by NPH (cloudy). Aspiration, or pulling back on the plunger of the syringe after the needle has been injected to check for blood, is not appropriate for subcutaneous injections.
Lente insulin A general term for slow-release INSULIN.
There are different types of insulin depending on how quickly they work, when they peak, and how long they last.
Insulin is available in different strengths; the most common is U-100.
All insulin available in the United States is manufactured in a laboratory, but animal insulin can still be imported for personal use.
Inside the pancreas, beta cells make the hormone insulin. With each meal, beta cells release insulin to help the body use or store the blood glucose it gets from food.
In people with type 1 diabetes, the pancreas no longer makes insulin. The beta cells have been destroyed and they need insulin shots to use glucose from meals.
People with type 2 diabetes make insulin, but their bodies don't respond well to it. Some people with type 2 diabetes need diabetes pills or insulin shots to help their bodies use glucose for energy.
Insulin cannot be taken as a pill because it would be broken down during digestion just like the protein in food. It must be injected into the fat under your skin for it to get into your blood. In some rare cases insulin can lead to an allergic reaction at the injection site. Talk to your doctor if you believe you may be experiencing a reaction.
in 2015 an inhaled insulin product, Afrezza, became available in the U.S. Afrezza is a rapid-acting inhaled insulin that is administered at the beginning of each meal and can be used by adults with type 1 or type 2 diabetes. Afrezza is not a substitute for long-acting insulin. Afrezza must be used in combination with injectable long-acting insulin in patients with type 1 diabetes and in type 2 patients who use long-acting insulin.
Inhaled insulin begins working within 12 to 15 minutes, peaks by 30 minutes, and is out of your system in 180 minutes. Types: Technosphere insulin-inhalation system (Afrezza)
