What is the difference between regular insulin (e.g. Humulin R, Novolin R) and long-acting insulin (e.g. Lantus, Levemir) for diabetes management?

From the Guidelines

The choice between regular insulin and long-acting insulin for diabetes management should be based on the individual's specific needs, with long-acting insulin serving as "basal" insulin and regular or rapid-acting insulin used for mealtime coverage, as recommended by the most recent guidelines 1.

Key Differences Between Regular and Long-Acting Insulin

• Regular insulin (Humulin R, Novolin R) is a short-acting insulin that begins working within 30 minutes, peaks in 2-3 hours, and lasts 5-8 hours.
• Long-acting insulin (Lantus, Levemir) works more slowly, has no pronounced peak, and provides steady insulin levels for 24 hours (Lantus) or up to 42 hours (Tresiba).

Recommendations for Insulin Therapy

• Most diabetes management plans combine both long-acting and regular or rapid-acting insulin to mimic natural pancreatic function, with the long-acting insulin providing background insulin and the short-acting insulin addressing food intake 2.
• The American Diabetes Association recommends considering regimen flexibility when devising a plan for the initiation and adjustment of insulin therapy for patients with type 2 diabetes, including the use of rapid-acting insulin and premixed insulin analogues 3.

Important Considerations

• Dosing varies by individual needs, weight, diet, and activity level, requiring personalized adjustment under medical supervision.
• The choice of insulin regimen should be based on the individual's specific needs and medical history, with consideration of factors such as cost, regimen flexibility, and potential for hypoglycemia 1.
• Continuous glucose monitors (CGM) and insulin pumps can be beneficial in people using insulin therapy, particularly in those with type 1 diabetes, to improve glycemic control and reduce the risk of hypoglycemia 2.

From the FDA Drug Label

PATIENT INFORMATION Levemir® (LEV–uh-mere) (insulin detemir [rDNA origin] injection) Important: Know your insulin. Do not change the type of insulin you use unless told to do so by your healthcare provider. The amount of insulin you take as well as the best time for you to take your insulin may need to change if you take a different type of insulin Make sure you know the type and strength of insulin prescribed for you. What is Levemir? Levemir is a man-made long-acting insulin that is used to control high blood sugar in adults and children with diabetes mellitus.

The choice between regular insulin and long-acting insulin, such as Levemir, for diabetes management should be made under the guidance of a healthcare provider.

• Key factors to consider include the type and strength of insulin prescribed, as well as the patient's individual needs and medical conditions.
• Long-acting insulins like Levemir are used to control high blood sugar in adults and children with diabetes mellitus, and their effects can last up to 24 hours after injection.
• It is essential to follow the healthcare provider's instructions for taking insulin, as the amount and timing of insulin doses may need to change if a different type of insulin is used 4.

From the Research

Difference between Regular Insulin and Long-Acting Insulin

• Regular insulin (e.g. Humulin R, Novolin R) is a short-acting insulin that starts working within 30 minutes after injection, peaks between 2 to 3 hours after injection, and has effects that last about 6 to 8 hours 5.
• Long-acting insulin (e.g. Lantus, Levemir) is a basal insulin that provides a steady level of insulin in the body for a full day or longer, typically lasting 20 to 42 hours 6.

Choosing between Regular Insulin and Long-Acting Insulin

• The choice between regular insulin and long-acting insulin depends on the individual's diabetes management needs and goals, as well as their lifestyle and preferences 7.
• Regular insulin is often used to control blood sugar levels after meals, while long-acting insulin is used to control blood sugar levels between meals and overnight 8.
• Long-acting insulin analogs, such as insulin glargine and insulin detemir, have been shown to be effective in reducing the risk of hypoglycemia and improving glycemic control in patients with type 1 and type 2 diabetes 9.

Considerations for Insulin Therapy

• Insulin therapy should be individualized and tailored to the patient's specific needs and goals 5.
• The choice of insulin type and dosage should be based on factors such as the patient's blood glucose levels, diet, physical activity level, and other health conditions 6.
• Patients should be educated on how to properly administer insulin, monitor their blood glucose levels, and adjust their insulin dosage as needed 7.
• Regular monitoring of blood glucose levels and adjustment of insulin dosage can help to achieve optimal glycemic control and reduce the risk of complications associated with diabetes 8.