From the Guidelines
Humulin N and Humulin R are not similar in their action profiles, with Humulin N being an intermediate-acting insulin and Humulin R being a short-acting insulin. The key differences between these two types of insulin lie in their onset of action, peak effect, and duration of action. Humulin N, which contains NPH insulin, has a slower onset of action compared to Humulin R, a regular insulin. According to the management of hyperglycemia in type 2 diabetes report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) 1, basal insulin, such as NPH, is crucial for regulating hepatic glucose production and is often used as the initial insulin formulation in patients with type 2 diabetes.
Some of the key characteristics of Humulin N include:
- Intermediate-acting insulin
- Slower onset of action (1-2 hours)
- Peaks at 4-12 hours
- Lasts about 18-24 hours
- Contains protamine, which delays absorption and makes it appear cloudy
In contrast, Humulin R:
- Is a short-acting regular insulin
- Starts working within 30 minutes
- Peaks at 2-3 hours
- Lasts 3-6 hours
- Appears clear in solution
These differences significantly affect how Humulin N and Humulin R are used in diabetes management. Humulin N is typically administered once or twice daily to provide background insulin coverage, while Humulin R is used around mealtimes to control blood sugar spikes. Both are human insulin products, but their distinct action profiles mean they serve different purposes in diabetes treatment regimens. The choice between these insulins should be based on the individual patient's needs and the specific goals of their diabetes management plan, considering factors such as the risk of hypoglycemia and the cost of the insulin, as noted in the report by the ADA and EASD 1.
From the Research
Comparison of Humulin N and Humulin R
- Humulin N and Humulin R are two types of insulin products, with Humulin N being an NPH (Neutral Protamine Hagedorn) insulin and Humulin R being a regular insulin 2.
- A study comparing the pharmacokinetic and pharmacodynamic equivalence of Biocon's biosimilar insulin N with US-licensed Humulin N formulation found that they were equivalent in healthy subjects 3.
- Another study compared the efficacy of once-daily glargine insulin with twice-daily NPH/regular insulin for control of hyperglycemia in inpatients after cardiovascular surgery, and found that NPH/regular insulin provided better control than glargine insulin monotherapy, but with a higher incidence of hypoglycemia 4.
- There is no direct comparison between Humulin N and Humulin R in the provided studies, but it can be inferred that they have different properties and uses, with Humulin N being a basal insulin and Humulin R being a bolus insulin 2.
Properties of Humulin N and Humulin R
- Humulin N has a longer duration of action compared to regular insulin, making it suitable for basal insulin therapy 2.
- Humulin R has a faster onset of action compared to NPH insulin, making it suitable for bolus insulin therapy 2.
- The pharmacokinetic and pharmacodynamic properties of Humulin N and Humulin R are different, with Humulin N having a more gradual onset and longer duration of action, and Humulin R having a faster onset and shorter duration of action 2, 3.
Clinical Use of Humulin N and Humulin R
- Humulin N is often used as a basal insulin, administered once or twice daily, to provide a steady background level of insulin throughout the day 5, 4.
- Humulin R is often used as a bolus insulin, administered before meals, to provide a rapid increase in insulin levels to control postprandial glucose spikes 5, 2.
- The choice between Humulin N and Humulin R depends on the individual patient's needs and the specific clinical situation, with Humulin N being more suitable for patients who require a basal insulin and Humulin R being more suitable for patients who require a bolus insulin 5, 2, 4.