1. Bridgeman, Mary B. PharmD, BCPS
  2. Dalal, Kavitha S. PharmD

Article Content

Do you know how they compare? Match the insulin formulation in Section I with the description in Section II.


Section I

_____ 1. Insulin detemir (Levemir, Novo Nordisk)


_____ 2. Regular insulin (Novolin R or Humulin R, Novo Nordisk or Eli Lilly)


_____ 3. Insulin human (Afrezza, MannKind Corporation)


_____ 4. Insulin glulisine (Apidra, Sanofi-Aventis)


Section II

a. Rapid-acting human insulin analogue for injection. This is one of several rapid-acting insulin formulations that generally takes effect within 15 minutes of administration. With a duration of action from 3 to 5 hours, it helps curb the postmeal rise in blood glucose. This drug must be administered within 20 minutes of starting a meal to prevent dangerous hypoglycemia; if a patient is N.P.O., holding this insulin may be necessary.


b. Long-acting insulin analogue. Indicated for treating diabetes in children and adults, this insulin formulation is administered subcutaneously either once or twice daily. Patients on a once-daily schedule should self-administer this drug with the evening meal or at bedtime. Those on a twice-daily schedule should administer the evening dose with the evening meal, at bedtime, or 12 hours after the morning dose.


c. Rapid-acting inhaled insulin. This new inhaled insulin formulation received FDA approval in 2014 for treatment of diabetes in adults. As a rapid-acting insulin, it must be administered at the beginning of a meal. It's available in single-use cartridges containing 4, 8, or 12 units of insulin each. This drug should be used in conjunction with a long-acting insulin formulation to optimize glycemic control, especially in patients with type 1 diabetes. This formulation is contraindicated in patients who smoke or have a chronic lung disease.


d. Short-acting insulin. An insulin formulation with an onset between 30 minutes to 1 hour, this medication should be administered 30 minutes before a meal. It can be administered I.V. or subcutaneously and may be used to treat diabetic ketoacidosis or hyperkalemia.


Resources available on request.


ANSWERS: 1b, 2d, 3c, 4a