March 27, 2012

Know Your Keywords for Insulin Medication

It is often difficult to know which is the official term for the different types of insulin. One author will use one set of terms and a different author uses another set of terms. Then when you get out the magnifying glass and decipher the text on the materials supplied with the insulin, you will occasionally see a third set of terms. For someone new or even experienced with using insulin, this can be a little confusing.

Since I do not have but two types of insulin that I use, I cannot find the terms best used in the materials supplied with many of the insulins so if you have other types, do not hesitate to add comments with the terms used. The best chart I have found to-date for the terminology is this in WebMD. An incomplete listing of terms can be found here and I will add other terms that I have been taught from various sources and some “off-label” terms.

The medically correct terms listed here are from many sources and the most often used. I have added other terms I have been taught or that I have learned over the years.

  • Onset refers to when the insulin starts to work. I was taught Begins or Activates.
  • Peak refers to when the insulin works hardest. I was taught Effective Period and Period of Maximum Effectiveness.
  • Duration refers to how long the insulin works. I was taught Length of Usefulness.
  • Official sources list nothing about when insulin ends and I was taught End.

Next, we need to consider the types of insulin:
  • Rapid-acting - I learned fast-acting insulin.
  • Short-acting - This was never explained to me and I lumped it with fast-acting,
  • Intermediate-acting - I learned this as 12-hour insulin.
  • Long-acting - I learned this as 24-hour insulin.
  • Pre-mixed - All I learned was mixed insulin.

Now that you have an idea of the different terms used, understand that this applies to the average person with diabetes. All the directions and times used are for the average person. I take Lantus, which is a 24-hour insulin. I cannot count on this as through experience and my body chemistry, I have learned that I have an 18 to 20 hour effective period of insulin use. Others have no problem of Lantus lasting for 22 to 24 hours. I believe your own body chemistry has some effect on the effective period insulin will last.

After discussing this with my endocrinologist after changing times for injection and always having problems at the end of the 24-hour period, we decided to split my Lantus injection and take half the dosage twelve hours apart. To many this is stacking insulin; however, this has eliminated the dawn phenomenon for me and leveled out the total day for me. For some people this does not work.

If you look at this chart, you will see that Novolog duration is 3 to 5 hours. I normally get the 3 1/2 hours and no further benefits. For every person, you will need to carefully monitor your results to determine if you are in the average group, or if you fit another area.

I never really thought that being my own lab rat would be any fun, but over the years, I have learned otherwise. More than once my own experiments have proven beneficial in managing my diabetes more effectively. This does not mean that I have not needed to repeat experiments, as I have. Sometimes, I need to make adjustments and other times they become temporary. Each person has to find his or her own level of comfort and tolerance.

Some weeks are great and sometimes days can become a nightmare trying to discover what needs to be adjusted. Keeping a positive attitude and realizing that some times an answer will not be discerned is important. Do not be taken aback when later you realize what happened. Just remember for the next time.

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