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Medications for Type 1 Diabetes

Insulin is the main medicine used to treat type 1 diabetes . Pramlintide may be used with it. Here are the basics about each of these medicines. Only common problems with them are listed.

Insulin

Insulin is injected 2 to 4 times during the day to replace the insulin that the pancreas cannot make. It is often given before meals, at snacks, and at bedtime. The amount of insulin must be balanced with the amount and type of food that is eaten and the amount of activity that is done. Making changes to a person's diet, exercise, or both without making changes to the insulin dose can cause blood glucose to drop too low or rise too high.
Insulin Injection Sites
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The main types of insulin are:
Type of insulin Onset* Peak time* Duration* Notes on use
Rapid-actingNovolog (aspart) Humalog (lispro) Apidra (glulisine)Afrezza (technosphere, inhaled) 10 to 30 minutes 0.5 to 3 hours 3 to 5 hours Inject right away before a meal.
Regular or short-actingNovolin R Humulin R 0.5 to 1 hour 2 to 5 hours 5 to 8 hours  
Intermediate-acting
(NPH )
1 to 2 hours 3 to 12 hours 18 to 24 hours This is often used with short-acting insulin.
Long-acting
Insulin glargine (Lantus), Levemir (detemir)
1 hour n/a 24 hours This may not be mixed with other types of insulin.
*Each person has a unique response to insulin. The times listed are approximate.
Premixed insulins are a mixture of short-acting and intermediate-acting. It is usually given twice per day with breakfast and dinner.
Type of insulin Onset Peak time Duration
Humulin (50/50) 30 minutes 2 to 5 hours 18 to 24 hours
Humalog mix (75/25) 15 minutes 0.5 to 2.5 hours 16 to 20 hours
Humulin (70/30) 30 minutes 2 to 4 hours 14 to 24 hours
Novolin (70/30) 30 minutes 2 to 12 hours up to 24 hours
Novolog Mix (70/30) 10-20 minutes 1 to 4 hours up to 24 hours
The table below shows types of insulin and common brand names.
Type of insulin Brand names
Rapid-acting Humalog (insulin lispro)
NovoLog (insulin aspart)
Apidra (glulisine)
*both require a prescription
Regular or short-acting Humulin R (regular)

Novolin R
Intermediate-acting Humulin N (NPH)

Novolin N (NPH)
Long-acting Levemir (detemir)
Lantus (insulin glargine)
Methods of Delivery
Here are methods to deliver insulin:
  • Syringe and vial —used to inject insulin into the fat layer between the skin and the muscles
  • Pen —a one time use pen that contains a dose of insulin is used to inject insulin
  • Pump —uses a device the size of a pager that is worn on a belt or in a pocket to deliver a steady, measured dose of insulin through a tube that is inserted through the skin
Pramlintide
Common name: pramlintide
Amylin is a hormone made by the same beta cells that make insulin. Pramlintide is chemically related to amylin. It lowers blood glucose when used with insulin. It is given to people who cannot manage blood glucose with insulin alone.
Pramlintide is injected right before meals. It can lower appetite and result in weight loss. This can be helpful to those who need to reach a healthy weight and those who have gained weight as a side effect of using insulin.

References

American Diabetes Association. Standards of medical care in diabetes-2019. Diabetes Care. 2019. Jan; 42 (Suppl 1):S1-193.
Diabetes mellitus type 1. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/diabetes-mellitus-type-1-34 . Updated June 28, 2019. Accessed November 22, 2019.
Type 1 diabetes. American Diabetes Association website. Available at: https://www.diabetes.org/diabetes/type-1. Accessed November 22, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 09/2019
  • Update Date: 12/13/2019
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