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"/>

The CGM Blog

Types Of Insulin And Their Impact On The Body

Insulin is a vital hormone that helps manage blood sugar levels. It's made in the pancreas and released into your system in response to rising blood sugar. It also helps your body use the energy from your food for daily activities, giving you the stamina you need to go for a bike ride, study for a test at school, or just take your dog for a walk.

 

Insulin is also an important factor in diabetes management plans. Understanding how it works, what it does, and how it affects you as you go about your day can be an important part of managing your health in the long run. If you’re looking to learn a little more about insulin and its role in the body, this article will walk you through some of the basics. We’ll cover the history of insulin, how it affects bodily functions, and the different types of insulin available to people living with diabetes. As always, be sure to discuss with your healthcare team what insulin may be right for you and your specific diabetes management plan.

How Insulin Works In The Body

Insulin is an important hormone in the body as it helps your cells use glucose (blood sugar) for energy or store it for later use. Insulin is produced by the pancreas, a small organ located behind your stomach, that helps your body turn blood sugar into energy as your body digests food.1

 

If you have type 1 diabetes (T1D), your pancreas doesn't make insulin, which means you must add insulin into your body through injections or an insulin pump.2 If you have type 2 diabetes (T2D), the pancreas does not make enough insulin or your cells don't use it as well as they should.3 In this case, you may need to take pills called "oral agents" to help manage your diabetes¹ or add insulin or non-insulin medications delivered through injections or pumps.

The Evolution Of Insulin

The discovery of insulin in 1921 by Canadian researchers Frederick Banting and Charles Best4 was ground-breaking as it allowed people with diabetes to live longer, healthier lives. It is considered one of the biggest discoveries of the twentieth century and remains the most effective treatment for people living with diabetes today.

 

While animal-derived insulin, such as NPH or regular insulin, were initially used in treatment, synthetic 'human insulin' was developed to counter hypersensitivity and allergic reactions.5 Today's insulin analogs have been associated with lower risks of hypoglycemia, a better quality of life, and higher satisfaction with treatments for those with diabetes.6

Types Of Insulin and Their Uses

The CDC currently recognizes six types of insulin, and each one has a specific use: rapid-acting, short-acting, intermediate-acting, long-acting, ultra-long acting, and premixed.7 Each works differently in the body and is tailored to meet the different needs of people living with diabetes. Those living with type 1 diabetes will generally take a variety of insulins, depending on their doctor’s recommendations. Only some people living with type 2 diabetes will need to take insulin.

 

Here’s a quick breakdown of six CDC recognized insulin types:

A rapid-acting insulin is usually taken before a meal and is often used alongside longer-acting insulin. Rapid-acting insulin start working within 15 minutes and lasts for around 2 to 4 hours. This class also includes the more recent ultra rapid acting insulins.7

Regular or short-acting insulin is usually taken 30 to 60 minutes before a meal and can last up to 6 hours in the body. Short-acting insulin will generally begin working within 30 minutes.7

Intermediate-acting insulin can be used to cover insulin needs for half a day or overnight. This type of insulin is generally used with rapid or short-acting insulin and lasts around 12 to 18 hours. Intermediate-acting insulin begins working in 2 to 4 hours.7

Long-acting insulin can help cover insulin needs for up to 24 hours. This type of insulin takes around 2 hours to kick in and does not peak throughout the day. Long-acting insulin is often used when needed or in addition to rapid or short-acting insulin.7

Ultra-long acting insulin can help cover insulin needs for up to a day and a half, or 36 hours. This type of insulin takes about 6 hours to take effect and does not peak during it’s use. Ultra-long acting insulin can be considered when needing steady insulin use over long periods of time.7

Premixed insulin is a combination of intermediate and short-acting insulin. It usually takes around 5 to 60 minutes to begin working and lasts for between 10 and 16 hours. Premixed insulin is usually taken 10 to 30 minutes before breakfast and dinner.7

 

Remember, it’s important to discuss insulin types and their effects with your doctor before use. Your healthcare professional will be able to help develop a treatment plan right for you.

Technology For Glucose Management

Insulin has been available as a treatment for diabetes for a century. As our understanding of diabetes has grown, so too have the types of insulin and various treatment plans. Similarly, new advances in technology are helping people living with diabetes better manage their condition by simplifying day-to-day tasks, such as monitoring glucose levels and making treatment decisions like administering insulin.

 

For example, the introduction of blood glucose monitoring (BGM) devices allows people living with diabetes to check their glucose levels, giving insights into how much insulin they need to take at any given time. Insulin pumps8, which are computerized devices that can automatically administer insulin at either continuous (basal) or intermittent (bolus) dosages, giving people with diabetes more treatment options.

 

Continuous glucose monitoring (CGM) devices, such as the Dexcom G6 CGM System, provide exceptional accuracy9, transmitting real-time glucose levels directly to a compatible smart device or receiver. This allows you to see how various foods and activities impact your glucose levels and adjust your insulin doses accordingly.* The Dexcom G6 can also be used connected with insulin pumps to send glucose readings directly to the pump, which automatically administers insulin. Dexcom G6 can only currently be integrated with the Tandem t-slim X2 with Control IQ Technology within Canada.

 

Digital tools used alongside Dexcom G6 such as the Dexcom Follow app and Dexcom CLARITY app, can help widen the user’s circle of care by allowing family, friends, and healthcare professionals access to glucose data remotely.§ This can help those closest to you stay informed of your glucose levels and give you the support you need. As well, Dexcom G6 alerts can notify you when glucose levels goes high, low, or trends toward a serious low. Use of these alerts, such as the predictive Urgent Low Soon alert, is associated with a significant reduction in hypoglycemia.10,11

Celebrating Insulin Then and Now

The discovery of insulin changed diabetes management forever and new technology continues to improve the lives of people living with diabetes. In the coming years, we look forward to more scientific advancements in treatment and technology.

 

Learn more about Dexcom G6 and how it can be used to monitor your glucose levels today.

 

 

* If your glucose alerts and readings from the Dexcom G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.

† An internet connection is required to send data to Dexcom CLARITY.

‡ For a list of compatible smart devices, please visit dexcom.com/compatibility.

§ Requires the Follow App and an internet connection. Users should always confirm readings on the Dexcom G6 CGM App or Receiver before making treatment decisions.

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2 Diabetes Canada. Type 1 diabetes. Diabetes Canada website. Accessed July 13, 2022. https://www.diabetes.ca/about-diabetes/type-1

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5 Donner T, Sarkar S. Insulin – Pharmacology, Therapeutic Regimens, and Principles of Intensive Insulin Therapy. Updated 23 February 2019. Accessed 20 July 2022. https://www.ncbi.nlm.nih.gov/books/NBK278938/

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7 Centers for Disease Control and Prevention. Types of Insulin. CDC website. Updated 25 March 2021. Accessed 20 July 2022. https://www.cdc.gov/diabetes/basics/type-1-types-of-insulin.html

8 American Diabetes Association. Insulin Pumps: Relief and Choice. ADA website. Accessed 20 July 2022. https://www.diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-pumps-relief-and-choice

9 Shah V LL, Wadwa P, et al. Performance of a Factory-Calibrated Real-Time Continuous Glucose Monitoring System Utilizing an Automated Sensor Applicator. Diabetes Technol Ther. 2018;20(6):428-433.

10 Puhr S et al. Real-World Hypoglycemia Avoidance with a Continuous Glucose Monitoring System's Predictive Low Glucose Alert. Diabetes Technol Ther. 2019;21(4):155-8.

11 Puhr S et al. Real-World Hypoglycemia Avoidance With a Predictive Low Glucose Alert Does Not Depend on Frequent Screen Views. J Diabetes Sci Technol. 2020;14(1):83-86.