Understanding Insulin: The Basics

Oct 26, 2020


Alto Pharmacy


The Ins and Outs of Insulin

It’s estimated that someone is newly diagnosed with diabetes every 21 seconds in America. Of this growing population of over 34 million, approximately 8.3 million people rely on taking one or more forms of insulin to manage their condition.

If you or someone you love is navigating a new insulin prescription, know that there is a learning curve involved. From wrapping your head around the different types of insulin to figuring out your very first injection, It’s normal to have plenty of questions as you settle into a routine. While your medical provider and pharmacist are your best sources of support, this article can serve as a framework for your conversations with them by giving you a good grasp of the basics.

What Is Insulin? 

Insulin is a hormone that most of us produce naturally in order to regulate our blood glucose levels. People with diabetes either do not produce insulin on their own, produce too little, or their bodies don’t react to it correctly. Insulin medications enable people with type 1 and type 2 diabetes to keep their blood sugar levels within a target range. For more on this, see our article, “What’s the Difference Between Type 1 and Type 2 Diabetes.” 

When blood sugar levels get too high or too low,  long-term or life-threatening complications can occur. The goal of insulin therapy is to mimic natural insulin levels and prevent spikes and dips. Insulin can’t be taken orally because it would be broken down during digestion. It must be injected into the fatty tissue under your skin so it can reach the bloodstream. While it is most commonly administered with a syringe, there are other methods of delivery such as pens and pumps . 

Getting started with insulin can be tricky because finding the right dosage is key. Taking too much or too little can cause rapid changes in your blood sugar levels. That’s why it is important to work with your healthcare provider to find an insulin regimen that works for you. Your pharmacist can also talk through any symptoms and side effects you experience to determine if an adjustment may be necessary. Alto’s pharmacists are just an in-app message or phone call away if you need advice. 

Insulin Types: A Matter of Time

Bear with us—this can seem a bit complicated at first glance. There are different types of insulin that are defined by three factors: how quickly they start working (onset), when they reach maximum effectiveness (peak), and how long they last (duration).

  • Rapid-acting insulin: Begins to work about 15 minutes after injection, peaks about 1 or 2 hours after injection and lasts between 2 to 4 hours. 

  • Regular or short-acting insulin: Takes effect within 30 minutes after injection, peaks between 2 to 3 hours after injection, and works for approximately 3 to 6 hours. 

  • Intermediate-acting insulin: Starts working about 2 to 4 hours after injection, peaks 4 to 12 hours later and remains effective for 12 to 18 hours.

  • Long-acting insulin: Takes several hours to reach the bloodstream after injection and usually lasts for up to 24 hours.

  • Ultra long-acting insulin: Makes its way into the bloodstream in 6 hours and lasts 36 hours or longer without any peak. 

Depending on the type of diabetes, progression of the disease, and other individual factors, a person might need one injection per day or several and may use one form of insulin or a combination. Most people who are prescribed insulin will eventually need a combination of rapid- or short-acting and long-acting insulins. A  normally functioning pancreas releases a continual supply of insulin (basal insulin) with additional bursts when you eat (bolus insulin). Combining several types of insulin reproduces these natural actions as closely as possible. 

Your healthcare provider can help you determine the combination of diabetes medications that’s right for you and this regimen will likely change over time. We cover some of the factors that can affect your individual medication needs in our article, “Managing Your New Diabetes Diagnosis.”

Insulin Forms: A Means of Delivery

There are several methods of administering the insulin you need. Your regimen will likely involve a needle but try not to worry about that—needles today are surprisingly small.  

  • Syringe: The classic and most common option. You’ll receive your insulin in a vial and use a syringe to inject it into the fatty tissue under the skin. 

  • Insulin Pen: These devices hold a cartridge of insulin and the dose can be controlled through a dial on the pen, making it easier to be precise. The insulin is delivered through a very small, replaceable needle. 

  • Insulin Pump: This option most closely mimics how the body releases insulin. A computerized pump delivers a continuous dose of medication around the clock via a catheter placed under the skin. 

  • Infusion: Typically only used in hospital settings, an infusion is when insulin is delivered directly into a vein through an IV. 

  • Inhaled Insulin: Inhaled insulin is a rapid-acting insulin that can be used by those with type 1 and type 2 diabetes at the beginning of a meal. It is not a substitute for long-acting insulin and is usually used in combination with insulin injections.

You’ve Got This (And We’ve Got You)

We know starting an insulin regimen can feel like a big change. But it’s important to think of your insulin regimen as a life skill, not a life sentence. Like any skill, mastering the intricacies will take time. What might seem frightening or confusing at first will eventually become a normal part of your daily routine. 

We’re here to take the stress out of managing your insulin prescriptions, from navigating insurance to coordinating multiple medications into one easy delivery. We’ll set up automatic refills so you never have to worry about running out of the supplies you need, plus our pharmacists will be on standby, should you have questions or need someone to walk you through your dosage instructions. 

We explain exactly how we can support you better than a traditional pharmacy in, “The Best Pharmacy for Your Diabetes Care.” Let’s make this next step in managing your diabetes as easy as possible together. 

Ready to switch to a better pharmacy for your diabetes care? Our team is available to answer your questions from 6 am - 9 pm PT Monday - Friday, and 7 am - 6 pm PT on weekends; reach out by in-app secure messaging or phone.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.