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31 years
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What is the best insulin for diabetic patient type one?
Aug 18, 2014
2nd opinion

Dr. Zakia Dimassi Pediatrics
Type 1 diabetes is also called insulin dependent diabetes, because the pancreatic cells responsible for insulin secretion are destroyed. As such, insulin therapy is needed as a lifelong treatment. It is given in different types according to the body needs (basal insulin, before meals, etc). So there's no one best type.

Rapid-, short-, intermediate-, and long-acting insulin preparations are available.
Rapid-acting insulins include lispro, glulisine, and aspart insulin.
These insulins are absorbed more quickly and their effect kicks in a rapid in a short amount of time (5-10 minutes), their peak action (the maximum effect) also occurs quickly (45-75 minutes), and their effect doesn't last long (2-4 hours). As such, they are generally used shortly before meals.
A rapid-acting inhaled insulin powder (Afrezza) for types 1 and 2 diabetes mellitus was approved recently by the FDA (June 2014). It is regular insulin (discussed below) but is considered rapid-acting because it peaks at 12-15 minutes and returns to baseline levels (the levels of insulin that are maintained in the blood while you're not eating) at about 160 minutes. In individuals with type 1 diabetes, the inhaled insulin's efficacy was equivalent to standard injectable insulin when used in conjunction with basal insulin at reducing hemoglobin A1c (تخزين السكر).
Short-acting insulin includes regular insulin. It is taken as an injection under the skin. The onset of action occurs in 0.5 hours, its peak activity at 2.5-5 hours, and its duration of action is 4-12 hours.
Both regular human insulin and rapid-acting insulin are good for lowering hyperglycemia that occurs after meals.

Intermediate-acting insulins include NPH insulin, which has a slower onset of action (at 1-2 hrs) and longer duration of action (14-24 hrs).

Long-acting insulins has no peak and produces a relatively stable level lasting more than 24 hours. It can be given once or twice daily.
A new ultralong-acting basal insulin, insulin degludec, which has a duration of action of up to 42 hours, is still pending FDA approval.

There's also the option of the insulin pump, which delivers the right amount of the needed type of insulin preparation according to the body needs (it regularly checks the blood sugar level).
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