Insulin classification name and dosage form

Insulin is the most commonly used therapeutic drug for diabetic patients. There are many types and names of insulin. Based on its chemical structure and source, it can be divided into animal insulin, human insulin pen and insulin-like drugs. In terms of types of insulin, there are short-acting insulin, regular insulin, intermediate-acting insulin and long-acting insulin, etc. There are also ultra-long-acting insulins.

1. Classification of insulin:

According to its source and chemical structure, insulin can be divided into animal insulin, human insulin and insulin analogs.

According to the characteristics of insulin action, it can be divided into ultra-short-acting insulin analogs, regular (short-acting) insulin, intermediate-acting insulin, long-acting insulin (including long-acting insulin analogs) and premixed insulin (including premixed insulin analogs).

Animal insulin comes in two types: pig and bovine. They are extracted from the pancreas of pigs or cows respectively. Pig insulin is more effective and has fewer side effects than bovine insulin. Most of the insulin produced domestically is pig insulin. Bovine insulin is slightly less effective and more prone to allergies, but is cheaper.

Human insulin is not extracted from the human pancreas, but is produced through genetic engineering. It has high purity and few side effects, but it is expensive. Its structure and function are similar to the insulin produced in the human body, and imported insulin is all human insulin.

Insulin analogs are a class of substances that are produced by modifying the amino acid sequence of human insulin through DNA recombinant technology and can simulate the secretion and action of normal insulin. Common ones include lispro insulin (Humalog), aspart insulin (NovoRapid), glargine insulin (Lantus), detemir insulin (Levopac), etc. Clinical trials have shown that insulin analogs have similar ability to control blood sugar as human insulin, but are superior to human insulin in simulating physiological insulin secretion and reducing the risk of hypoglycemia.

2. Common types and dosage forms of insulin:

1. Ultra-short-acting (rapid-acting) human insulin analogs - injected immediately before meals

NovoRapid—Insulin Aspart Injection, Humalog—Insulin Lispro Injection, Suxiulin—Insulin Lispro Injection.

Injection immediately before meals - subcutaneous injection takes effect within 10 to 20 minutes, the maximum effect time is 1 to 3 hours after injection, and the effect lasts for 3 to 5 hours. Compared with regular insulin, it is more in line with the physiological secretion pattern of insulin. Injection before meals is rapidly absorbed, with a short peak time, and can more effectively control postprandial blood sugar.

2. Short-acting (regular) insulin: injected 30 minutes before meals

Novolin R—biosynthetic human insulin injection, Humulin R—recombinant human insulin injection, Chonghelin R—recombinant human insulin injection, Gansulin R—conventional recombinant human insulin injection.

Injection 30 minutes before meals - is the only insulin that can be injected intravenously. The drug takes effect within 30 minutes after subcutaneous injection, reaches its peak in 2 to 4 hours, and lasts for 6 to 8 hours. Since short-acting insulin has an absorption process under the skin, its peak shape is not as sharp as that of ultra-short-acting insulin, and it is somewhat different from the physiological insulin secretion pattern of human beings. Eating meals in advance can easily lead to poor blood sugar control, while delaying meals can easily lead to hypoglycemia.

3. Intermediate-acting insulin - takes effect in 1.5 hours

Novolin N-protamine biosynthetic human insulin injection, intermediate-acting Humulin-NPH recombinant human insulin injection, Gansulin N-low-protamine recombinant human insulin injection, and Chonghelin N-protamine recombinant human insulin injection.

It is slowly absorbed, with an average onset of action of 1.5 hours, peak effect in 4 to 12 hours, and a duration of action of 18 to 24 hours. Intermediate-acting insulin is often used for bedtime administration in insulin intensive therapy to control fasting blood sugar at night and in the early morning.

4. Long-acting insulin - takes effect in 3 to 4 hours

Protamine zinc insulin (animal source).

Protamine zinc insulin is low-protamine zinc insulin with a larger proportion of protamine, which makes it absorbed more slowly and has a longer duration of action. It takes effect 3 to 4 hours after subcutaneous injection, reaches its peak effect in 12 to 20 hours, and lasts for 24 to 26 hours. Its disadvantage is that its absorption is unstable, resulting in unstable efficacy, and it is rarely used nowadays.

5. Ultra-long-acting human insulin analogs

Noprazosin - insulin detemir injection, Lantus - insulin glargine injection, Changxiulin - recombinant insulin glargine injection, and degludec insulin.

After subcutaneous injection, the concentration can be kept relatively constant for 24 hours without obvious peak. It can be injected at any time of the day, takes effect in 1.5 hours, and its effect can be maintained steadily for about 24 hours. It is more suitable for basal insulin treatment and is less likely to cause nocturnal hypoglycemia.

6. Premixed insulin analogs - Inject immediately before meals (Scheme: ultra-short-acting human insulin analogs + intermediate-acting insulin)

NovoRapid 30 + Insulin Aspart 30 Injection: 30% soluble insulin aspart and 70% protamine insulin aspart.

NovoRapid 50 + Insulin Aspart 50 Injection: 50% soluble insulin aspart and 50% protamine insulin aspart.

Humalog 25+protamine zinc recombinant insulin lispro mixed injection (25R): lispro insulin 25% and protamine zinc lispro insulin 75%.

Humalog 50+protamine zinc recombinant insulin lispro mixed injection (50R): 50% insulin lispro and 50% protamine zinc insulin lispro.

7. Premixed insulin - injected 30 minutes before meals (plan: short-acting human insulin + intermediate-acting insulin)

Novolin 30R + protamine biosynthetic human insulin injection (premixed 30R): 30% soluble neutral insulin and 70% low-protamine zinc insulin suspension.

Novolin 50R + protamine biosynthetic human insulin injection (premixed 50R): 50% soluble neutral insulin and 50% low-protamine zinc insulin suspension.