Knowledge & Updates

Different types of Insulin

Rapid, Short, Intermediate, Long, Ultra Long, and Premixed

There are also different concentrations

Each type has different onset time frames, peak times, and durations.

• Rapid-acting

Onset is 15 minutes

Peak time is 1 hour

Duration is 2 to 4 hours

• Short-acting

Onset is 30 minutes

Peak time is 2 to 3 hours

Duration is 3 to 6 hours

• Intermediate-acting

Onset is 2 to 4 hours

Peak time is 4 to 13 hours

Duration is 12 to 18 hours

• Long-acting

Onset is 2 hours

Does not peak

Duration is up to 24 hours

• Ultra Long-acting

Onset is 6 hours

Does not peak

Duration is 36 hours or longer

• Premixed

Onset is 5 to 60 minutes

Peaks vary

Duration is 10 to 16 hours

Pen Priming

If you are using an insulin pen, you have to prime the needle every time you use it. Priming is where you dial the pen to a specific amount of units and "release" the insulin through the needle tip to ensure all air bubbles are out and that you will get the full dose of insulin. Each pen has a different priming dose, you can use the chart above to determine how many units your pen needs to prime with.

Days of Supply for Insulin Pen Users

At the pharmacy, to accurately calculate what we call Days of Supply we need to know: how many times you are injecting, max daily units, and we use the pen's priming dose. See the above chart for pen priming doses. 

Days of Supply or DOS is how many days your amount of medication will last you.

Ex: 

You are using a humalog kwikpen, your script is for 2 boxes of 5 pens each box (which are 3 mls a pen at 100 units per ml), you are injecting 6 times a day, and up to 80 units max daily.

Math time!

Priming dose is 2 units x 6 times a day = 12 units

Daily units are 80 max units + 12 units for priming dose = 92 units

Amount of insulin you are getting is 30mls x 100 units which is 3000 units. 

Divide 3000 units by 92 units daily which is 32.61.

We round down so your Days of Supply would be 32 days. 

WOW that was a lot of math!!

Hopefully your pharmacy is correctly calculating your DOS, but some pharmacies do not take into account the priming dose for pens. This error can change the DOS, and not in the patient's favor! Please use this information to ensure you are getting the correct amount of insulin and it is getting billed for the correct amount of days. You can ask your pharmacy what the DOS is for the amount you are picking up and with this tidbit of information, you can calculate your own DOS!!