Insulins with delayed action cover for basal needs of the body and are therefore calles basal insulins (fasting insulins).
There are 3 main groups of insulins with delayed action:
1. NPH-insulin (can be injected by means of an insulin pen)
2. Zinc-insulin (cannot be injected by means of an insulin pen)
3. analogue insulins with delayed action: glargine, detemir, glulisin (can be injected by means of an insulin pen)
NPH-insulin
NPH stands for Neutral Protamin Hagedorn. It is released slowly and provides an effect of middle term duration. Insulin is bound to the carrier NPH which causes the delay of resorption into the blood. Due to the dose the delay can be different. Normally the duration of the effect is 12 (8 – 16) hours. The peak of the effect develops after 4 to 6 hours.
Zinc insulins
Depending on the grade of crystallization of insulin they provide middle term (12 – 16) to long term (24 – 46) duration of the effect.
Analogue insulins with delayed action
One of the newer developments of insulin analogues are analogues with delayed action like glargine, detemir or glulisin. Their duration of effect ist longer (average 24 hours) than from NPH insulin, they act more constantly and decrease therefore the risk of a hypoglycaemia.
