Diabetes--------

Inside the pancreas, beta cells make the hormone insulin. With each meal, beta cells release insulin to help the body use or store the glucose it gets from food.

In people with Type 1 diabetes, the pancreas no longer makes insulin. The beta cells have been destroyed. They need insulin shots to use glucose from meals.

People with Type 2 diabetes make insulin, but their bodies don’t respond well to it. Some people with Type 2 diabetes need diabetes pills or insulin shots to help their bodies use glucose for energy.

Insulin cannot be taken as a pill. It would be broken down during digestion just like the protein in food. Insulin must be injected into the fat under your skin for it to get into your blood.

There are more than 20 types of insulin sold in the United States. These insulins differ in how they are made, how they work in the body, and price. Insulin comes from animals (pigs or cows) or is made in labs to be identical to human insulin.

There are four types of insulin, based on

how soon the insulin starts working (onset)
when it works the hardest (peak time)
how long it lasts in your body (duration).
However, each person responds to insulin in his or her own way. That is why onset, peak time, and duration are given as ranges
The four types are:

Rapid-acting insulin (Lispro) reaches the blood within 15 minutes after injection. It peaks 30 to 90 minutes later and may last as long as 5 hours.

Short-acting (regular) insulin usually reaches the blood within 30 minutes after injection. It peaks 2 to 4 hours later and stays in the blood for about 4 to 8 hours.

Intermediate-acting (NPH and lente) insulins reach the blood 2 to 6 hours after injection. They peak 4 to 14 hours later and stay in the blood for about 14 to 20 hours.

Long-acting (ultralente) insulin takes 6 to 14 hours to start working. It has no peak or a very small peak 10 to 16 hours after injection. It stays in the blood between 20 and 24 hours.

Some insulins come mixed together. For example, you can buy regular and NPH insulins already mixed in one bottle. They make it easier to inject two kinds of insulin at the same time. However, you can’t adjust the amount of one insulin without also changing how much you get of the other insulin.

Strength
Insulins come dissolved in liquids at different strengths. Most people use U-100 insulin. This means it has 100 units of insulin per milliliter (ml) of fluid. Be sure that the syringe you use matches the insulin strength. U-100 insulin needs a U-100 syringe. In Europe and Latin America, U-40 insulin is also used. If you’re outside the United States, be certain to match your insulin strength with the correct size syringe.

Additives
All insulins have added ingredients to keep them fresh and help them work better. Intermediate- and long-acting insulins also have ingredients to make them act longer. Today’s insulins are very pure. Allergic reactions are rare.

Storage and safety
Using cold insulin can make your shot more painful.
You can keep the bottle of insulin you are currently using at room temperature or warm the bottle by gently rolling it between your hands before you fill the syringe.

If you buy more than one bottle of insulin at a time, store the extra bottles in the refrigerator until you start to use them.

Never store insulin at very cold (under 36 degrees Fahrenheit) or very hot (over 86 degrees Fahrenheit) temperatures.
Extreme temperatures destroy insulin.

Do not put your insulin in the freezer or in direct sunlight.
Insulin may lose some potency if the bottle has been opened for more than 30 days.

Look at the bottle closely to make sure the insulin looks normal.
If you use regular, it should be perfectly clear—no floating pieces or color.

If you use NPH or lente, it should be cloudy, with no floating pieces or crystals on the bottle.
Do not use insulin past the expiration date.