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PEBC: What You Need to Know: Mealtime Insulins

Rapid-Acting: Humalog (insulin lispro), Apidra (insulin glulisine), Novorapid (insulin aspart)

-inject 15 minutes and up until prior to meal

-faster onset, faster peak, shorter duration of action


Ultra-Rapid: Fiasp (insulin aspart)

-inject at the start of meal or within 20 minutes of starting to eat

-ultra fast onset, faster peak, shorter duration of action


Short Acting: Humulin R (regular insulin)

-inject 30 minutes prior to meal

-slower onset, later peak, longer duration of action


Adverse Effects:

-hypogylcemia (<4 mmol/L) is common

-weight gain


Drug Interactions:

-increased hypoglycemia risk with other diabetic agents, especially sulfonylureas, meglitinides

-increased risk of hypoglycemia with GLP-1 agents such as liraglutide, semaglutide: a 50% reduction in insulin is recommended

-contraindicated with pioglitazone due to risk of heart failure and edema

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