Type 2 Diabetes: Injectable medication for diabetes

See our patient handout about injectable medications for diabetes.

A. Short/rapid-acting insulin

Rapid-acting analogues

  1. Insulin aspart (NovoRapid, Fiasp)
  2. Insulin glulisine (Apidra)
  3. Insulin lispro (Humalog)
  • Inject 0-15 minutes before meals
  • Starts to work in about 15 minutes
  • Peaks 1 to 1.5 hours after injection
  • Lasts about 3 to 5 hours
  • Clear

Short-acting

  1. Regular (Humulin R; Novolin ge Toronto)
  • Inject 30 minutes before meals
  • Starts to work in about 30 minutes
  • Peaks 2 to 3 hours after injection
  • Lasts about 5 to 10 hours
  • Clear

B. Intermediate/long-acting insulin

Intermediate-acting

  1. NPH (Humulin N; Novolin ge NPH)
  • Usually injected once or twice daily
  • Starts to work in about 1 to 3 hours
  • Peaks 5 to 8 hours after injection
  • Lasts about 12 to 18 hours
  • Cloudy; must be mixed before injection

Long-acting analogues

  1. Insulin degludec (Tresiba)
  2. Insulin detemir (Levemir)
  3. Insulin glargine (Lantus, Basaglar, Toujeo)
  • Usually injected once or twice daily
  • Lantus, Levemir and Basaglar start to work in   
    about 1 to 2 hours and last about 16 to 24 hours with no peak
  • Toujeo starts to work in about 6 hours and   
    lasts up to 30 hours with no peak
  • Tresiba starts to work in about 1 hour and
    lasts more than 42 hours with no peak
  • Clear

C. Pre-mixed insulin

Pre-mixed

  1. Humulin 30/70 (30% R; 70% NPH)
  2. Novolin ge 30/70 (30% R; 70% NPH)
  3. Novolin ge 40/60 (40% R; 60% NPH)
  4. Novolin ge 50/50 (50% R; 50% NPH)
  • Usually injected twice daily (breakfast & supper)
  • Cloudy; must be mixed before injection

Pre-mixed analogues

  1. Humalog Mix25 (25% rapid-acting; 75% longer-acting)
  2. Humalog Mix50 (50% rapid-acting; 50% longer-acting)
  3. NovoMix 30 (30% rapid-acting; 70% longer-acting)
  • Usually injected twice daily (breakfast & supper)
  • Cloudy; must be mixed before injection

D. GLP-1 analogues

Daily

  1. Liraglutide (Victoza) 0.6mg-1.8mg per day (with or without food)
  2. Lixisenatide (Adlyxine) 10mcg-20mcg per day (within 1 hour prior to any meal)

Weekly

  1. Dulaglutide (Trulicity) 0.75mg-1.5mg once weekly
  2. Semaglutide (Ozempic) 0.25mg-1mg once weekly”
  • Replaces GLP-1 usually made by the body
  • ONLY for people with type 2 diabetes
  • May result in some weight loss
  • Nausea is a common side effect; it decreases over time in most people
  • Clear

 

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