The subcutaneous route is the most widespread route of administration and is preferred by most patients due to its ease and convenience in administration. The route of administration usually depends on the patient condition and setting. Insulin administration can be via subcutaneous, intravenous, and intramuscular routes. Their long duration of action helps in reducing the frequency of dosing throughout the day. Dosing is usually during the night time after meals. They provide a plateau effect over 12 to 24 hours. Long-acting insulins, such as glargine and detemir, start action in 1 to 2 hours. Dosing is usually twice a day and helps maintain the blood sugar levels throughout the day. Intermediate-acting insulins (NPH) start the action in 1 to 4 hours and peak in 4 to 8 hours. Patients take these agents before meals, and food is necessary within 30 minutes after its administration to avoid hypoglycemia. Short-acting (regular insulin) starts the action in 30 to 40 minutes and peaks in 90 to 120 minutes. They are generally used before meals and always used along with short-acting or long-acting insulins to control sugar levels throughout the day. Rapid-acting insulins (lispro and aspart) start their action in 5 to 15 minutes and peak in 30 minutes. Brain cells: Involved in appetite regulationÄepending on the duration of action, insulin categorizes as short-acting, intermediate-acting, and long-acting.
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