Consumer Guide to Insulin

Brands and types

The following three brands of insulin are available in New Zealand.

  • Eli Lilly
  • Novo Nordisk
  • Sanofi Aventis

Each brand has several different types with different presentations and durations. Most insulins come in both 3 ml cartridges for use in Insulin pens and 10 ml vials, and are administered with syringes.

  • Rapid-acting. These insulins (Novo Rapid, Humalog) act very quickly and only last an hour or two
  • Short-acting. These insulins (Actrapid, Humulin R) take effect after about half an hour and last 3 to 4 hours
  • Intermediate - and long-acting. These insulins (Humulin NPH, Protaphane, Lantus and Levemir) take effect after about an hour and are designed to last “all day”
  • Premixed. These insulins are a mixture of short and intermediate acting insulins and act just like two injections of the separate components taken at the same time.

With the exception of Lantus and Levemir, all insulin is fully subsidised. Unless a special exemption is obtained only 30 days supply of insulin may be picked up from your pharmacy at one time.

Taking and storing insulin

Insulin is always taken by injection using either a small syringe, or an Insulin Pen.

Insulin must be stored in a refrigerator although the vial or pen in use can be kept at room temperature.

Insulin types

Insulin is described as “Rapid-acting”, “Short-acting”. “Intermediate-acting” or “Long-acting”.

Rapid and short-acting insulins are described as “Bolus” and are clear in appearance.

Intermediate and long-acting insulins are described as Basal and with the exception of Lantus and Levemir are cloudy in appearance.

All types of insulin have a delayed onset of their peak activity and different durations of activity.

  • Rapid-acting. These insulins act very quickly and only last an hour or two (Novo Rapid, Humalog)
  • Short-acting. These insulins take effect after about half an hour and last 3 to 4 hours (Actrapid, Humulin R)
  • Intermediate - and long-acting. These insulins take effect after about an hour and are designed to last “all day” (Humulin NPH, Protaphane, Lantus and Levemir)
  • Premixed. These insulins are a mixture of short and intermediate acting insulins and act just like two injections of the separate components taken at the same time.

Some 3 ml cartridges contain a mixture of both Short and Long acting insulin, and some short and long acting Insulins may be mixed in a syringe prior to injection.

Insulins are now made “biosynthetically” and match normal human insulin exactly. Some people are however intolerant of these insulins and a limited supply of insulin derived from animal sources is still available under special authority can be obtained.

  • Animal insulins. There are a small number of porcine insulin analogues that will be available in New Zealand until December 2006.

Typical insulin regimes

Your health professional will advise on the insulin regime that meets your needs.

Typically…

  • Type 1 Diabetes may be controlled with one or two daily injections of Intermediate or long acting insulin, and three or four injections of Rapid-acting insulin, at meal times
  • Type 2 Diabetes may be controlled with one or two injections of Intermediate or long acting insulin each day often in association with an Oral medication.

All insulin supplied in New Zealand contains 100 International Units of Insulin per millilitre (often called 100 strength) and your required dose will be measured in “Units”.

Insulin is not a “Stat”1 item and although your doctor can prescribe 90 days supply, only 30 days supply can be uplifted from a pharmacy at any time unless a specific exemption is provided.

The vial or cartridge of insulin in current use may be kept at room temperature for up to 28 days. If not all used in that time it should be discarded.

Your stock of insulin must be stored in a refrigerator between 2 and 8 degrees C. This is normal operating temperature for a domestic refrigerator. DO NOT STORE in the DEEP FREEZE.

All insulin has an expiry date, and any unused should be discarded after that date whether or not in the refrigerator.

  1. PHARMAC describes "Stat" (from the Latin word "Statin" meaning "at one time") items where 90 days supply can be uplifted "all at once". For other items, including insulin, only 30 days supply can be uplifted at one time unless an exception is provided. ↩

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