Insulin can be divided into animal insulin and gene-synthesized human insulin according to the source of preparation: (1) Bovine insulin: extracted from the bovine pancreas, there are three amino acids in the molecular structure that are different from that of human insulin, so the efficacy of the drug is a little worse, and it is prone to allergy or insulin resistance; (2) Porcine insulin: extracted from the porcine pancreas, there is only one amino acid in the molecule that is different from that of human insulin, that is to say, it is closer to the structure of human insulin, so the efficacy is higher, and the antigenicity is lower. insulin structure is the closest, so the efficacy is higher and the antigenicity is lower.　　　　(3) Human insulin: Obviously, it is not extracted from human pancreas. Human insulin is converted from porcine insulin, and the amino acids in the molecule of porcine insulin that are different from human insulin are replaced with the same amino acids as those in human insulin, so as to turn into human insulin, or it is artificially synthesized by using recombinant gene technology. Human insulin has high efficacy and low antigenicity, but is more expensive.

According to the purity from low to high can be divided into ordinary insulin, single peak insulin and single component insulin. Clinically, they are usually divided into short-, medium-, and long-acting insulin and premixed insulin according to the speed of onset of action and the duration of action. Familiarizing yourself with the pharmacodynamic characteristics of different dosage types of insulin is essential for the correct formulation of insulin treatment plans.

(1) Short-acting insulin: also known as regular insulin, the domestic ones are ordinary insulin or neutral insulin injection produced by Shanghai and Xuzhou, and the imported ones are Novalin-R and Uvalin-R. It takes effect 0.5 hours after subcutaneous injection, and the peak of action occurs 1-3 hours after the injection (2-4 hours for animal insulin), and the duration of action is 5-7 hours, which is mainly used for controlling the postprandial hyperglycemia. It is mainly used to control high blood sugar after meal.

(2) Intermediate-acting insulin: It is also called low-arginine zinc insulin, and the imported Novalin-N and Uvalin-N belong to this category. It takes effect 1.5 hours after subcutaneous injection, the peak effect occurs 6-10 hours after injection, and the duration of effect is 18-24 hours. It is mainly used for basal insulin supplementation, controlling basal blood glucose in fasting state.

(3) Long-acting insulin: Shanghai and Xuzhou production of fish protein zinc insulin (referred to as PZI) belongs to this category. There is no such thing in the imported pharmaceuticals. It takes effect 3-4 hours after subcutaneous injection, the peak effect occurs 10-16 hours after injection, and the duration of effect is 28-36 hours. It is mainly used to supplement basic insulin when applied alone, and is usually mixed with short-acting insulin in a certain proportion in the clinic.

(4) Premixed insulin: It is a premixed preparation of short-acting insulin and intermediate-acting insulin in different ratios, Novolin 30R, Novolin 50R, Ulorin 70/30.

The effect is onset in 30 minutes after subcutaneous injection, the peak of action occurs 2-8 hours after injection, and the action lasts 24 hours, which is used for the control of basal and postprandial blood glucose.

(5) New insulin preparations: Since the 1990s, a variety of new ultra-short-acting and long-acting human insulin analogs have been gradually introduced into the clinic. (1) Ultra-short-acting human insulin analogues: such as aspart and lispro, which have the characteristics of fast onset of action (about 15 minutes), fast peak effect (30-60 minutes), high peak concentration and short duration (about 3 hours), can be injected immediately before or even after meals, which is similar to the human body's physiological insulin secretion, and can effectively control postprandial blood glucose, and can be used to control postprandial blood glucose. It can be injected immediately before or even after a meal, similar to the physiological insulin secretion of the human body, which can effectively control postprandial blood glucose and seldom occurs hypoglycemia.

2. Long-acting human insulin analogs, such as Lattice (glargine), are characterized by stable drug absorption, slow action, and once a day, the hypoglycemic effect can be maintained for 24 hours without any obvious peaks, which can better simulate the normal basal insulin secretion. The glucose-lowering effect of Ledex with the intensive treatment program of ultra-short-acting insulin injection before meal is similar to that of insulin pump. In addition, some foreign studies have confirmed that the combined treatment of using glucagon insulin instead of intermediate-acting insulin (NPH) at bedtime and oral hypoglycemic drugs during the daytime has better and safer glucose-lowering effect.