Some people who live with type 2 diabetes use insulin to help control their blood glucose levels. This is a decision you usually make with your healthcare provider so you can meet your healthcare goals. Note that insulin is also used for other types of diabetes, like type 1 diabetes or gestational diabetes.

If your doctor tells you to use intermediate-acting insulin and you don’t know what it is or why, ask them to explain more. You can also read on to learn about this important medication for controlling diabetes.

1. Intermediate-Acting Insulin Is a Form of Basal Insulin

When people think about injecting insulin, they usually envision something that they take every time they eat. However, there are other kinds of insulin, too. Intermediate-acting insulin is a form of what doctors call basal insulin. This is insulin you only have to inject once or twice a day. It can be used alongside shorter-acting forms of insulin. It may be used on its own, too. All of that depends on your body and how your particular blood sugar responds to insulin.

What Does ‘Intermediate-Acting’ Mean?

Intermediate-acting insulins are in the middle when it comes to how fast they start working, when they reach their peak levels in your body, and how long they last. They work faster than some other types and slower than others. You and your healthcare team will need to choose the type or types of insulin that work best for your needs.

2. Intermediate-Acting Insulin Is Different From Rapid-Acting and Short-Acting Insulin

Intermediate-acting insulin is different from both rapid-acting insulin and short-acting insulin. Short-acting insulin is also known as regular insulin, so it’s different from that, too. Depending on who you ask, the intermediate version might start working within one or two hours, or it can take as long as four. It’s maximally effective between four and 12 hours after you inject it, and it can last for as long as 12 to 18 hours in your body.

Both rapid-acting and short-acting insulins work faster, peak sooner, and don’t last as long overall. Each one of these types has its own parameters in these areas. You can talk to your physician if you want to know more.

3. Intermediate-Acting Insulin Is Also Different From Long-Acting and Ultra-Long-Acting Insulin

Long-acting insulin and ultra-long-acting insulin also exist. These work differently in your body than intermediate-acting insulin does. These different types of insulin have little to no peak, start more slowly, and last longer than intermediate-acting insulin.

4. Intermediate-Acting Insulin Works by Lowering Blood Sugar Levels

When you're living with type 2 diabetes, your body usually makes insulin but doesn’t use it the way it should. It becomes resistant to insulin, so you need to make more and more to have the same effects. If it can’t keep up with your insulin resistance, your blood sugar levels go up. Eventually, you can develop type 2 diabetes. Occasionally, type 2 diabetes may mean that your pancreas doesn’t make insulin or doesn’t make enough for your needs.

When this happens, your body needs extra support so it can get the insulin that it needs to thrive. Intermediate-acting insulin can be that support. If your body isn’t making insulin, it supplies what you need. If you need more insulin than you can produce, it helps keep your levels high enough. Intermediate-acting insulin specifically works by providing you with low levels of insulin for as long as the medication lasts.

5. Different Intermediate-Acting Insulins Are Injected on Different Schedules

There’s no single time to inject intermediate-acting insulin. The number of times you need insulin injections each day will depend on the type of insulin you take.

NPH insulin is the main type of intermediate-acting insulin. Most people inject it with a syringe twice a day. It starts working within one to three hours, peaks between four and 10 hours, and lasts between 10 and 16 hours.

Your healthcare team may tell you to use intermediate-acting insulin in ways that are different from what's listed here. You should always follow their advice as closely as possible so you can get maximum control over your blood sugar. They may also have you use short-acting insulin alongside intermediate-acting insulin. This helps make sure you have some insulin all the time.

6. Intermediate-Acting Insulin Has a Few Risks

There are a few risks that you should look out for when you’re using intermediate-acting insulin. These may not happen, but you should keep your eye out just in case.

The risks of intermediate-acting insulin include:

• Problems at the injection site, such as itching, discoloration, pain, or bruising
• Fatty lumps that develop under your skin
• Problems with your vision
• Hypoglycemia (low blood sugar)

Hypoglycemia happens when you end up with too much insulin in your body or your insulin absorbs too quickly and causes your blood sugar to dip too low. Actions like exercise, massaging the injection site, and keeping your insulin too warm before you inject it can all speed up absorption. If you’re going to be eating less than you usually do, you should talk to your doctor about lowering your dose of intermediate-acting insulin to avoid hypoglycemia, too. You can also carry a source of glucose with you all the time, in case you need to treat hypoglycemia fast.

If you experience any unusual or unexpected symptoms after using intermediate-acting insulin, get medical help right away.

7. The Benefits of Intermediate-Acting Insulin Usually Outweigh the Risks

Type 2 diabetes has a lot of complications if it’s not managed well. It can affect your heart, lungs, eyes, kidneys, nerves, skin, mouth, ears, digestive tract, and sexual function. Keeping it under control, then, becomes important because you want to avoid these if at all possible.

Since intermediate-acting insulin helps control your blood sugar, it’s an important part of this process. Having that level of control over blood glucose levels is usually worth the potential risks associated with intermediate-acting insulin. If you’re concerned about how this all balances out in your particular case, talk to your doctor today to get the answers you need.

8. Your Doctor Will Tell You How Much Intermediate-Acting Insulin To Use and When To Inject It

You don’t have to figure out intermediate-acting insulin therapy on your own. In fact, you shouldn’t. Your diabetes care team will tell you how much to take and when to take it. All you need to do is follow their instructions so you have enough insulin — but not too much.

If you have kidney or liver problems, make sure you understand how much insulin your doctors want you to use. You may need reduced doses of insulin.

If tracking insulin and glucose monitoring is hard for you, talk to your doctor about using a patch or an insulin pump. These can help you assess your glucose levels and make sure you get the treatment you need when you need it. Your doctor can also monitor your A1c levels over time, to make sure your type 2 diabetes is under control over the long term as well as the short term.

Your doctor should be an ally for you as you learn to live with type 2 diabetes. Any time you have a question about intermediate-acting insulin, talk to them to get the answers you need.

Talk With Others Who Understand

DiabetesTeam is the social network for people with diabetes and their loved ones. On DiabetesTeam, members come together to ask questions, give advice, and share their stories with others who understand life with diabetes.

Do you use intermediate-acting insulin? How has it helped manage your diabetes? Share your experience in the comments below, or start a conversation by posting on your Activities page.