| colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left" | '''Notes:''' Protect from light and heat<br> Do Not Freeze, [[Resuspending insulin|Resuspend]]<br> Do not use if product does not [[re-suspend]]<br>Do not use [[intravenously]] <ref>{{cite web|title=Small Animal Clinical Pharmacology|author=Maddison, Jill E.,Page, Stephen W.,Church, David B.|year=2008|publisher=Saunders Ltd.|isbn=0702028584|page=510|url=http://www.amazon.com/Animal-Clinical-Pharmacology-Maddison-DipVetClinStud/dp/0702028584/ref=sr_1_1?s=books&ie=UTF8&qid=1296451134&sr=1-1}}</ref><br>Do not refrigerate in use cartridges/pens.
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[[Image:Insuman.PNG|thumb|left|300px|Insuman insulins in pen cartridge form.]]<br clear=left>This 70% NPH/isophane crystal <ref> {{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000201/WC500033779.pdf|title=Scientific Discussion-Insuman|publisher=EMEA}}</ref> and 30% R/neutral insulin mix <ref>{{cite web|url=http://images2.wikia.nocookie.net/diabetesindogs/images/7/7f/Insuman_Comb_25_patient_info_leaflet.pdf |title=Patient Information Leaflet-Insuman Comb 25|publisher=Sanofi-Aventis}}</ref><ref>{{cite web|url=http://web.archive.org/web/20080208084240/http://www.drgc.cwc.net/Care_pathway/Patient_information/Insulin/Insuman_insulins.htm |title=Insuman Prescribing Information}}</ref> is intermediate-acting and made by [[Aventis]] as part of its Insuman line of products. <ref>{{cite web|url=http://www.yorkshirediabetes.com/downloads/A11456_Range_Poster.pdf |title=Aventis Poster-Insuman & Lantus Insulins|publisher=Sanofi-Aventis}}</ref><ref>{{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000201/WC500033779.pdf|title=Scientific Discussion-Insuman|publisher=EMEA}}</ref>
[[Image:Insuman.PNG|thumb|left|300px|Insuman insulins in pen cartridge form.]]<br clear=left>This 70% NPH/isophane crystal <ref> {{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000201/WC500033779.pdf|title=Scientific Discussion-Insuman|publisher=EMEA}}</ref> and 30% R/neutral insulin mix <ref>{{cite web|url=http://images2.wikia.nocookie.net/diabetesindogs/images/7/7f/Insuman_Comb_25_patient_info_leaflet.pdf |title=Patient Information Leaflet-Insuman Comb 25|publisher=Sanofi-Aventis}}</ref><ref>{{cite web|url=http://web.archive.org/web/20080208084240/http://www.drgc.cwc.net/Care_pathway/Patient_information/Insulin/Insuman_insulins.htm |title=Insuman Prescribing Information}}</ref> is intermediate-acting and made by [[Aventis]] as part of its Insuman line of products. <ref>{{cite web|url=http://www.yorkshirediabetes.com/downloads/A11456_Range_Poster.pdf |title=Aventis Poster-Insuman & Lantus Insulins|publisher=Sanofi-Aventis}}</ref><ref>{{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000201/WC500033779.pdf|title=Scientific Discussion-Insuman|publisher=EMEA}}</ref>
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==Why Lente doesn't equal 70/30==
==Why Lente doesn't equal 70/30==
[[Image:Lente-70 30.jpg|thumb|300px|left|Direct comparison of insulin activity profiles for Lente and 70/30 insulins. The early strong action from the non-suspended R/neutral/normal insulin is seen at the "bump" from hours 0-6.]]
[[Image:Lente-70 30.jpg|thumb|300px|left|Direct comparison of insulin activity profiles for Lente and 70/30 insulins. The early strong action from the non-suspended R/neutral/normal insulin is seen at the "bump" from hours 0-6.]]
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Let'slook at the differences in the two insulins. Lente is comprised of 70 % [[:Category:Long-acting|long-acting]] [[Ultralente]] insulin and 30% [[:Category:Short-acting|short-acting]] [[Semilente]] insulin. So proportions of a long-acting and short-acting insulin are being combined to produce a [[:Category:Intermediate-acting|intermediate-acting]] insulin. Both Ultralente and Semilente insulin are [[suspension|suspended]] by adding [[:Category:Zinc|zinc]] and the size of their respective insulin crystals. The largest insulin crystals are those of Ultralente, while Semilente contains the smallest, or microcrystals. Simply put, you're combining a long insulin and a short insulin to make an intermediate-acting one.
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Let's look at the differences in the two insulins. Lente is comprised of 70 % [[:Category:Long-acting|long-acting]] [[Ultralente]] insulin and 30% [[:Category:Short-acting|short-acting]] [[Semilente]] insulin. So proportions of a long-acting and short-acting insulin are being combined to produce a [[:Category:Intermediate-acting|intermediate-acting]] insulin. Both Ultralente and Semilente insulin are [[suspension|suspended]] by adding [[:Category:Zinc|zinc]] and the size of their respective insulin crystals. The largest insulin crystals are those of Ultralente, while Semilente contains the smallest, or microcrystals. Simply put, you're combining a long insulin and a short insulin to make an intermediate-acting one.<ref>{{cite web|url=http://images1.wikia.nocookie.net/diabetesindogs/images/4/42/2010_T35-greco-western-2010.pdf|title=Treating Diabetes Mellitus in Dogs and Cats|author=Greco, Deborah|publisher=Western Veterinary Conference|year=2010}}</ref>
70/30 insulin starts with 70% [[NPH]]/isophane insulin, an [[:Category:Intermediate-acting|intermediate-acting]] insulin which is suspended by [[Protamine|protamine]]. To that, 30% [[R]]/neutral/normal insulin, which is [[:Category:Short-acting|short-acting]] and [[Soluble insulin|soluble]], meaning there is no suspension; nothing is added to this insulin to delay its action. In this case, you are taking an intermediate-acting insulin with a suspension and adding to it a short-acting one with no suspension to create an intermediate-acting insulin.
70/30 insulin starts with 70% [[NPH]]/isophane insulin, an [[:Category:Intermediate-acting|intermediate-acting]] insulin which is suspended by [[Protamine|protamine]]. To that, 30% [[R]]/neutral/normal insulin, which is [[:Category:Short-acting|short-acting]] and [[Soluble insulin|soluble]], meaning there is no suspension; nothing is added to this insulin to delay its action. In this case, you are taking an intermediate-acting insulin with a suspension and adding to it a short-acting one with no suspension to create an intermediate-acting insulin.
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==References==
==References==
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<references/>
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{{Reflist|colwidth=30em}}
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==More Information==
==More Information==
*[http://www.yorkshirediabetes.com/downloads/A11456_Range_Poster.pdf Chart of Insuman Insulin Ranges] Yorkshire Diabetes
*[http://www.yorkshirediabetes.com/downloads/A11456_Range_Poster.pdf Chart of Insuman Insulin Ranges] Yorkshire Diabetes
Notes: Protect from light and heat Do Not Freeze, Resuspend Do not use if product does not re-suspend Do not use intravenously[1] Do not refrigerate in use cartridges/pens.
Insuman insulins in pen cartridge form.
This 70% NPH/isophane crystal [2] and 30% R/neutral insulin mix [3][4] is intermediate-acting and made by Aventis as part of its Insuman line of products. [5][6]
While this type of Insuman insulin is approved and sold in the EU and elsewhere, it is the only one of the Insuman insulins not offered in the UK.
Direct comparison of insulin activity profiles for Lente and 70/30 insulins. The early strong action from the non-suspended R/neutral/normal insulin is seen at the "bump" from hours 0-6.
Let's look at the differences in the two insulins. Lente is comprised of 70 % long-actingUltralente insulin and 30% short-actingSemilente insulin. So proportions of a long-acting and short-acting insulin are being combined to produce a intermediate-acting insulin. Both Ultralente and Semilente insulin are suspended by adding zinc and the size of their respective insulin crystals. The largest insulin crystals are those of Ultralente, while Semilente contains the smallest, or microcrystals. Simply put, you're combining a long insulin and a short insulin to make an intermediate-acting one.[7]
70/30 insulin starts with 70% NPH/isophane insulin, an intermediate-acting insulin which is suspended by protamine. To that, 30% R/neutral/normal insulin, which is short-acting and soluble, meaning there is no suspension; nothing is added to this insulin to delay its action. In this case, you are taking an intermediate-acting insulin with a suspension and adding to it a short-acting one with no suspension to create an intermediate-acting insulin.
So we have an insulin (Lente), made up of a long-acting and short-acting insulin, both with zinc suspensions, and a mixed insulin (70/30), made from an intermediate-acting protamine suspended insulin and a short-acting one without any suspension. Because of these differences, the insulin action profile for these two insulins is going to be quite different, even though both insulins are classed as intermediate-acting.
Mixed insulins cover a wide range as they can be animal origin, r-DNA/GE/GM origin or analog insulins. The non-analog mixed insulins are made up of intermediate-actingNPH/isophane insulin and short-actingR/neutral. normal insulin. The analog mixes are made from intermediate-acting protamine-suspended analog insulin (suspended similar to NPH/isophane insulin) and fast-acting analog insulin. They can also vary in the fraction (amount or percent) of the two types (R/neutral and NPH/isophane) of insulin used to make a non-analog mix, and in the percentage of fast/rapid-acting analog insulin and slower-acting protamine suspended analog insulin.
For some reason, those in the US choose to list the slower, NPH/isophane based insulin fraction first, such as Humulin or Novolin 70/30. The rest of the world gives the faster insulin top billing and the result is 30/70. Regardless of how this is written, it means that the insulin is made up of 70% NPH/isophane insulin and 30% R/neutral insulin.
The most common mixes are 70/30 (30/70) (non analog) or 75/25 (25/75) (analog). There are no currently-marketed mixes which combine insulins of different origins. Eli Lilly's form of beef/pork Iletin and Novo Nordisk's Lentard were discontinued some time ago. Here are the most common ones that could cause confusion:
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