These insulins are a suspension of insulin crystals and so form a cloudy fluid when prepared for injection. This cloudy fluid has to be mixed well before drawing up, as the insulin particles settle to the bottom of the bottle.

Protaphane HM (Isophane insulin NPH)

Protaphane has a moderately slow action.

This is a Human Isophane. Protaphane may start to have its effect within 1 1/2 hours of the injection and has its maximum effect from between four to twelve hours. Activity fades rapidly after twenty hours. For some children on small doses it may provide good coverage of insulin through the whole day, but many children need a small addition of quick acting insulin (Actrapid) to the Protaphane to cover the early part of the day. The proportion of Actrapid to Protaphane will usually be about one to three or four, but this varies according to how a child responds to the insulin. For many children the effect of Protaphane is not strong enough through the night and it may be necessary to give an evening injection as well.

A hypoglycaemic reaction due to Protaphane given before breakfast is likely to occur in the late afternoon, but may occur during the night.

Insulatard (Isophane insulin NPH)

Insulatard has a moderately slow action.

This is Human Isophane insulin. Insulatard may start to have its effect within 1 1/2 hours of the injection (sometimes even before) and has its maximum effect from between four to twelve hours. Activity fades rapidly after twenty hours. For some children on small doses it may provide good coverage of insulin through the whole day, but many children need a small addition of quick acting insulin (Velosulin) to the Insulatard to cover the early part of the day. The proportion of quick acting insulin to Insulatard will usually be about one to three or four, but this varies according to how a child responds to the insulin. For many children the effect of Insulatard is not strong enough through the night and it may be necessary to give an evening injection as well.

A hypoglycemic reaction due to Insulatard given before breakfast is likely to occur in the late afternoon, but may occur during the night.

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