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NPH Insulin: How Can it Help Manage Diabetes?

NPH Insulin: How Can it Help Manage Diabetes?

Neutral protamine Hagedron (NPH) Insulin is a type of medication that is used in the management and treatment of Diabetes Mellitus (DM), a condition that comes about due to poor blood glucose control. If uncontrolled, DM can increase the risk of developing coronary artery diseases and other complications.

What does NPH Insulin do?

NPH insulin works by increasing the cellular intake of glucose in the liver, fatty tissues, and skeletal muscles.

This type of insulin acts on the aforementioned tissues to produce the following effects:

  • Liver – promotes hepatic glycogen synthesis.
  • Adipose (fatty) tissues – promotes fatty acid metabolism leading to lipoprotein synthesis.
  • Skeletal muscles – promotes glycogen and protein synthesis.

In short, NPH insulin works like the insulin that is normally produced in the human body. It does so by increasing the uptake of glucose in the liver, fat, and skeletal muscles, the level of glucose in the blood can be controlled.

What benefit does using NPH insulin have over other types of insulin?

NPH insulin is classified as an intermediate-acting insulin.

There are different types of insulin and they are classified according to the following factors:

  • The onset of their effects
  • The peak of their effects
  • The duration their effects last
  • Their concentration
  • The route which they are delivered (either injected subcutaneously or intravenously)

Taking the factors mentioned above into account, insulin has 3 types:

  • Rapid-acting insulin works in a more narrow and predictable range of time. Its effects may begin as soon as 5 minutes, peaking at around 1 hour.
  • Short-acting insulin which is absorbed into the bloodstream shortly after being administered into fatty tissues. It is useful when used during meals
  • Intermediate-acting insulin is absorbed much slower than fast-acting insulin, but lasts longer. It is useful when taken in between meals, during fasts, and before bed.
  • Long-acting insulin is absorbed very slowly with a minimal peak level in the blood. However, the effects of this insulin lasts throughout most of the day.

Certain combinations of the different types of insulin can also be mixed together in a single syringe in order to get the benefits of 2 types.

When this type of insulin is mixed with regular insulin (a short-acting insulin), it can help control blood sugar levels for a longer period of time.

What are the risks of using this type of insulin?

Patients who take NPH insulin have a somewhat higher risk of developing hypoglycemia (low blood sugar levels) due to improper insulin administration.

This is likely because of inadequate resuspension of the drug. To avoid this, rotate the vial several times until it is uniformly cloudy prior to administering the medication.

When taken at night, this type of insulin typically peaks during midnight, when the body typically does not need much insulin.

This can cause nocturnal hypoglycemia. Alternatively, patients are also at risk of developing fasting hyperglycemia, as the duration of NPH insulin typically does not last until the morning. These effects can be avoided by giving the insulin at bedtime rather than after the evening meal.

Other side effects of insulin intake include weight gain, edema, decreased potassium, skin atrophy or hypertrophy at the site of injection.

Who should take NPH insulin?

Patients with Type 1 and Type 2 Diabetes Mellitus may take this type of insulin, though the dosage may vary according to the blood sugar level of the patient.

Who should not take this type of insulin?

Patients taking NPH insulin should immediately stop taking this medication and consult their physician for alternative therapies if they manifest any of the following:

  • An allergic/ hypersensitivity reaction which can manifest as itchiness and redness on the skin or a rash all over the body.
  • If they have repeated episodes of severe hypoglycemia, which can manifest as shakiness, sweating, chills, irritability, fast heartbeat, hunger, nausea and vomiting, headaches, or sleepiness.

nph insulin

How is NPH insulin taken?

If prescribed by your physician, you may administer NPH insulin subcutaneously via a pen-injector or in a subcutaneous suspension. It is typically injected on the subcutaneous fat tissues around the abdomen and its absorption can be increased by exercise, massaging near the site of injection, and applying warm compress.

This type of insulin may be given once or twice daily as morning and evening doses.

Key Takeaways

NPH Insulin is an intermediate-acting insulin effective in the management of DM; the main advantage of using this medication is that it can be mixed with a short-acting insulin. This provides the benefit of immediate effect with a longer duration of effect.

If you have been diagnosed with diabetes, remember to consult your doctor to determine the best type of insulin for you.

Learn more about diabetes and insulin, here.


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Hello Health Group does not provide medical advice, diagnosis or treatment.

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Written by Gerard Tamayo Updated Jun 17
Medically reviewed by Elfred Landas, M.D.