Diabetes mellitus - Type 1
Choice of insulin depends on the needs of the individual patient, considering lifestyle, age, preference and capabilities. Patients should not be changed from the insulin that they are currently receiving without advice from a specialist or a clinician with the appropriate skills and expertise.
Patients commencing blood glucose lowering agents may need to inform the DVLA and their vehicle insurance company. Advise patients to check with their insurer and the DVLA website.
SIGN 116 & 154: Management of diabetes NICE NG17: Type 1 Diabetes
Insulin aspart (Trurapi).
Insulin aspart (NovoRapid).
Insulin lispro (Humalog). Note different strengths available.
Insulin aspart (Fiasp) has a faster onset of action than NovoRapid and may be useful in patients failing to achieve glycaemic control with current fast acting insulin.
Insulin lispro (Lyumjev) has a faster onset of action than Humalog.
Prescribing Notes:
- Type of insulin, device and needle gauge and length should be specified.
- Write the brand name in full to avoid errors such as, for example, administration of Humalog in place of Humalog Mix50.
- When writing prescriptions for insulin the dose should always be written as ‘units’.
- Insulin is available in 3ml cartridges, 10ml vials, 3ml disposable pens. To support environmentally sustainable prescribing, consider reusable insulin pens and cartridges as first line options. The appropriate pen device must be prescribed with cartridges as not all insulin cartridges fit all pens.
- Humalog Junior Kwikpen, Lyumjev Junior Kwikpen and the reusable Novopen Echo devices allow half unit dose increments.
History Notes
30/07/2026
Regional formulary chapter launched.
Insulin soluble human (Actrapid).
Insulin soluble human (Humulin S).
Prescribing Notes:
- Consider rapid-acting insulin analogues that are injected before meals, rather than rapid-acting soluble human or animal insulins, for mealtime insulin replacement for adults with type 1 diabetes.
- Type of insulin, device and needle gauge and length should be specified.
- Write the brand name in full to avoid errors such as, for example, administration of Humalog in place of Humalog Mix50.
- When writing prescriptions for insulin the dose should always be written as ‘units’.
- Insulin is available in 3ml cartridges, 10ml vials, 3ml disposable pens. To support environmentally sustainable prescribing, consider reusable insulin pens and cartridges as first line options. The appropriate pen device must be prescribed with cartridges as not all insulin cartridges fit all pens.
History Notes
30/07/2026
Regional formulary chapter launched.
Insulin isophane human (Humulin I).
Prescribing Notes:
- Type of insulin, device and needle gauge and length should be specified.
- Write the brand name in full to avoid errors such as, for example, administration of Humalog in place of Humalog Mix50.
- When writing prescriptions for insulin the dose should always be written as ‘units’.
- Insulin is available in 3ml cartridges, 10ml vials, 3ml disposable pens. To support environmentally sustainable prescribing, consider reusable insulin pens and cartridges as first line options. The appropriate pen device must be prescribed with cartridges as not all insulin cartridges fit all pens.
History Notes
30/07/2026
Regional formulary chapter launched.
Insulin Glargine (Semglee, Lantus or Abasaglar). Prescribed by brand - Semglee is the most cost-effective at present.
Prescribing Notes:
- Type of insulin, device and needle gauge and length should be specified.
- Write the brand name in full to avoid errors such as, for example, administration of Humalog in place of Humalog Mix50.
- When writing prescriptions for insulin the dose should always be written as ‘units’.
- Insulin is available in 3ml cartridges, 10ml vials, 3ml disposable pens. To support environmentally sustainable prescribing, consider reusable insulin pens and cartridges as first line options. The appropriate pen device must be prescribed with cartridges as not all insulin cartridges fit all pens.
History Notes
30/07/2026
Regional formulary chapter launched.
Insulin glargine (Toujeo). Toujeo is a high strength formulation of insulin glargine with a flatter profile. See prescribing notes for guidance on DoubleStar pens.
Insulin degludec (Tresiba). Note different strengths available.
Prescribing Notes:
- Type of insulin, device and needle gauge and length should be specified.
- Write the brand name in full to avoid errors such as, for example, administration of Humalog in place of Humalog Mix50.
- When writing prescriptions for insulin the dose should always be written as ‘units’.
- Insulin is available in 3ml cartridges, 10ml vials, 3ml disposable pens. To support environmentally sustainable prescribing, consider reusable insulin pens and cartridges as first line options. The appropriate pen device must be prescribed with cartridges as not all insulin cartridges fit all pens.
- Toujeo Solostar pens allow dosing in 1 unit increments however DoubleStar pens only allow dosing in 2 unit increments.
History Notes
30/07/2026
Regional formulary chapter launched.
Insulin isophane biphasic human (Humulin M3).
Insulin aspart biphasic (NovoMix 30).
Insulin lispro biphasic (Humalog Mix50). Humalog Mix comes in different mixtures of insulin lispro and insulin lispro protamine, prescribers should ensure the correct mixture is selected.
Prescribing Notes:
- Type of insulin, device and needle gauge and length should be specified.
- Write the brand name in full to avoid errors such as, for example, administration of Humalog in place of Humalog Mix50.
- When writing prescriptions for insulin the dose should always be written as ‘units’.
- Insulin is available in 3ml cartridges, 10ml vials, 3ml disposable pens. To support environmentally sustainable prescribing, consider reusable insulin pens and cartridges as first line options. The appropriate pen device must be prescribed with cartridges as not all insulin cartridges fit all pens.
History Notes
30/07/2026
Regional formulary chapter launched.