Which type of insulin is least likely to cause hypoglycemia if a meal is skipped?

Long-acting insulin is designed to provide a steady release of insulin over an extended period, usually up to 24 hours or more. This gradual action helps maintain a baseline level of insulin in the body, which is less likely to lead to rapid drops in blood glucose levels, especially if a meal is skipped. Since long-acting insulin does not peak in the same way that rapid-acting or short-acting forms do, the risk of hypoglycemia is significantly reduced in situations where meal timing is not aligned with insulin administration.

In contrast, rapid-acting and short-acting insulins are designed to manage postprandial (after eating) blood glucose spikes. They have more pronounced peaks of action, meaning that if a dose is taken without eating, there is a higher chance that blood sugar levels might drop too low, leading to hypoglycemia. Intermediate-acting insulin falls between these two categories but also has a risk of causing hypoglycemia if meals are not consumed as planned due to its peak action times. Thus, long-acting insulin presents the lowest risk for hypoglycemia in the event of a missed meal.