[LarryT]

Thought I'd ask for some thoughts on adding a 'fast acting/duration' Insulin to my D treatment. I am currently using 50 u NovoLog 70/30 twice per day. Having some trouble with that regimen in that at night my BG goes low, often (2-3 times per week) While during the day my BG is fairly well controlled until Lunch or after then the 2 hour drop does not work very well.
For my thoughts, the night dose is apparently a bit much and the day dose seems to quit before evening meal time. While a fast acting Insulin would complicate things, I do test fairly often usual 4-5 times per day. Last A1c was 6.9 but previous tests were in the 5.x range and would greatly prefer back into that area

 

[Jeremymc1]

Here is my regimen (not better, just different than yours). I use Lantus as my "foundation" insulin. Meaning that is my long lasting. I then use Humalog (really, the same thing as Novolog) with my meals. While Humalog last up to four hours in the body, it peaks fairly quickly at around 1.5 hours. I typically take it about 20 minutes before my meal to match my food. Depending on what I am eating, I might take it sooner or later than 20 minutes (this does make a big difference in my body).

Where I am a bit confused, is that I have seen a few posts recently stating fairly specific amounts of bolus insulin consumed each day. Mine varies greatly depending on the meals I am eating. If you are taking bolus only twice a day, rather than what is needed before specific meals, it would make sense for it to weaken between doses, thus giving you less control over your BGL. With that said, perhaps I am missing something as I am in no way an expert!

Cheers,

Jeremy

 

[LarryT]

Jeremy,

The different insulins are pretty confusing, at least for me! What I take is NovoLog 70/30 and it is considered a basal or 'foundation' insulin. Active for 12-14 hours, while the plain NovoLog is active 4-5 hours supposedly.

Your varied use is exactly what I'm thinking would work better for me to control my times of higher BG during day. Then to possibly reduce my nightly injection 'foundation' amount and avoid lows! Of course my 'best laid plans' would be subject to thoughts from my Doc. I do not see an Endo, but the Family Doc does have considerable experience. About 3 years back I tried Levemir along with NovoLog and found that combination to not work well for me, while others have great luck.

 

[BamaLou]

Jeremy,

The different insulins are pretty confusing, at least for me! What I take is NovoLog 70/30 and it is considered a basal or 'foundation' insulin. Active for 12-14 hours, while the plain NovoLog is active 4-5 hours supposedly.

Your varied use is exactly what I'm thinking would work better for me to control my times of higher BG during day. Then to possibly reduce my nightly injection 'foundation' amount and avoid lows! Of course my 'best laid plans' would be subject to thoughts from my Doc. I do not see an Endo, but the Family Doc does have considerable experience. About 3 years back I tried Levemir along with NovoLog and found that combination to not work well for me, while others have great luck.

Hi Larry,

It seems to me, and of course I am not a doctor, but you might do better if your doctor switch you to Lantus or another insulin like it, in place of the NovoLog 70/30. If I remember right, a 70/30 mix is like taking 70% of a long lasting insulin and 30% of a fast acting insulin at the same time. I was on a 70/30 mix years ago. That 30% part will have a peak time of a couple of hours after taking it and might be what is causing the hypos. A long acting insulin that has no peaks, like Lantus might work better. Again, just something to discuss with you doctor... and there are others on this forum way more informed than I am... I may be way off the mark.