Ok.
I just found out that my chemist sells humalog and that they will sell it to me without a prescription.
I am currently using Humulin 70/30 daytime and Humulin-N at night. My endo only wanted me on human insulins as I will be trying again to have a baby.
Although Humulin-R (fast acting) is available, it is only available in vial, not pen. I like the ease of using the pens as opposed to insulin needles etc. (actually have only ever used pens).
So, I am prepared to do this myself. Is it possible to use the Humulin-N as the basal (I haven’t had any obvious problems with this during the night)? But I don’t like the 70/30 as I have to eat to the insulin and I do get lows on this from time to time.
Can I combine the Humulin-N as my long acting insulin, with Humalog as my fast-acting meal-time insulin? I would have to work out things like basal insulin requirements, and carb insulin-ratios, but then would have the flexibility of eating what and when I want (within reason) and covering it with insulin.
Considering I want to start training again for triathlon / to dramatically improve my fitness levels, I think having more flexibility with what, when and how to eat would be liberating.
The Humalog is just a rearranged insulin molecule. You can use it in conjunction with the NPH. The only real differences between the two is that the analog has a faster onset and quicker peak and clears from the system faster than the Humulin. You can get it OTC? How much does it cost over the counter? Are you an enlightened Canadian?
Humalin R is not the same as Humalog. Humalin R is what many people refer to as “Regular insulin”. It is slower acting than Humalog, but probably faster that the 70/30 (plus many people just don’t like the unpredictability of mixed insulins).
I think that it is fine to use Humalin-N for your basal and Humalin-R for the meals (but it takes 30-45 minutes to start acting – so there is still a longer wait than with Humalog). Can you check with your endo at least?
I actually prefer syringes to pens. The syringe fit neatly in my meter case. So I always used that instead. You might give it a try and see if you can get used to it.
The biggest difference you will see from making this change will be in the amount of carbs you can eat at breakfast and dinner. In a sense you will be doing your own “mixing”. 70/30 insulin is 70% NPH insulin and 30% Regular insulin. Since you will be still using the NPH as your basal you will essentially be switching the Regular for the Humalog and possibly be adding some additional mealtime insulin if you give Humalog at dinner. You are still going to need plan your Lunch around your NPH dose you give in the morning. So here is how it breaks down:
Whatever your morning 70/30 dose is x .70 (this represents the 70% for NPH) = Your new NPH dose in the morning
Whatever your morning 70/30 dose is x .3 (this represents the 30% for regular)= Your morning Humalog dose.
You would take your same NPH dose at night and potentially give some Humalog with your dinner based on the carbs you are eating (I am afraid the only reason you haven’t been going low at night is because you do not give any insulin that is meant to “cover” your dinner with your current regimin so be careful with giving Humalog with dinner and/or reduce your current NPH dose if you do give Humalog with dinner). The only main difference between the above regimin and what you currently do is you would see a fater rise and less of a tail assosiated with your breakfast insulin (you may also have the flexibility to eat more if you carb count and adjust your Humalog dose based on that) and you would see similar benefits with dinner if you give Humalog with dinner.
Your best bet would be if your chemist could get you some Lantus or Levemir so you had less of a peak associated with your “basal” which would then give you even more freedom.
Just to clarify: What you can buy – is it Humalin-R or Humalog? These are two different types of insulin and it would be important for you to know as Humalin-R starts acting more slowly and lasts longer than Humalog.
I am currently on essentially a Humulin NPH/R regime. Humulin R is an insulin that is identical to human insulin, but has been produced by using a genetically altered bacteria (Recombinant DNA engineered). Humalog is a form of insulin which actually has a slightly altered molecule, so while it “acts like” human insulin, it has some slightly different properties.
I take N as a basal by injecting twice a day, once at 6a and then another dose at 10pm (my evening dose is 50% higher than my morning dose). I actually need much more insulin overnight, so at least where I am now, N works better than a flat basal. I am then using Humulin R for a bolus.
In my case, this NPH/R regime has worked out pretty well, I eat very low carb and have remaining insulin production which means that I can achieve reasonably tight control.
I live in Houston, Texas. I can buy the Humulin-R over the counter, without a prescription; for a cost of $24.88 per bottle; it is NOT available in the pens. I take Lantus 60 units in the morning; and then I take Humalog usually 20 units before each meal. I have tried to count carbs, but I just cannot do it. So I am using a blind Insulin:Carb ratio. Then at bedtime I take 45 units of Humulin-R. If I do not take the nighttime dose of Humulin, then my blood glucose is in the range of 250 to over 300 in the mornings. But with taking the Humulin-R at bedtime, my
blood glucose is about 80 to 85. The Humalog KwikPens are very expensive; they average almost $50.00 per pen; about the same as the Lantus. Last year the pharmaceutical company that makes Lantus took in over 4 billion dollars, just from the sale of Lantus alone. So finding a cure is not cost effective for them; and as we know, the pharmaceutical companies run the world.
