Actrapid is the short-acting insulin. Here are the specs:
Onset: within 30 minutes
Maximum effect: 1 ½ - 3 ½ hours
Duration: 8 hours
So it takes about 30 mins to start acting and the maximum effect is for about 3.5 hours.
Insulatard is the intermediate-acting NPH insulin. Specs are:
Onset: within 1.5 hours
Maximum effect: 4-12 hours
Duration: 24 hours
My doctor told me that the ‘maximum effect’ time is the time for which the insulin will have an effect. So Actrapid for 30 min - 3.5 hours and Insulatard for 1.5 hours - 12 hours ( I take it twice a day for 24 hour coverage).
So I have 2 shots each of Actrapid and Insulatard in a day. My doctor said that once I start Lantus, I could take Lantus once a day and Actrapid twice as usual. He said that Lantus has a much more constant and uniform action than Insulatard NPH.
As for the cost, Lantus is 2-3x costlier than the Insulatard which it will substitute. I am not aware of the cost of the modern equivalent of Actrapid. Let me find out.
And as for the quick reply, I am always online when I am at home. I get instant email notifications when there is activity and I immediately reply.
Insulin affects you at an uneven rate, so more of it is released in the “maximum effect” period, but the full duration for Actrapid is 8 hours and the insulin will continue to have some effect for that full time, which makes it really hard to manage blood sugars. You want your fast acting insulin to as close as possible hit right when the food hits and then not have much of a "tail " after your food spikes. So a rapid acting insulin like Humolog, Novolog or Apidra will be completely gone from your body after 3 1/2-4 hours, not hanging around still having some effect on your blood sugar.
If the Actrapid starts action after 30 min you’d probably get the best results if you waited 1/2 hour to eat. I use Apidra which acts in 15 minutes, so I always bolus 15-20 min before eating. Are you using the Actrapid as a mealtime insulin? I’m confused because you say you take it twice a day.
I work online so when I’m home my computer is always up on the table. TuD is definitely addictive.When I first came on here 2 1/2 years ago I barely knew what insulin was, let alone bolus and basal and I:C ratios and correction boluses! I’ve learned a lot here,more than from doctors.
It is still best to split the lantus into 2 shots/day. Can you get a book called “using insulin” by John Walsh. It explains modern insulin therapy in great detail.
The other thing is to possibly change your diet. Meat, fish and non starchy vegetables would be best. Rice and wheat based foods are the worst possible since they are full of starch that turns into blood sugar very quickly.
I am a vegetarian and hence meat, fish are ruled out. I do take in a lot of green vegetables with rice/wheat, so that the quantity of rice/wheat is lesser. This is the best I can do for now.
When I visited my doctor a couple of days back, he suggested that I could start using Levimir and NovoRapid, which I believe are fairly modern and recent and are much better quality insulins than my old Actrapid and Insulatard. I will be starting the new insulins in a week’s time and I will share how my body responds to the new insulin regimen Keeping my fingers crossed.
When I visited my doctor a couple of days back, he suggested that I could start using Levimir and NovoRapid, which I believe are fairly modern and recent and are much better quality insulins than my old Actrapid and Insulatard. I will be starting the new insulins in a week’s time and I will share how my body responds to the new insulin regimen Keeping my fingers crossed.
My doctor has suggested 1 bed-time dosage of Levemir = sum of the 2 Insulatard (NPH) dosages I have been taking and 2 doses of NovoRapid (aka NovoLog) corresponding to the 2 doses of Actrapid that I have been taking.
But I am still skeptic, uncertain about 1 bed-time dosage of Levemir instead of 2 split dosages as I do with Insulatard. I am worried about the 24 hour coverage since I will be taking only 2 shots of rapid acting insulin - one each before breakfast and dinner. Confused totally since I happened to read in a lot of places that 2 dosages of Levimir is better than 1 consolidated dose.
You are right on the Levemir, most people do 2 shots. I actually do 3 because it doesn’t last for 12 hours for me. If you were able to the Using Insulin book, John Walsh recommends doing basal testing to get your rates set correctly. By doing basal testing, I know how long my Levemir lasts and that I have it set correctly.
Do you know why he doesn’t want you taking the fast acting before each meal?
It is not like the doctor wants me to take 2 shots of fast-acting insulin. The previous insulin that I was using had a longer effect period than most modern rapid-acting insulins and I was taking 2 shots of that. Doctor just asked me to continue with it and add a third shot if needed.
Thanks for the explanation Guruprasa, I misunderstood. I guess the old insulin is the same as what we call Regular here & that lasts for about 6 hours in our system.
Oh, ok, I remember now that you use animal insulins; sounds like your regiment works very differently. I was wondering how you bolused for mealtime without testing but it sounds like you don’t technically use a bolus. Good for you for figuring out what works for you.
