Insulin

are there any people here use regular insulin? it is the only one I can affor

I believe there are a few here. I was thinking maybe @blufickle does, or did. and @David_dns takes it occasionally for certain situations, although I know he prefers Apidra for his bolus insulin in general

What other insulin do you take for your long acting?

(Welcome to the community!)

I also use novolin

I used to take R insulin and N, but after my cancer surgery my new endo switched me to humalog and lantus which I hate with a passion. I know most diabetics hate N and R, but Iā€™ve never had a problem with them. I have more problems with the humalog and lantus than I ever had with N and R. Iā€™ve been on humalog and lantus for over 2 years, I think Iā€™ve given it a fair chance. At my next appointment, Iā€™m telling her I want to go back on N and R. Well keep N when I donā€™t use my pump :slight_smile:

1 Like

I use R insulin for the majority of my self-prepared meals. They are low carb/high protein meals and the slower response curve and lower peak of R lines up better with the way protein is digested.

1 Like

Where IĀ“m from EVERYONE uses regular insulin, its just some of us with insulin pumps that have the need of using other insulins that are of course not provided by our state and health institutions but that we manage to pay :frowning:

Blufickle, what is wrong with Humalog ? Besides it is rather slow.

I used Aspart in the hospital and it was very fast.

1 Like

Iā€™m one of those who felt like getting off R/N was like being let out of prison, but Iā€™m also a firm believer that whatever works for you WORKS so I wouldnā€™t remotely want to impose my views on yours. But two questions: it sounds like youā€™re currently alternating between Lantus/Humalog MDI and using a pump? And youā€™re planning on doing more or less the same when you switch back to R/N? The reason I ask is because it sounds like youā€™re planning to use R in a pump and I thought the longer-lower response curve of R doesnā€™t fit with how a pump is designed to work.

1 Like

Robert, the thing I hate most about humalog is how long itā€™s taken me to get used to it. When I switched from pure beef to beef-pork then pure pork, I didnā€™t have nearly the same problems. Sunday night was a prime example. I knew how many carbohydrates my supper was. So I put that into my pump. I didnā€™t have anything else to eat all night long and my blood sugar kept rising all night long. Because Iā€™m one of a few who canā€™t believe what the CGM says, I have to keep going and checking my blood sugar to make sure it is going as high as the CGM was saying. It wasnā€™t until 2am Monday morning that my blood sugar finally began to drop. This never happened while I was on N and R. But then I wasnā€™t counting carbohydrates either. I was using the sliding scale and exchanges. My A1C was 6.6-7.0, right where we wanted it.

DrBB, I mainly use the pump and the humalog. I have the lantus only if Iā€™m off the pump. Iā€™ll buy a bottle of R and see how it works. If it works, then Iā€™ll tell my endo I want a script for it.

Could someone tell me what regular insulin is. Iā€™ve been lots of different ones in past.
Levemir my 12 hour
Novolog 70/30
Novolog
This is my daily now. Are these regular or which ones are

Here is a link to a chart that shows the various insulin.

insulin comparison

Regular was the original meal time insulin, before they came out with the faster ā€˜rapidā€™ insulin, but is still available today.

The Novolog, which you listed, is considered faster than Regular
Novolog 70/30 is a mix of Novolog and Novolin (NPH), and considered intermediate in itā€™s action. See the chart for estimated times for the insulin to start working (onset), and how long it stays in your system, and when it ā€˜peaksā€™.

But keep in mind that the chart numbers are not precise. There will be variations for each person.

Itā€™s not common to be using 70/30 along with both Levemir and Novolog. Can you describe what your normal routine is ?

1 Like

Ok. Thanks for the chart.
My routine in aggressive more than ever right now.
20 units Levemir morning and night (if having extreme lows skip night)
8 to 12 units of 70/30 Novolog morning and mIā€™d evening
Only correction of Novolog if numbers are high and use sliding.
My doctor wants me on long lasting more so than meal time
First A1C under 7 in 10 years, cried when she started me on this more aggressive treatment but it helps, only issue when active I bottom out for days then my routine is out of wack

A more recent chart at WebMD includes more recent insulin additions such as Toujeo and Tresiba (although strangely neglecting Afrezza).

One of the main things about the R/N routine is that you ā€œeat to the insulinā€ā€“youā€™re aiming to line your meals up with when the insulin peak times occur. So when you eat, the insulin is already starting to kick in. With the shorter acting insulins like Novolog and Humalog the standard training tells you to take the bolus just as youā€™re about to eat, more or less, and the result (if you have carbs in your meal) is going to be a spike in BG that your insulin takes a while to catch up to and rein in. If you have a CGM, what a lot of us do to avoid that (or try) is to bolus further ahead of the meal and wait until you see your BG starting to curve down as the insulin takes effect. That doesnā€™t always prevent a spike but it keeps them much more in range. When you think about it, itā€™s almost like a way of getting the short acting insulin to behave more like the older ones did.

I donā€™t know if thatā€™s what youā€™re doing but the description sounds like what typically happens to me if I donā€™t pre-bolus and ā€œwatch the bend.ā€ Sometimes itā€™s just not convenient and I wonā€™t bother, and Iā€™ll see a spike starting 45 min to an hour and a half after eating that may take several hours to bring down again. It seems to be a rule that reining in a spike is harder than preventing it.*

*Thanks @Terry4

1 Like

ā€¦ preventing it! Sorry to put words in your mouth, @DrBB, but thatā€™s the direction I think you were heading.

2 Likes

Thanks for this. Well, if nothing else these charts always confirm the YDMV rule. I would say, however, having read lots of member comments on other threads that this generalized info in the chart misses the mark for a lot of folks with regard to Apidra and Lantus.

I have heard widely on this forum - and experienced myself - faster onset with Apidra than with either Novolog or Humalog. Novolog peak seems much too short in the chart as well.

Similarly, forum comments and my own experience seem a bit at odds with ā€œno peakā€ for Lantus, which for me had a considerable variation in efficacy over a day. Well, I get that these charts are just generalizations so as always you have to get calibrated with regard to your own body. And even then things can change of course.

DrBB, I always have my insulin before I eat, always. I believe because my body reacts so differently is why I didnā€™t have problems with N and R and do with Humalog and Lantus.

My blood sugar shouldnā€™t have kept going up after I gave myself bolus to cover the higher number, yet it did. This happens about 2 or 3 times a month with no rhyme or reason. If I didnā€™t have a hysterectomy Iā€™d say that was the cause.

Nowadays I find that I use R more often than I use Humalog.

I eat very low carb per Dr. Bernstein, so up to 30 grams of carbs a day and no meal more than 12 grams at most. I eat plenty of fat and protein and noticed that I tend to digest very very slowly, even when eating more vegetables, It seems that with R, given at the right moment and timing, I seem to get a pretty good coverage with this type of food. Timing with R, however is the key as itā€™s much slower and has a longer duration than rapid-acting insulin.

I still like Humalog for corrections but my issue with it as that it seems to take longer than it should to affect me, and once it does, it drops me quite a bit even when I use tiny doses.

I know of one person on a strict Ketogenic diet who takes NPH twice a day and R for all meals and sees great results so it seems like these types of old generation insulins lend themselves better to a more strict low carb diet than the more wide-spread western diet.

You also canā€™t be very flexible with times of meals when using R as it takes longer than rapid insulin and stays in your body much longer as well.

1 Like

Maya, I have used a similar strategy for years, and for very much the same reason. Most of my home meals are low carb and high protein. The action profile of R just plain fits those meals more closely. I have to smile when I hear people diss R as obsolete or old fashioned. It isnā€™t anything of the sort. :wink:

1 Like