I think that you and Maya have found appropriate uses for Regular. I would not want to use it exclusively as a meal insulin, however. I’m eating a lower carb diet but not in the 30 grams per day range. I usually eat about 75 grams/day. For me, the long pre-bolus time leaves me open to getting distracted between dosing and eating. There’s a story behind this but I won’t bore you!
If I wasn’t using a pump, I think the ideal insulin supply for me would include Tresiba, NPH, Regular, Apidra, and Afrezza. I would likely use Apidra + Regular for most meals and would replace the Regular with NPH for meals like a holiday steak dinner.
There’s definitely more than one way to manage things as you, Maya and Dr. B. have shown.
I’m so curious I have to ask what is regular insulin??? I’m from ireland, I use novorapid only as I use a pump but I have never heard the term/name regular insulin and I have t1 over 30 years.
Hey @Allyj I belive it’s under the brand name Actrapid in EU and UK.
Despite the name it’s a short-acting insulin with a peak of about 3-4 hours and a range of 6-8 hours while rapid-acting insulin such as Humalog, Novorapid, Apidra and likes have a much faster and shorter range (peak at 1.5 hours, last up to 4).
Hey @Terry4 I’m curious how would you use NPH for large meals?
I used to take it as my basal insulin back in the day. Wouldn’t it be too long to cover a meal? I know it has a more defined peak than the newer kinds of long acting insulins, but would that be enough to cover food without a short or rapid insulin as well?
That would only be for a Thanksgiving style meal with lots of carbs and fat. Chinese restaurant food would match it, too. But I haven’t used NPH since 1987 so I’m sure I’d have a lot to learn. I imagine most of my meals on a hypothetical MDI plan would likely be covered by Regular + a rapid acting analog like Apidra.
I went off the pump last year for three months and used Tresiba, Apidra, and Afrezza and that worked well enought but not as good as the pump for me.
That’s an interesting combination and timing, but if your result was a lower A1C, then it’s good for you !!
But you mention extreme lows, and that may be a result of using both Levemir and 70/30 Novolog which can stay active in your system quite awhile. So when you are more active, you basically need to ‘feed the insulin’, to keep you from going low.
I think that’s why it’s more common to use a long-acting (basal) such as levemir, lantus or tresiba, and then do a fast/rapid acting for meals. So when activity is planned, sometimes cutting down the meal time dosage prevents going low after the activity, and there is less insulin in your system at that time. Doing a calculated meal time bolus for each meal generally provides more flexibility.
For years, I used just NPH and Regular, which were only sold in separate vials. NPH was my long acting, since Lantus, Levemir, Tresiba were not yet available. In the morning, I took NPH+Reg. The Reg covered my breakfast meal. Then no injection at lunch time, since the NPH was peaking about then to cover it. At dinner time I took Reg only, and then before bedtime took a smaller dose of NPH to cover me until late morning the following day.
