One of my biggest complainants about MDI was that it seemed incomplete without the ability to extend boluses. As most experienced pumpers probably know, extended boluses are not just for pizza and pasta, but for delayed protein and fat spikes caused by all sorts of meals. I know many on MDI just take more rapid an hour or two later, but I never found this to be a good solution for a few reasons. It is harder to bring down a spike that is already happening and this was my experience when I tried this. It also requires more attention, to set a timer and to have to stop whatever you’re doing to take another injection which can be extremely annoying. Lastly, sleep is a problem, especially for meals that will spike you up to 6 hours later. I know a lot of people have bad memories of R, but I think this was caused by combining it with NPH and using large amounts of it as a primary bolus insulin, which it isn’t well suited for. What I have found it to be great for though is solving the problem of how to cover protein/delayed fat spikes, when used in combination with rapid-acting insulin.
Yes, I think that’s exactly right. Of course pre-Lantus/Novolog there really weren’t any alternatives so that was the standard, recommended way of using it, and most of us Old Timers’ attitudes reflect that experience. Doesn’t mean there aren’t other ways to do it now, as you rightly point out, and your suggestion seems quite logical. As Duke Ellington said, “If it sounds good, it is good.” If it works, do it.
I agree… I refill humalog pens with R and use it to cover things like pizza, steaks, and peanut butter binges
I see very little faster action with Apidra vs Regular. In fact I have very minimal problem switching back and forth between the 2. The big beneficial change was with changing from NPH to Lantus.
My daughter has tried regular with a good amount of success splitting the dose with 50% regular and 50%rapid for pizza, pasta and grazing type days like Xmas.