My Endo has now approved me for Humulin-N (NPH), and Humulin 30/70, after I told him I was having problems with lows on the 70/30, but still needed to increase insulin to handle some high numbers.
So how do I combine the two? Was thinking of trying the NPH at night, the long action should cover the high morning numbers.
But then there won’t be a peak to handle eating…
And still using the 70/30 during the day, but trying harder with managing low carb and spreading food out…
Hmmm…
I am using cartridges. I asked and they do have humulin-R available. But only in vials. I don’t know how to inject this… though i guess I could learn. And I’d prefer to work with the doctor than doing something behind his back.
But on the positive, my endo is expecting me to send him email weekly with BS numbers and I can discuss and modify with him if things get weird.
You basically need 2 kinds of insulin, basal and bolus. The 70/30 insulin tries to combine both of those into one. Unfortuantely, it is hard to get good control using those. The basal insulin is your background insulin. Lantus and Levemir are the 2 modern-day basals. Alot of people (including me) prefer Levemir. The bolus insulins are Humalog, Novolog and Apidra. You can also use Regular insulin but it is slower to work and stays in your system longer. The idea behind your basal is you can take it and should not have to eat. You use the bolus when you eat and adjust it according to how much you eat. If you feel like skipping a meal or eating late, your BS should not drop low. Unless you are having some financial issues and having the 2 copays is hard for you, I would ask to be switched - you will be able to get much better control.
I would generally consider this insulin regime (NPH and 70/30) as unworkable. As Kelly notes, you really need a basal and bolus, and for a bolus you need a rapid insulin whose action matches the blood sugar surge you get eating. Neither 70/30, nor NPH really fits that bill. Humalin 70/30 is 70% NPH and 30% R. You can see the differences in the peak and overall times of action in this chart (http://www.diabetesnet.com/diabetes_treatments/insulin_action_times…).
If you must use NPH and R (I realize you are in the Philippines), you might be better served by using NPH to for your basal levels and then R as a bolus for your meals. If you choose to follow a very low carb diet, you may find R works reasonably well. Dr. B actually finds that R does a better job (because of its long action) covering meals that have a glucose load that comes mostly from protein.
As to injecting with syringes and vials, I am sure you could pick that up with little effort.
