From Plano, Texas, USA:
Our son was diagnosed at age 4. He is currently 11 1/2 years old. Our doctor recently (one month ago) moved him to lispro insulin (Humalog) instead of Regular.
He is on three shots a day: morning Humalog and NPH, dinner Humalog, and bedtime NPH. It seems that, at least for now, we don't notice much difference, except that when he takes his morning shot of Humalog and NPH, the NPH is not as effective in late afternoon as it used to be. Have you heard of any cases where Humalog given in combination with NPH diminishes the potency of the NPH?
I have had patients with experiences similar to what you report. I think the most likely explanation is that the Regular before breakfast was continuing to work in the afternoon overlapping the time when the NPH was working. Humalog has a much shorter time of action than Regular, so probably you have less total insulin working in the afternoon when you stopped the Regular (which can last up to 16 hours). I would discuss with your physician possibly increasing the NPH to compensate for this.
Original posting 7 Nov 96
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