From West Virginia, USA:
Do you have any information on mixing Humalog, Humulin N, and Humulin R together? I read an article in Diabetes Forecast in 1997 on this, but have not been able to find any other information Sliding Scale formulas.
Eli Lilly has not yet competed formal studies evaluating the stability of mixtures of Regular and Lispro/Humalog, so they cannot yet state that there is no problem mixing these preparations in the same syringe. However, there was a small study published in abstract form by Burge, Castillo, and Schade in Supplement 1 of the journal Diabetes, Volume 43, page 156A called "An equimolar Mixture of LysPro Insulin Analog and Regular Insulin Improves Postprandial Glycemia in IDDM." This study compared blood sugar control using Humalog (Lispro) alone, Regular alone, and a combination of equal amounts of Regular and Humalog. According to this study, the combination of Regular and Humalog produced lower blood sugars after meals than Regular alone given 30 minutes before meals, and fewer low blood sugars after meals than Humalog alone. The authors postulate that a mixture of Regular and Humalog may actually be the ideal mixture for some people.
Another study appeared in the Journal of Clinical Endocrinology and Metabolism: "Prolonged efficacy of short acting insulin Lispro in combination with human ultralente in insulin-dependent diabetes mellitus" by Burge MR, Waters DL, Holcombe JH, Schade DS, Eli Lilly and Company, Indianapolis, Indiana 46285, USA. J Clin Endocrinol Metab 1997 Mar;82(3):920-4 (abstract, full text, PDF).
These articles did not evaluate sliding scales; they just compared various combinations of insulin.
Original posting 20 Apr 1998
Posted to Insulin
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