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From Briarcliff Manor, New York, USA:

My eight year old son was diagnosed with type 1 six months ago. Do you have any information on how a cocktail of NPH, Regular and Humalog works? According to an [an insulin manufacturer] there have not done any clinical trials on mixing the three together.

For the past few weeks (and with my doctor's consent) I have been giving him a morning "cocktail" of NPH, Regular and Humalog to help avoid mid-morning highs (200-300 mg/dl [11.1-16.7 mmol/L])) and have a pre-lunch reading preferably below 140 mg/dl [7.8 mmol/L]). We use a sliding scale with 6 units of NPH, 1.0-2.0 units of H and 0.5-1.0 units of R. The highs have been a bit better, but, many times, my son goes low before lunch (in the 60s mg/dl [3.3 mmol/L]). It is my understanding that NPH mixed with Humalog can delay its onset, therefore would I be better off taking the R out of the morning cocktail since the Humalog is not kicking in until a bit later anyway?


I am unaware of any studies done that involved large numbers of patients who mixed the insulin as you do. If you are having success mixing it this way, I would not necessarily change. I would suggest, however, that it is going to become difficult to tell which insulin is providing a benefit to your son when you mix three insulins together. Whichever way you decide to mix insulins, I would discuss it at length with your diabetes team and utilize them frequently to assist you in making changes to provide for your son's needs.


Original posting 29 Nov 2000
Posted to Insulin


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Last Updated: Tuesday April 06, 2010 15:09:16
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