May 4, 2002
Insulin
Question from the Netherlands:
Now and then, I find it a challenge to maintain blood sugar control, although most of the time, the measurements are within the range of 4 to 8 mmol/L [72-144 mg/dl] (also after eating). In order to reach those values, I’m eating in two steps — first two biscuits and then, after an hour, bread. I’m also experimenting with multiple injections of NovoRapid into three spots at the same time instead of one. I have the feeling that this helps to control the peak after dinner. I can’t believe this hasn’t been tried before since I don’t think I am the person with diabetes who has a bit of scientific experimental behavior. Is there any information on the net about attempts to reach almost perfect control? Is it worthwhile trying this ‘multiple injection system’?
Answer:
When I think about the concept, I am struck by the fact that each of the injection sites will have its own absorption that might be accelerated or delayed, depending on local factors. The result will the sum of the three sites which may have fewer high/low peaks. It has the disadvantage that not many people would accept it, and it uses up more injection surface area than other schemes. It is my opinion that intermittent injections is still not the perfect way to administer insulin. It suffers from too much at one time and an imperfect means of providing basal insulin.
JTL
[Editor’s comment: You should investigate the possibility of using an insulin pump which has the option of varying the bolus delivery.
SS]
