June 28, 2000
Insulin
Question from Nashville, Tennessee, USA:
In addition to being a very well controlled type 1 myself, I am also a CDE, but have not worked in that field for about 3 years. I seem to remember an insulin company representative saying that 70/30 insulin was likely to contain too much Regular for a person with type 1 diabetes who has no to minimal insulin resistance. 70/30 was initially intended for use in type 2 diabetes.
I have a good friend who is a 38 year old male, who is quite thin, and has had diabetes since age 12. He is on 70/30, and is having severe swings in blood glucose, with (expected) low blood sugars before lunch and at bedtime. I have suggested that he ask his doctor to try him on mixing, rather than the pre-mix, but he is uncomfortable asking this without something in writing that might back up his question. I can’t seem to find anything in my previous teaching materials, or on the Internet. Could you give your opinion on this?
Answer:
There is no perfect mixture of insulins. Ideally, everyone would “mix and match” combinations of insulin to match their own needs. Premixed insulin is convenient for people who have difficulty mixing their own insulin and who are relatively stable (often type 2 diabetics). If your friend is having highs and low, he should definitely speak to his doctor about individualizing his insulin doses.
TGL
Additional comments from Heather Valdes Speer, Clinical Research Coordinator:
Lilly has just come out with a 25% Humalog and 75% NPH in the pen. You can talk to your doctor, diabetes educator colleagues and read about it on the Eli Lilly website. The Humalog changes the action of the mix and may help prevent those pre-lunch lows. This may be a good tool for your friend’s diabetes management.
HVS
