My brother-in-law has had type 1 diabetes for 24 years. He used beef/pork insulin for 23 years and never had problems with hypoglycemia. His doctor changed him to human insulin (Reg/NPH) last year. (He had eye complications.) Since then, he has had many lows and has started to develop unawareness. Ironically, his A1c is 7.1%. What is different about the human insulin? Any suggestions? His wife and children are very frightened.

We have received anecdotal reports of increases in hypos using human insulin, but, when actually scientifically researched, it isn’t true. My personal experience is that human insulin has a bit shorter time of action. Are the hypos related to the timing of Regular insulin? If so, use Humalog. One hypo seems to beget another, that is, you are at increased risk to have a hypo if you’ve had an earlier one. Maybe it’s time to think about a more intensive pattern of care: a pump?

LD

[Editor’s comment: It may be that his insulin needs adjusting. Be sure that he is monitoring frequently. Better yet, have him ask his doctor about using the The Continuous Glucose Monitoring System to establish a pattern of control. This information will then allow your brother-in-law and his diabetes team to find a better treatment plan. If he is not currently being followed by a team specializing in diabetes care, I would strongly suggest that he find one.

SS]