My 67 year old father-in-law has had diabetes for about five years, and he used to take Regular insulin only as needed, but his doctor has now prescribed 70/30 insulin every night regardless of what his blood sugar is. What is the difference between 70/30 and Regular insulin? My father-in-law is concerned about taking the insulin even when is blood sugar is not high. Could you please help us understand this?

The doctor must feel he needs a longer acting insulin throughout the day. He might want to discuss with the doctor taking the Regular insulin based on his blood glucose levels and just taking straight NPH before bed. Another thought is to seek the advice of another physician. We really do not like to use this combination insulin except in very special circumstances just for the reason indicated — that he may be taking too much of a fast-acting insulin and run into hypoglycemia.

LSF

[Editor’s comment: The main idea behind insulin therapy is to prevent the blood sugar from going high. When the pancreas is working properly, it puts out small amounts of insulin continually to prevent blood sugars from going higher. 70/30 insulin is a mixture containing 70% intermediate-acting insulin (NPH) which begins to work in two to three hours, peaks in six to eight hours, and lasts for about eight to twelve hours, and 30% short-acting insulin (Regular) which begins to work in about 30 minutes, peaks in two to three hours, and lasts for about four to six hours.

It would appear that your father-in-law’s doctor feels that the evening and overnight blood sugars are too high and prescribed this insulin for that reason. The dose is not particularly high for a man your father-in-law’s age and should not pose a problem, but if you still are concerned, I would suggest you ask him to speak directly with the doctor.

It also seems like both your father-in-law (and you) are lacking in diabetes education and would benefit greatly from a diabetes education program. Treatment of type�2 diabetes these days is very individualized and complex. There is a wide variety of treatment options available. I suggest that you and your father-in-law request a referral to such a program. Additionally, I think that a consultation with a diabetologist would be in order at this point to explore all treatment options.

SS]