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October 23, 2002

Daily Care

Question from Mumbai, India:

My wife currently on a four injection regimen involving Regular insulin before meals and NPH at bedtime. Her blood sugar control is not bad, but I have a feeling that it could be better with Humalog instead of Regular pre-meal and Lantus at bedtime. Am I correct? In switching from Regular to Humalog, can I substitute unit for unit?Is Lantus available in a pen device?


I agree with you that Lantus (insulin glargine) plus Humalog is a very good regimen, and I very often substitute the Humalog unit-for-unit. The only exceptions would be if you think the Humalog dose will be less than Regular because of lows after meals or if patients are not injecting the Regular 30 minutes or more from the meal. If patients are injecting Regular only a few minutes before the meal, they may get by with less Humalog than Regular insulin.

Lantus is available in a pen device in Germany and the UK. (In the USA, it’s presently only available in 10-cc vials.)