Recently, the hospital that provides my Mixtard is running low, so the doctor would like to change me to either Actrapid [Regular] or Monotard [NPH}. I heard they would switch back once the stock is restored. Is that sensible? Is there any formula for the interchange?

I think that you would greatly benefit in terms of blood sugar stability and quite probably metabolic control as well if you stopped using Mixtard and began a regimen using Regular insulin at meals with Monotard at bedtime. In my experience, this approach is greatly superior when compared to the mixed insulins in achieving more stable blood sugar levels over the 24 hour period. If possible, try your best not to go back to Mixtard.

MS

[Editor’s comment: Mixtard is Novo Nordisk’s brand name for their mixtures of fast-acting (soluble or Regular, brand name Actrapid or Novolin R) insulin, mixed with intermediate acting insulin (Isophane or NPH, brand name Insulatard and Protaphane) insulin. It is available in different ratios of R to N. Your doctor, diabetes nurse, or pharmacist can easily teach you how to mix the two products to get better control of your diabetes than by using premixes. Or, as Dr. Songini suggests, you can get even better control by splitting the shots into a basal/bolus insulin program.

WWQ]