December 27, 2006
Insulin
Question from Dallas, Texas, USA:
I have noticed that I sometimes require less insulin as I reach the bottom of the insulin pen. I roll the pen in my hands before injecting, but I am wondering if the insulin becomes more concentrated? Can it also be distributed unevenly and cause variations in insulin response?
What is a normal amount of basal and mealtime insulin (carbohydrate ratio) for a person with type 1 who is not insulin resistant? I notice amounts all over the place in your previous questions.
Answer:
These are good questions!
With regard to insulin in solution, it clearly can become more concentrated at the end of a vial or pen. As much as we like to think of the insulin solution as being uniform, it probably is not. It is helpful to roll the pen and gently move the contents back and forth. The other thing that may happen is a concentrating of the insulin where the diluent may be removed by evaporation during warmer temps.
The ideal ratio of basal to bolus insulin is around 50:50. Patients who are more insulin resistant appear to require much higher amounts of basal insulin.
JTL
