Hi
@Barkingmad2, As a T1D of 52 years, not as medical advice or opinion: I have been prescribed insulin similar in effect to Humulin M plus later Novorapid and a long acting insulin with similar effects to Lantus insulin
It sounds like you were prescribed a regular, fixed dosage of Novorapid and Lantus which is not how most people use it. The dose of Novorapid is usually tailored to deal with the particular meal. So X amount of carbs requires Y units of insulin.
When on multiple doses of insulin per day
I found that I needed more insulin per amount of carbs in the morning than for lunch or dinner. And I could miss lunch if I was busy by just omitting the before lunch Novorapid dose.
Doctors who encourage their patients and work with them to find the best doses are like fine craftpersons. You learn with them how to fine tune doses of insulin AND food so there is less trouble. Not shonky joints or planing.
Then there is diet.
The more carbs you eat the more insulin you need and the more chance of a mismatch and BSLs going too high or low.
Humulin M is a mixture of insulins. You cannot vary the dose to solve one trouble with blood sugar without affecting the other part of the 12 hours or so. I am assuming you are prescribed it for injection twice per day.
That is before breakfast and before dinner.
Below is a graph of how effective in lowering the blood sugar the Humulin M is over time. The higher the line is on the graph the more the effect on getting Blood sugar down. The following is a bit of guess work based on the Humulin M graph.
Each of us is a bit different in how insulin affects our blood sugars and when so this is also why the following is only a rough draft plan, so to speak. A guess only.
Mostly the blood sugar from a meal rises up to a maximum by about 2 hours after a meal.
You will notice that Humulin M taken just before, say breakfast, only reaches its maximum effect nearer 4 hours so it is late to the party. So you might discuss with your prescribing doctor whether you eat differently, or accept that your blood sugar might rise even higher than on the Novorapid x 3/Lantus x1 regime ? (Novorapid peaks in effect about the 2 to 3 hour mark).
The 4 hour peak of the morning Humulin M might subside slowly enough to see you through a small early lunch.
The other peak of the Humulin is smaller in lowering blood sugar and happens about 8 to 10 hours after injection. That completely misses lunch but might have some small effect for dinner at say 6 pm.
Now that might sound fine and dandy for dealing with daytime, what about the Humulin M taken before dinner? Blood sugars go up before the Humulin M can catch them (again). A dose injected at say 7 pm will peak in its blood-lowering effect about 11 pm when you are likely to be turning in for the night (unless you are a night owl like me)!!
Also that smaller 9 to 10 hours peak threatens to lower your blood sugar about 4 to 5 am. When asleep it is much more difficult to recognise a hypo or low blood sugar event. (and I can vouch for that)!!
Because we do not tend to dine in the middle of the night Humulin M is often prescribed at a smaller dose in the evening. That fits with most long-action part of insulins used in the evening.
If your doctor increases the evening dose of Humulin M3t o do something about that pesky high blood sugar after your evening meal all that might do is makes you more at risk of low blood sugars when you are trying to or are asleep.
I appreciate that
@rochari has adapted back to older insulins but as he points out he has had to be careful with when and what he eats to cater for this change and there can be very little variation. I would bet (if I were a betting man) that he would be taking a supper to try and ward off low blood sugars at night. Certainly when I was on similar insulin way back that was a necessity !!
So I wish you well and I hope your doctor will work with you to get the blood sugars as good as possible.
As prescriber he has that responsibility.
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