50/50 Humalog

[Daz]

Is anyone else on 50/50 Humalog, ive just been put on this (40 units in morning and 60 in evening) but my sugars still seem to be quite high !!! (12's 17's etc)

I was on 60 Glargine at night and Humalog with a meal (10-20) but Im rubbish at compliance and kept forgetting to take my humalog during the day and was having to correct at bedtime with a dose along side my glargine.

So my Docs going back to basics with 2 injections a day, but I dont think its working !!!

 

[LittleSue]

I think you mean Humalog Mix 50? If by 50/50 you mean big doses of Humalog morning and evening I wouldn't expect that to work for a type 1.

When changing to a new insulin the initial dose is always an educated guess, whilst some people will need a much bigger dose compared to the old insulin, others will need less. So medics are (wisely) cautious. You may need to adjust the dose significantly before you find the right level.

Bear in mind a mixture has a fixed ratio of short to longer acting insulin, so unless you're happy to bolus with extra Humalog as well, your carb intake will need to be more consistent from day to day than if you were adjusting Humalog and Glargine doses separately.

Sue

 

[Katharine]

You need to match your insulin to your meals.

What are your blood sugars doing before your meals, at bedtime, at 2-4 am?

What are you eating and when?

 

[Daz]

Im a bit confused, I used to be on 60 unit injection of glargine at night then 3 x 10-20 unit injections of fast acting humalog with meals.....

Now Ive been put on a 40 unit injection of Humalog50 in the morning and a 60 unit injection of Humalog50 at about 6/7 oclock after my Tea.....( ive only been told to have 2 injections a day)

Is the morning one suppose to cover both my breakfast and lunch ? or am I only to have 2 meals a day (breakfast and Tea).....? it dont make sense.....can some one explain ???? :?

 

[Katharine]

Good question. Shame more people on biphasic regimes don't ask it!

What I think is necessary is to match the biphasic to your basal needs AND match the fast acting bit to your meals.

This means that your lunch and bedtime snacks must be VERY LOW CARB. There is no insulin dedicated to covering these meals.

So for lunch and bedtime snack you should eat, meat, fish, eggs, cheese, low starch veg, fats and nuts only.

At breakfast and evening meal you can of course have all the lunch/bedtime stuff but you can include moderate amounts of fruit, legumes, grains, milk, sugars ....(carby stuff).

You can adjust your breakfast and evening meals to your blood sugar results.

I think your doc has come to the conclusion that you would be better off with fewer jags as you don't seem to be able to motivate yourself to go the whole hog with multiple daily injections.

We can certainly help you get the best match for you but if you think you can go for a more sophisticated insulin regime you can certainly eat more carbs and still have good blood sugar control.

One thing is for sure you can't have normal blood sugars without either a disciplined diet or a disciplined insulin regime. The discipline must come from YOU. There is no way we can make you have normal blood sugars. You must want to have normal blood sugars.

I think that it help to have a very clear picture in your mind of what will happen if you do have normal blood sugars and what will happen if you don't have normal blood sugars.

 

[Daz]

Its strange stuff this Humalog50 !!!,

After having tea at 7pm I took 60 units, when I tested my sugar before bed (12.30am) it was 5.9 to which I thought great !!! I had a gulp of milk (about 1/5th of a glass) just to make sure I didnt go any lower in my sleep and took my various pills with a drink of sugar free orange squash and went to bed......

I woke up this morning at 9.00am, tested my blood and it was 15.7 !!!!! whats going on ???, Im not sleep walking/eating cos I aint got owt in...lol

 

[iHs]

Its strange stuff this Humalog50 !!!,

After having tea at 7pm I took 60 units, when I tested my sugar before bed (12.30am) it was 5.9 to which I thought great !!! I had a gulp of milk (about 1/5th of a glass) just to make sure I didnt go any lower in my sleep and took my various pills with a drink of sugar free orange squash and went to bed......

I woke up this morning at 9.00am, tested my blood and it was 15.7 !!!!! whats going on ???, Im not sleep walking/eating cos I aint got owt in...lol

Hello Daz

I query the amount of Humalog Mix 50 that you are using before your evening meal. 60 units is quite a lot. I think that your dosages should be 60 units before breakfast and then 40 units before evening meal. The 60 units should see you ok for breakfast, snack?, lunch, snack?,. With twice a day insulins you do need to feed your insulin. I used Humalog Mix 25 for about 20 years so I know how it works lol. If you inject 40 units before evening meal, this should see you ok for the meal and a small bedtime snack (depending on what yr bg is) but because you havent injected so much, it wont make you go hypo which is what I think has happened to you through using 60 units. Biphasic insulin takes about 3 hrs to reach its peak unlike the fast rapid acting insulins. Just make sure that you test your bg as much as you can (5-6 times?? lol) and then you will be able to sort out your doseages, carb intake to suit what your bg levels are.

 

[Daz]

Ive been told to inject 40 units in a morning and 60 at tea time by my doc, what you have said makes sense but why has my sugar levels gon up so much in the morning if you think I took too much ?

 

[iHs]

Hi

Because your liver has stepped in to compensate for the excess insulin floating around and has shoved out some glucose Maybe if you had drunk a full glass of milk before bed the hypo (if that is what you have had) would not have happened and you would have woken up with an ok bg level instead of 15 lol.

I hope you have still got some fast acting insulin available in your fridge that you can use as a bolster to get your bg down if your bg levels have gone up the wall. If you havent, then youve just got to increase the morning jab up a few units or eat bacon and eggs lol.

Try tomorrow turning your insulin doseages around - 60 units morning, then 40-50 units (depending on what you are eating carb wise and what your bg level is) and then see how you go.

You might be surprised to know that when I used Humalog Mix, my bg level was on about 12 before bed but I always eat weetabix and milk and woke up in the morning with a bg of 3-4 lol. If I didnt eat, I would be off with the fairies come 3am.

 

[Daz]

Still cant make sense of this bloody stuff, Seems to me like its taking a backward step and may even do mor harm than good.....

So, Ive gone back to my usual regeem, 60 Glargine and Humalog with meals, Im just gonna have to remember to take the pen with me all the time, At least my readings seem better like this which has got to be a good thing.....

Also been reading up about Novolog which is suppose to work faster than Humalog (with Novolog) peaking just after an hour to Humalogs 2 hour, so might ask about that next week.

 

[iHs]

Still cant make sense of this bloody stuff, Seems to me like its taking a backward step and may even do mor harm than good.....

So, Ive gone back to my usual regeem, 60 Glargine and Humalog with meals, Im just gonna have to remember to take the pen with me all the time, At least my readings seem better like this which has got to be a good thing.....

Also been reading up about Novolog which is suppose to work faster than Humalog (with Novolog) peaking just after an hour to Humalogs 2 hour, so might ask about that next week.

I'm sorry that you are not getting on too well at the moment using Humalog Mix. It does take a while in sorting out your carb intake and correct insulin dose to suit what your bg levels reveal.

I was wondering if you have been eating specific quantities of carb every 2-3 hrs or have you been eating just 3 meals a day. For sure eating little and often is the way biphasic insulin works best.

As well as Novolog, do have a look at Apidra too. It has a very fast onset of action.