Changing insulin to NPH

[beckysalvage]

Hi all,

I am a T1 diabetic, and have been for 25 years. I am now well controlled (HbA1c is around 6.8%) and I currently use Humalog Lispro and Glargine for my management. Having done a DAFNE course I carb count for my quick acting insulin.

I have recently moved abroad, and here you have to pay for some types of insulin, including Humalog and Glargine. On the NHS-type system here I have been told I can get "quick acting insulin" (I am assuming some sort of actrapid) and NPH for long acting, which I have never heard of. Has anyone any experience with changing to these insulins? I haven't changed my insulin type in about 15 years so I have no idea whether it is worth it to change. I can afford financially to stay on Humalog and Glargine, but it means less money for exploring a new country, plus I already pay about $200 a month to the NHS-type system here so it seems ridiculous to not use it.

Thanks for any advice,

Becky

 

[tigger]

According to Wikipedia nph is isophane ie the long acting version that goes with actrapid/ neutral. Depending on when you were diagnosed it might have been called monotard or insulatard. Until last year when I got a pump I used porcine isophane and neutral with a regime based on the old 2 injections a day.

Try and get some trade names and maybe you'll get more responses. In the meantime the questions you may want to consider might include :

1. If you use mdi are these insulins suitable for your regime?
2. What are their onset times, duration and peaks?
3. Are there any reports of bad reactions to them? Or other side effects you should be aware of?
4. If you're female and of childbearing age are they safe to use in pregnancy?
5. Are they available in the delivery method you need eg cartridges or vials?
6. If you try them out how easy/difficult will it be to switch back to your current insulin?

Good luck.

 

[tim2000s]

Hi @beckysalvage , NPH insulin and Actrapid are the old insulins that were used on MDI (i.e. when I first started MDI, I used Insulatard twice daily and Actrapid for meals). The below graph explains it:

Actrapid is considered to be a regular insulin and obviously NPH shows as pink on the graph. The key difference in what you're used to and what these do is that NPH has a very clear peak that Lantus and Levemir have less of (although not as flat as this makes out), and that Regular (Actrapid and Humulin-R) peak a lot later than the faster analogues.

Practically this means you'll need to basal test when you first move on to NPH and you'll need to inject much earlier with the Regular.

If you think you can manage with the way these insulins work, then use them. Personally, I'd not want to go back to NPH due to the rather high variability in absorption that it tends to have, but that's not vastly different from Lantus, so if you are okay with Lantus, you may find that NPH works okay for you. I'd also not want to going back to the level of planning timing of eating that Actrapid requires, but again, you can always try it and see how you get on!