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Humalin M3 and Mixtard

R

Rach79

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Hello,

I'm curious about the above types of insulin and am considering changing to either one of them. I am asking the following:-

Is Humalin M3 relatively easy to find in the UK?
Also is there just Mixtard 30/70 or are there other types in the UK?
Has anyone changed to any of the above and if so have they experienced a positive or negative change in their diabetes control?

Thanks people :-)
 
Rach

I'm on Mixtard 30( 30/70) and have been since dx 9 weeks ago (god, is that really all its been :( ). Its a mix of intermediate and a short acting insulin (human insulin I think). It was made in other mixes (ie 50/50) but I think they might have been discontinued.

I currently take 5u am and 4u pm and likely in honeymoon period so dont know what typical doses are post honeymoon though I believe it likely on a mix that your TDD would be lower than combined basal / bolus amounts - though of course I stand to be corrected.

I've had reasonably good 'control' on it and first A1c was 7.7 after 6 weeks and bs came down quite quickly after dx. I have however been managing my diet very strictly since dx.
I still get higher bs than id like for fasting but not been higher than 7 for about 6 weeks - tends to be around 6 on average. I've seen lots of previous pre-mixers slate the mixes due to the poor control it has given some people and whilst this is not wholly the case for me, it certainly doesnt allow for much flexibility.

Risk of hypos appears to be problem(ive read for others too) and whilst it is possible to get a pattern of sorts, its not always possible to predict things though sure you could say that with all insulins, i suppose. After a while you do get a flavour and im not sure about other regimens but the drops can be quick for me. Ie tonight i tested 4.4 before dinner and knew that if i injected and then waited half hour (like you are meant to) then i would be hypo for def. Consequently need to snack to ensure this doesnt happen but you will learn when this is likely.

As you cant control the dose, you cant really control post prandials without being very rigid with diet IMHO and as you have a set dose if decide to eat more carbs/ more in general on one day/meal time than another, it will show in your bs.

Benefit of course is that you only need to inject 2x daily. ONe DSN has said to me not to test post meal as there is no point on this kind of insulin but I know others that do and have established a pattern of what effects them. Presumably you may already know this for yourself.

HOwever, most people on a mix eventually move to b/b i believe though im not sure if through need for flexibility or for better control.

Lib
 
Hi Lib, thanks for your advice. I actually find on the insulin I'm on (which is Novarapid day and Lantus night) that I still have to plan my meals in advance. I dislike having to do this as I can have sudden urges to eat something really sweet or savoury (but of course not adjusted my Novarapid) so it means I have to gauge how much extra insulin I can take. For instance I knew I was having sausages and mash for tea tonight with a couple of glasses of wine. However then my bf got some chocolate out and I just thought 'I HAVE to have that chocolate' so I therefore have it and take extra insulin. I feel no matter what insulin I'm on I have to plan somehow and if I am likely to have an urge for say roasted chestnuts, a cheese and ham toastie or sweets then I should plan ahead regardless. So, I figure I can still do this but with different types of insulin and inject less often. I currently inject roughly 3 to 4 times a day with my two types of insulin but if BG is high then I can go up to 5 or 6 injections to try to remain in good control. I feel this is too much for me and lipodystrophy (scarring of tissue) has set in. The balance I'd like to achieve is finding an insulin that suits me and at the same time managing to curb cravings but not miss out on say the spontaneous decision of a friend or host to cook a snack and me missing out due to improper planning. I am trying to conclude which insulin is best for my type of eating. Sometimes I will crave a tasty snack, whereas other times I simply do not want to snack and I feel that if I take the same insulin - I have to snack for fear of a hypo so it means I eat when I don't want to in order to not have a hypo and I don't eat when I want to to avoid a high BG level after eating. It is very difficult.

Lib - with your BG's being 4.4mmol or say below 5mmol before a meal - I would say to not wait half an hour but more 15 minutes. I would also test before mealtimes but that is only because I can gauge better and because I'm used to doing this so would advise this for others. I used to be on Mixtard 30/70 ten years ago and have researched this insulin a little bit and it says you can inject between 15 - 30 minutes before a meal. Therefore if your BG's are hitting the 4 to 5mmol mark - at an estimation I would say 15mins is fine. However if they are more towards the 6 to 7mmol mark - I would say 30 minutes is ok to avoid the high BG after eating. You can be a little bit flexible with the injection times. It is difficult for me to remember what my BG's were at during my short period on this insulin. Also I can't remember why I came off the insulin. I could possibly discuss with my diabetic clinic - although their records are a bit sketchy (without going into boring detail).

Anyway - I feel the very fast acting (Novarapid) I'm on sometimes gives very erratic BS (or BG) levels and it is difficult for me to predict both what my BG is before and after a meal as it can vary from one day to the next. The night insulin (Lantus) seems to work quite well and I have the hang of this some of the time but not others. I am interested in different doses of Mixtard not just 30/70 and also this Humalin M3 as I think it is possibly more closely related to that of how natural insulin might be within the body should I not be diabetic. However I am unsure?
 
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