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Insulatard

WhitbyJet

WhitbyJet

Well-Known Member
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1,597
I am occasionally looking after a woman, type 2 diabetic. She is injecting Insulatard twice a day, 25units in the morning, 10 units evening.
She is testing around 5 times a day, when her bg goes down to around 4.5 she eats something to bring it back up to around 6.5 or 7.
I must say that she doesnt seem to eat all that much, average of 50 - 70 carbs a day.
My question is would she not be better off to just take a fast acting insulin to cover the food that she eats, instead of needing this Insulatard 24/7?

She is under care of her GP, she has never been to a diabetes clinic. Would be grateful for your thoughts on this matter, I know next to nothing about insulin.
Thank you in advance.
 
I don't know much about this sort of insulin either but it's possible that the lady produces lots of glucose from her liver. Some people with T2 have a lot of insulin resistance in the liver which causes this (metformin works partly to counter this) The background insulin can help control this. I know that some people now use lantus, alone in this way
Insulatard has a very peaky action though (see graph on link) http://www.emrn.org.uk/documents/Insuli ... s_17_8.pdf and it lasts for 14-16 hours so when you inject twice a day there will be times when there is more active insulin in the body. If these peaks coincide with meals they can 'cover' some of the meal... you say that she doesn't actually eat much.. As with other older regimes I think it works best with regular meal times and consistent amounts of carbs/food.
I think that some people begin to realise that there are periods in the day that they regularly go low on this type of regime .. so it's better to have a planned snack at that time.

what's amazing is that not so long ago, (well actually quite a while ago but within my lifetime) is that many T1s including children used one or two injections of long or intermediate insulin a day . One of the reasons that some had very inflexible regimes.
 
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