brett said:
Yes, twice daily injections only give good results if eating the same amounts at same times as to continually work properly with insulin.
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Just to explain things so as to not mislead, twice daily insulins can vary in their doseage. Most people will inject more of the twice daily in the morning and then less of it later.
People can eat fairly well like 30 - 40g carb at breakfast, 10g snack mid morning, 30-40g carb lunch, 10g carb snack mid afternoon and then give another injection before eating evening meal which can also be varied a bit according to what amount of carb is going to be eaten. Lots of people using bolus/basal give themselves multi injections and still adopt the same way of eating.
As long as people keep to eating the sameish amounts of carb within set time frames and not go overboard, then bg levels stay fairly well controlled and hypos will only happen if they forget to eat when they should or if they do exercise and don't eat or adjust the insulins in hot weather. Now that bolus insulins are available, people can use twice daily insulins and if more carb at lunch is going to be eaten than the usual amount, 1 or 2u of bolus can also be used probably for every 10g carb eaten in excess so its possible to get the best of both worlds. For kids who are young and growing up, twice daily insulins are an option to consider. Even a few units of bolus will enable kids to go to birthday parties and eat whatever is there without sticking to the usual amount of carb that they would need to eat normally, so all is not lost.
The only drawback to twice daily insulins is that over the years, many of the mixtures have been withdrawn because of basal/bolus but some are still available and are probably cheaper to prescribe than analogue insulins and can also offer better stability.