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Types of Insulin available?!

S

suzannelatta

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Hi All

Just wondering fi anyone could give me advice... My daughter was diag in May 08 and sugars stil are not great hardly ever beloe 10 averagin the last wile between 10-15 even though we are sticking to exchanges. shes on Mixitard 30 at present twice daily 42 in am and 22 at pm. NovaRapid for emergencys. Hb thingy at 8.1.
she hating the no lie ins cuz she has to get up to do her jag and to eat - typical teenager!
anyone got any advice please?
 
Have you considered MDI?

This is when you take two different insulins.

A basal insulin - which covers you for when you're not eating, usually Lantus or Levemir, they're marketed at 24 hour insulins but i've never heard of it actually lasting 24 hours, some people split the dose so they take two injections of background a day.

Then you have the Bolus insulin, to cover for meals and snacks. You have an insulin to carb ratio, so you need to know how many carbs you're eating, for example, if you ate 20 carbs, you would take 2 units of insulin IF your ratio was 10g Carbs to 1u Insulin. There are a few bolus insulins available, one of which is NovoRapid. Humalin S is another (i think it' S, someone will correct me if im wrong). I've always used NovoRapid.

MDI gives you a lot more freedom than mixtard, but it does mean more injections. If you want to skip a meal you can, if you want to lay in you can (depending on when you take your basal injection). You should also find that the essential snacking between meals becomes unessassary as well becasue if the ratio and basal rate is good then there's no excess insulin in the system to cause a low.

Failing that, you have pumps, which use only fast acting insulin. It's connected to you 24hours a day 7 days a week and delivers tiny amounts of insulin every 15 minutes or with a basal rate, then you just give a bolus with the push of a few buttons for meals. However you usually have to have tried MDI and be unable to gain good control or get your HbA1c below 8.5%, or have a lot of hypo's to be considered for a pump.

I would think MDI is you're best option here, but it will mean 4-5 injections a day + corrections.

Hope this helps!
 
Humulin S, is a soluble insulin, which is more of a mid acting insulin as you need to inject it about ½ hour before you eat you meal… but does pick similar to quick acting insulin at about 2 hours and gone by around the 4 hours mark..

Soluble insulin’s (insulin’s that require to be injected ½ hour before meals)
Actrapid
Hunulin S
Hypurin Porcine Neutral (animal insulin)

Quick acting insulin’s (that is injected prior to eating)
Humalog
NovoRapid
Aipdra

N.B with Humalog and Novorapid, take about 10 minutes to start to work, peaks around the 50 – 90 minutes, and can effect BG’s for 2-5 hours after injecting… Apridra is a lot faster and doesn’t is general used with in the 90 minute mark

Long acting Insulin

Levemir (Detemir)
Lantus ( Glargine)

These are portrayed as 24 hours insulins, the Lantus peaks slightly but the profile is a lot more even and longer before tailing off, Levemir actuall starts to tail off a lot earlier…

Some as my husband found that he can inject the long acting once a day, and it works.. But I found that I couldn’t get it to work so had to spilt to a pm and am injections

There is another group of insulin’s (which are cloudy and needs mixing before injecting) these are normally injected 2x daily, so are really a left over from days where about the only regime was 2x daily injections and a strict food regime..

These are

Insulatard
Humulin I
Monotard
Hypurin Porcine Isophan (animal insulin)

You daughter would more likely find swapping to the basal/bolus regime would give her a lot more flexibility, so that she can have that much wanted sleep in, also being more able to decide the timing and amount of what she eats..
 
Hi Suzanne&Shannon,
My son was on mixtard20 a few yrs back with novorapid for emergency use, then they took it off the market and although we struggled and changed insulins about 4 times, looking back they did us a favour. The best way to go is basal bolus, it gives your child so much more freedom. Andrew is on 19units of Levemir at night and does carb counting with meals and uses humalog fast acting. It means he can eat what he wants and inject the correct ratio of insulin per meal, it does mean 4 injections a day, but he doesn't complain as the benefits far outway the disadvantages. At weekends if the lie in is long enough and he has managed to wake up at lunchtime then 3 injections does him that day.
Next time your daughter is at her hospital appointment ask to change, you will have to do a carb counting course, but its not rocket science. Andrew did a FABB course in our area (flexible adjustment of basal bolus) and learnt to carb count, he's only 10 and has managed it really well.
I think the health proffessions tend to put the kids on the 2 daily injections to ease them in to routine, because believe me they all end up on 4 injections per day eventually.
Best of luck, anything else just ask, i'd be glad to help,
take care,
Suzi x
 
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