Using Human Actrapid and Human Insulatard

[SHmano]

I am a Type 1 diabetic recommended with Human Actrapid and Insulatard. This type of insulin has a cycle in the sugar level high low, high, low. Post having food it increases but reduces after 2 hours and then it forms a circular motion of high and low. But the problem with that is maintaining a regular sugar level i.e normal during night and early morning. Does anyone in the group provide a solution on how to maintain a normal sugar rhythm.

 

[NinaB73]

I am surprised you are on this regime now as a type 1 but every consultant is different I guess. I have had that combination of insulin in the past and I wasn't too bad on it but I believe Actrapid is only available in vial and syringe form now? I may stand to be corrected but if it is I am sure you would find a pen and cartridge system much more manageable.

I switched to Humalin S and Humalin I shortly after for that reason but the highs and lows you are experiencing I can understand particularly overnight. Insulatard like Humalin I has a peak action and I would find I would hypo quite regularly overnight with it, around 2am. I tried splitting the dose but then had a peak action mid morning! Insulins are a nightmare aren't they? they never quite do what they say on the tin! Humalin S is very similar to Actrapid and I like it and remain on it as I like the slower duration compared to analogue insulin as I am a grazer and eat little and often and being on multiple injections I can pretty much take into account the snack I will have in 3 hours!
Are you newly diagnosed or is this a regime that you have been on for some time.?
Do you have a decent DSN as there are many other alternative insulin types that may suit you and your lifestyle much better.
Or you may consider a pump? but I'm not sure of your circumstances and what support you are receiving. But it does sound to me like it isn't working for you and I would push to find an alternative.
If you do seek advice let us know how you get on as I would be interested to know!
Hope you get it sorted,
Nina

 

[SHmano]

Thanks for your reply. Though I discuss with doctor of my problem with Human Insulatard and Human Actrapid they do not seem to change it. I have been diagnosed with diabetic at the age of 7 and now I am 51 years old. It is quite tough a times to monitor it in the night. Doctors do not advice on pump as there are chances of infection and when it goes low a times I do not even realize it is low.
How do you adjust the dose with changes in the diet. Are there any measurements like so many calories require so many units etc....
Please let me know.

 

[catapillar]

How do you adjust the dose with changes in the diet. Are there any measurements like so many calories require so many units etc.....

Most type 1s on a basal bolus regime (who's is what your insulatard/actrapid is) will adjust their bolus (fast acting/meal time) insulin according to what they are eating by carb counting. Calories don't have anything to do with blood sugar, the thing that impacts on blood sugar is how much carbs you are eating - all carbohydrates eaten will turn into glucose and raise blood sugar. Carb counting adjusts you bolus dose by working out your insulin:carb ratio (ie how many carbs can 1 unit of insulin deal with), once you know your I:C ratio you work our your insulin dose for a meal based upon how many carbs you are eating, if 1 unit covers 17g of carbs you divide the total carbs in what you are going to eat by 17 to work out how many units to take.

Where are you based @SHmano ? A lack of hypo awareness nd overnight hypos would certainly meet NHS funding criteria for a pump.

There is a free NHS course on carb counting available online - https://www.bertieonline.org.uk

 

[SHmano]

Most type 1s on a basal bolus regime (who's is what your insulatard/actrapid is) will adjust their bolus (fast acting/meal time) insulin according to what they are eating by carb counting. Calories don't have anything to do with blood sugar, the thing that impacts on blood sugar is how much carbs you are eating - all carbohydrates eaten will turn into glucose and raise blood sugar. Carb counting adjusts you bolus dose by working out your insulin:carb ratio (ie how many carbs can 1 unit of insulin deal with), once you know your I:C ratio you work our your insulin dose for a meal based upon how many carbs you are eating, if 1 unit covers 17g of carbs you divide the total carbs in what you are going to eat by 17 to work out how many units to take.

Where are you based @SHmano ? A lack of hypo awareness nd overnight hypos would certainly meet NHS funding criteria for a pump.

There is a free NHS course on carb counting available online - https://www.bertieonline.org.uk

Hi,
I am from Chennai, India.

 

[tim2000s]

Hi @SHmano, a regime using Insulatard and Actrapid was very common in the UK in the 90s and early noughties, as it was one of the few ways to provide more flexibility to types 1s. I myself was on this regime for a good ten years.

The difficulty with both of these insulins is that they peak and drop, and the timings are quite long. Insulatard (NPH) peaks at around 4-5 hours after injection and has quite a long peak, while Actrapid (Short, Regular) peaks at about 3 hours after injection, as per the graph below:

What can happen is that if the peaks and troughs overlap in a funny way, you can get major ups and downs by accident. It's worth plotting your injection timing on a graph using these curves to see where the peaks and troughs of insulin action coincide and then work out a strategy on when and how much to eat to tie in with that.

 

[Chas C]

Hi @SHmano, I was on a similar regime too 5-6 yrs ago and had similar problems to you. Whatever I did I could not manage the night time and early morning BG's effectively. After I'd moved to a pump these issues were resolved as I was able to manage my bodies differing needs over these times of the day.

 

[TheBigNewt]

I don't know how access to insulin works in India. Do you have national health insurance like in the UK? I did the NPH/regular thing for a few months in 1985 then shifted to Basal/bolus. I'd recommend you suggest using a very long acting basal like Lantus(glarine) which is now "generic" and available from more than one company (I switched to the new company this year and noticed no difference at all). Your blood sugar will tend to be more stable if the long acting doesn't peak between meals or while you sleep.

 

[Kanika]

I am a Type 1 diabetic recommended with Human Actrapid and Insulatard. This type of insulin has a cycle in the sugar level high low, high, low. Post having food it increases but reduces after 2 hours and then it forms a circular motion of high and low. But the problem with that is maintaining a regular sugar level i.e normal during night and early morning. Does anyone in the group provide a solution on how to maintain a normal sugar rhythm.

Hi, I'm from Mumbai, is there any way I can contact you, Twitter, Facebook or some other? As my son (12 years old) has the same insulin and I have some questions

 

[Angie 2]

Hi, I have been newly diagnosed and on Actrapid and Lantus, but it is getting really difficult to control morning sugars. Can anybody suggest something.

 

[Angie 2]

Hi I am from Mumbai, been recently diagnosed, on Insulin, getting it difficult to control morning sugars. Can some one pl suggest something.

 

[Heathero]

Used to use same insulin’s ( before use of pump) lantus did not last as long as expected with me was advised to take twice a day/ split dose according to need. Please discuss with your Diabetes nurse advisor first, but helped me.