Long Acting Insulin

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derekh1965 DAFNE Graduate
Western General Hospital, Edinburgh
90 posts

Hi,
I have a question for an HCP. When I was diagnosed type 1 in 1994 I was put on a Humilin Soluble/isophane mix twice a day.
Then in 1996 I was put on this great new quick acting insulin which gives greater control, Humalog. Told to take that before every meal and to only take my long acting, Humilin Isophane (BI) at dinnertime. Which I have done for the past 16 years.
Now after doing the DAFNE Course I am told to take my BI twice a day, why? If QA lasts 2 - 5 hrs why do I still need BI for during the day?

Regards
Derek

marke Site Administrator
South East Kent PCT
669 posts

Because QA is for a completely different purpose than BI. The QA covers the period that your body is digesting your meal after which your body requires insulin to cover the background sugar requirements. The BI is for this period. What happens if you don't eat anything for 6 hours ? Your 2 - 5 hour insulin is all gone but your body needs insulin. Our QA dose is based on the carbs for the meal not our background needs.
The reason for splitting the humilin is beyond me as I'm not a HCP. I split Levemir because it doesn't last 24 hours so I need 2 doses to cover 24 hours but humilin will have a different profile so I'm not sure if the same issues apply.

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,800 posts

explained well by marke.........

we all need a background dose, as our bodies are continuously using/needing glucose that is provided by the liver and other stores such as those within muscles..........this is because there isn't always food in our bellies to provide our essential systems thier fuel....

taking it twice s a day is purely down to the engineering of the insulin [how long its made to last] and how each individual body uses it.......

the most common where I am is Lantus [24 hours] and Levemir [12-18 hours]....