Preventing Hypos

[shs]

Hi guys,

I have started to eat less in the evening to better control my diabetes. However, with my current use of Humalog (3.5mg/ml), I've been using 17 units before bed, which then can lead to a hypo later in the night. My question is, for example if my BG level prior to bed is say 12, then I should in theory take less units to prevent the hypo ?, is anyone aware of a formula that can determine the revised number of units ?, if not I will need to experiment over a few evenings noting the BG level prior to taking the insulin and then 2 ish hours later and build up a trend and take it from there.

Any insight / advice on this, most welcomed.

Many thanks.

 

[Pumper_Sue]

Are you sure you are using humalog as this is a fast acting insulin to be used 15/30 mins before you eat?

Humalog: Uses, Dosage & Side Effects - Drugs.com

Humalog (insulin lispro) is used to treat type 1 (insulin-dependent) diabetes in adults. Includes Humalog side effects, interactions and indications.

www.drugs.com

If you are using humalog then I would suspect you have either misunderstood it's use or you have been prescribed the wrong insulin.

 

[Inka]

That’s what I thought too @Pumper_Sue and wondered if it was perhaps a Humulin mix, but I googled and found this:

https://www.medicines.org.uk/emc/product/7474/smpc

Humalog Mix50 consists of 50 % insulin lispro solution and 50 % insulin lispro protamine suspension.

Which I don’t think I’ve heard of.

@shs What is the exact name of your insulin and is it a mixed insulin? You’re correct in theory that you might need a reduced amount but if we knew exactly what insulin it was it would help make better suggestions.

 

[Pumper_Sue]

@Inka basically the 50/50 mix is what was known isophane in the good old days. Or to some people NPH for the long acting part.
Even if it is a mix @shs needs to take it before her evening meal due to the quick acting (bolus) part of the mix.

I also wonder if it's Humulin as there are I think 2 different mix strengths and also a neutral.

 

[Inka]

Yes, and I think Humulin is commonly prescribed for Type 2s?

I was on a mixed insulin when I was first diagnosed and in hospital, but it was only for a few days as the proportions of the mix didn’t work for me. I took it morning and evening (before my evening meal).

The taking it “before bed” was what confused me (that and the “Humalog” of which I’ve only ever used the fast version). So perhaps it is indeed the basal Humulin? If it is, that has a peak, I think, so could be causing the hypos.

 

[James B]

I have humalog as my QA insulin would only correct at bedtime (yet to do this) but it wouldn't be 17 units that would bring my BG down 34 - 42.5 mmol which would definitely cause a hypo if not a coma. I mean once I took 18 units of Humalog instead of my basal the second day after diagnosis and i fell pretty quickly in around 10 minutes that was fixed by nearly a litre of full fat coke and a sarny.

 

[brisr949]

I don't take a fixed amount of basal as it does depend on my bg level before bed. I know i should have my lvl pretty much sorted with evening meal but my messed up routine doesn't make it always right.
I do read a lot of you take fixed amounts and will eat a little something before bed if your reading is too low which is probably the right way to do it.

 

[James B]

I don't take a fixed amount of basal as it does depend on my bg level before bed. I know i should have my lvl pretty much sorted with evening meal but my messed up routine doesn't make it always right.
I do read a lot of you take fixed amounts and will eat a little something before bed if your reading is too low which is probably the right way to do it.

Mine is based on what I wake up if I’m below 10 and around 7 it’s stays the same above 10 it goes up 2 units

 

[James B]

Mine is based on what I wake up if I’m below 10 and around 7 it’s stays the same above 10 it goes up 2 units

For three consecutive days

 

[everydayupsanddowns]

Please get in contact with your DSN / GP for a medication review @shs to make sure they are happy with any possible dose changes you are considering.

Is the insulin Humulin I? that’s an intermediate acting one that might be taken in the evening - but dose adjustment and timings are best discussed with a healthcare professional if you are in any doubt