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Help understanding this type of insulin!

Discussion in 'Adults with Type 2' started by shannong, Feb 4, 2013.

  1. shannong

    shannong Approved members

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    Hi there, my father-in-law has had Type 2 for 25 years. He is on Humalog 25/75 mix. He had a major hypoglycemic reaction in December, where paramedics gave him glucagon (this was his first major hypo). A month later he had a heart attack. When he was in hospital, they switched his insulin to Lantus and Humalog. However, when they released him, he switched back to Humalog 25/75 mix because he has used that for 25 years and wanted to do what he has always done. Since being released from the hospital, he has had problems with lows and highs (the problem with lows is new for him). They do not carb count and know nothing about carb counting. I want to help my father-in-law out with all this. My son is a Type 1, so I know about Type 1, but I know nothing about about Humalog 25/75 mix works. He takes it morning and evening. On this type of insulin, how shoud he eat? Shoud he have the same about of carbs for all meals? What about snacks? I want to help prevent the lows because I don't think his heart could take another major hypo, but don't know much about this type of insulin.
     
  2. TheFormerLantusFiend

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    You've got the numbers backwards, I think- it's 25/75.

    It's 25% Humalog and 75% NPH. How much exactly he should be eating depends on his body, but the way it works is that when he takes the shot, he should be eating like he just got a bolus for 1/4 that shot (if he took 16 units, then he just got 4 units of Humalog and should eat for 4 units of Humalog).

    The NPH is a basal but also has a peak that most people need to eat for. He should probably be eating both a lunch and a bedtime snack. Some people on NPH find that they have enough dawn phenomenon to not need a snack but NPH users really run a risk for night time lows without a bedtime snack. Something with protein and/or fat is recommended so that you don't spend time high before the NPH peak happens.

    I suggest he carb count to find out what he's eating right now, and increase or decrease the carb content of meals that come before his highs and lows. If overall it ends up being too little or not enough food, then raise or decrease one of the doses (the morning dose is more flexible because it's easier to monitor daytime numbers).
     
  3. shannong

    shannong Approved members

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    Thanks Jonah. That info really helps. I didn't even realize the other part of the mix was NPH (I know a little about NPH because my son was on that for a short time). Last night, my father-in-law was at 14 (or about 250) before bed. I thought he was high enough that he would be fine until morning. But then he was 3.3 (or 59) in the morning! Now I understand that with the NPH component, he probably needed a bedtime snack. Thanks for the info!
     
  4. selketine

    selketine Approved members

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    William was on NPH for maybe 4-5 months when he was first diagnosed and giving it at night was very stressful. NPH given in the morning would peak enough to cover lunch - so imagine that same peak comes in the middle of the night when you're asleep.

    We used to give him a drink yogurt and mix in cornstarch and that helped. Cornstarch is a slowly released carb to help keep the BG steady over time. I think there are special "diabetic bars" like Extend bars - that contain cornstarch. I used to see cornstarch recipes for diabetics back when NPH was more common - found some: http://www.childrenwithdiabetes.com/download/BCChildrensCornstarch.pdf

    It has to be uncooked corn starch - FYI!
     
  5. mmc51264

    mmc51264 Approved members

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    Usually it's 70/30 or 75/25.
    I am a nurse and a parent of a T1. I am still trying to figure out all the T2 options.
    I still think the best is a basal, like lantus and sliding scale using whatever works (regular insulin or a mix). WAAAAAAAYYYYY too many options out there and too many non-D aware doctors.
     

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