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What is Humalog 75/25?

Discussion in 'Parents of Children with Type 1' started by Charlotte'sMom, Feb 20, 2014.

  1. Charlotte'sMom

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    This isn't a question for my kid, but this forum gets the most traffic and I need a quick answer...

    My dad (T2) has just been prescribed Humalog 75/25 after he ran out of Lantus. He's been taking Lantus for about 2 months now. He was up to 90 units/day with 45 in the morning and 45 and night. His numbers were getting down into the 100s, but he was still having quite a few in the 200s thanks to emotional eating. (my mother died a month ago)

    The doctor said to start out with 90 units of the Humalog 75/25-- 45 in the morning and 45 at night. I thought Humalog 75/25 was 75% fast acting and 25% long acting. (Is that right?) Wouldn't that drop his blood sugar drastically? I'm a little worried and need some insight.
     
  2. C6H12O6

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    This product is called Humalog Mix 25 in Canada. Its 25 percent Humalog and 75 percent NPH (well not technically NPH but quite similar).













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  3. Charlotte'sMom

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    That helps a lot. So as long as he always splits the dose and doesn't try to do one shot a day, it should work fairly similarly to Lantus then? With the fast acting in it, does he need to take it with a meal? I know he's planning on taking it at 8pm tonight, after dinner.
     
  4. C6H12O6

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    I don't remember much about the rules of NPH, but you have to take mix 25 with a meal and you have to eat lunch at a specific time. You would probably need a bedtime snack.

    I would say the regimen is fairly similar to NPH and Humalog.
     
  5. nebby3

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    Lantus is a 24 he insulin. NPH is an intermediate acting one, more like 6 hrs. It has a strong peak which requires a meal at a certain time. If it is NPH I would ask a lot more questions about that. 90u seems like a very high dose. If it were my relative I would also ask about combining insulin with other meds. There is so much available for type 2.
     
  6. Mish

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    Just want to correct one part of what Nebby just said:
    NPH is a 12 hour insulin with a peak around 6 hours.

    You have to understand that NPH is used not just as a basal but also to cover meal carbs. It sort of does both in a way. You'd take your NPH and novolog at 6am but wouldn't need to take a shot at lunch for your carbs eaten, as that's when your NPH is peaking. It wasn't uncommon when more people used it, to have a large dose of NPH in the AM to cover that food, and a much smaller dose of NPH at bedtime. Worked well for kids at school - no shot needed at lunch. Of course, it stunk if you wanted extra food or lunch was late...

    Having a 75/25 mix really is going to require that he eat at a set time of day and a set number of carbs. But it's probably meant to help him address the meal time highs.

    It sort of seems like a weird thing to do to a guy who is already stressed out (sorry about your mom), unless he's expressed an extreme desire not to give himself more shots.
     
  7. dianas

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    Generally taken before breakfast and dinner if taken twice daily. May need a bedtime snack also as the NPH portion of the shot tends to peak during the night.
     
  8. Charlotte'sMom

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    No, this is just what the doctor prescribed probably because he was still having a lot of highs on a Lantus dose that high. I'm actually surprised he's doing insulin at all, though he seems to be doing really well with giving himself the insulin. (not getting his numbers down just causing more emotional eating, however) My mom's passing has been really hard on him. I have no experience with anything but Lantus, Novolog and Apidra. All the insulins in between are a mystery to me. Besides taking his oral meds, he hasn't done anything to control his diabetes in the last 20 years. Judging by his Lantus dose, he is severely insulin resistant. At this point in his life, I'm not expecting any serious lifestyle changes. So having a regimen where he's got to eat a certain number of carbs at a certain time each day is probably not going to work. I was hoping that with the Lantus his blood sugar would come down enough that it would be good enough. But he's still eating too many carbs. I thought about giving him a vial of Apidra and having him bolus for carb-heavy meals. However, I have no idea where to start on an I:C ratio for him, so I haven't. I didn't want to be the one responsible for a severe hypo. But this intermediate insulin or whatever it's called is confusing to me.
     
    Last edited: Feb 20, 2014
  9. Charlotte'sMom

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    He says he just took 40 units at 8pm after dinner. His blood sugar was 344 though. He's been out of Lantus completely for a week.
     
  10. nebby3

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    I stand corrected. Thanks, Mish. It's been a long time since we used NPH and I wouldn't mind blocking the whole horrible 9 months out.
     
  11. Mish

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    Oh I totally agree!!!! What a ridiculous insulin to give a 5 year old fairly picky eater. The only saving grace for us was that he liked to eat the same things at every meal, so it helped. But otherwise, what a horrible, horrible thing.
     
  12. hawkeyegirl

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    Oh yeah. It was boatloads of fun with a 3 year old picky eater. I remember begging him to eat some Cheetos at one point so that we could get enough carbs into him. Awesome. I know they thought they were doing us a favor because he hated shots so much, but NPH was so, so bad.
     

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