By: Scott M. King
My mom and I were on the phone last night talking about our diabetes. She’s a type 2 on insulin and really struggles keeping her blood sugars down.
We have often shared a similar frustration in what to do when our BGs are high before a meal. We know we are “supposed” to take insulin and wait for our glucose levels to drop (at least below 140) before we eat. But both of us get so hungry we can’t wait. So we take extra units and chow down anyway.
It can take my mom two or even three hours to get a blood glucose reading down from 220 by taking Regular insulin.
So last night while we were talking, I shared with her that I am trying Eli Lilly’s new super-fast Humalog insulin.
I was skeptical; I wasn’t sure it was going to be the wonder-drug Lilly promised. But after hearing its virtues touted by educators, DIABETES HEALTH board members and friends, I had to try it.
The first time I tested my blood sugar after breakfast and saw an 81 pop up on my meter, I knew I could lower my breakfast dose, and I wanted to keep taking this insulin.
The wonder of the insulin is in its fast onset peak. One of our board members, Keith Campbell, recently told me that since switching to Humalog he is no longer constantly hungry. With a quick peak the waiting periods for eating a meal are cut exponentially. So I told my mother long waits could be over for her too.
One other factor playing into the diminishing hunger Keith-and hopefully soon my mother-feels is the fact that with a fast insulin there is simply less insulin hanging around in the body. Sue Thom, another board member, pointed out to me that excess insulin can cause hunger.
The new insulin offers many benefits, but I can also see why it is only available with a doctors prescription. It needs to be coupled with education on insulin action, and may also require that changes be made to the timing and amounts of other insulin or anti-diabetic pills we might take. Humalog has been used very successfully on type 2’s also.
One of the points Nancy Bohannon, MD, and Stuart Brink, MD, brought up in their presentations of Humalog at the American Association of Diabetes Educators (AADE) meeting this past August is the fact that such quick action requires a solid basal (long-acting) insulin. Humalog clears from the body very quickly, and any user must be sure to have good background coverage.
Stuart found some patients on Humalog needed their number of shots of NPH to be raised from two to three per day. The children Stuart looks after were not getting enough coverage in the late afternoon because the morning NPH had run out, and the Humalog is gone after two hours. A pre-lunch NPH shot was added solving the problem. He says the smaller the kid the shorter the action of NPH.
Because I have a fast metabolism human NPH clears from my body in about six hours. I have found the animal Lente to work best for me-it is the longest acting insulin in the United States now that animal ultralente has been pulled altogether.
Without a good basal background insulin dose, a person taking Humalog could find himself going hyperglycemic when the insulin wears off, in addition to the risk of going hypoglycemic if he waits too long to eat.
Cindy Onufer, RN, MA, CDE, who presented a Lispro study with Nancy Bohannon, is also quick to point out that Humalog has been great for her patients who exercise because it leaves the body quickly, reducing chances of hypoglycemia.
Check with your doctor about trying Humalog.