What is the difference between Humulin (human insulin) 70/30 and 50/50?

From the Guidelines

Humulin 70/30 and 50/50 are premixed insulin formulations that differ significantly in their ratio of NPH insulin to regular insulin, affecting their onset and duration of action, and are typically used to manage blood glucose levels in patients with diabetes, with the choice between them depending on individual patient needs and blood glucose patterns, as outlined in the 2017 American Diabetes Association standards of medical care in diabetes 1.

Key Differences

• Humulin 70/30 contains 70% NPH insulin and 30% regular insulin, providing more basal insulin coverage, making it suitable for patients who need more all-day coverage with less mealtime insulin.
• Humulin 50/50 contains 50% of each type, providing a more immediate glucose-lowering effect after meals, suitable for patients with higher post-meal glucose spikes.

Administration and Flexibility

• Both formulations are typically injected twice daily, usually before breakfast and dinner.
• The choice between these formulations depends on individual blood glucose patterns, with 70/30 being more commonly prescribed for patients with higher fasting glucose levels and 50/50 for those with higher post-meal glucose spikes.
• These premixed insulins simplify dosing by eliminating the need to mix separate insulins but offer less flexibility than using separate basal and bolus insulins, as noted in the studies 1.

Clinical Considerations

• Providers should consider regimen flexibility when devising a plan for the initiation and adjustment of insulin therapy for patients with type 2 diabetes, taking into account the advantages and disadvantages of different insulin regimens, including premixed insulins like Humulin 70/30 and 50/50 1.
• If one regimen does not achieve HbA1c targets, another regimen should be considered, such as basal insulin plus a single injection of rapid-acting insulin or twice-daily premixed insulin, highlighting the importance of individualized treatment plans in diabetes management 1.

From the Research

Humulin 70/30 and 50/50 Comparison

• The main difference between Humulin 70/30 and 50/50 is the proportion of NPH human insulin and regular human insulin in each mixture 2.
• Humulin 70/30 contains 70% NPH human insulin and 30% regular human insulin, while Humulin 50/50 contains 50% NPH human insulin and 50% regular human insulin 2.
• A study comparing the two mixtures in elderly non-insulin-dependent diabetes mellitus (NIDDM) patients found no significant differences in postprandial hyperglycemic response, maximum and minimum glucose concentrations, or areas under the curve 2.

Insulin Therapy in Diabetes Mellitus

• Insulin therapy is a crucial aspect of managing diabetes mellitus, and various types of insulin are available, including human insulin and analog insulin 3, 4.
• The choice of insulin therapy depends on the type of diabetes, patient preferences, and individual glycemic targets 3.
• A review of insulin therapy in adults with type 1 diabetes mellitus suggests that most patients should follow a regimen of multiple daily injections of basal/bolus insulin, while those with frequent or severe hypoglycemia may consider continuous subcutaneous insulin infusion 3.

Comparison of Analog Insulin Mix 50:50 with Human Insulin Mix 30:70

• A study comparing analog insulin mix 50:50 with human insulin mix 30:70 in persons with type 2 diabetes during Ramadan found that switching to analog insulin mix 50:50 resulted in better postprandial blood glucose control without increasing the incidence of hypoglycemia 5.
• The study suggests that analog insulin mix 50:50 may be a suitable alternative to human insulin mix 30:70 for patients with type 2 diabetes, particularly during Ramadan 5.