From the Guidelines
The typical starting dose for insulin 70/30 in patients with hyperglycemia is usually administered before breakfast and before dinner, with the dose adjusted based on blood glucose monitoring results 1. The administration of insulin 70/30, a premixed insulin containing 70% NPH insulin and 30% regular insulin, is typically given twice daily, allowing for both immediate and extended glucose control.
- The dose is usually adjusted gradually, based on the patient's blood glucose levels, which should be monitored at least twice daily, before meals and at bedtime.
- Patients should be educated about proper injection technique, rotation of injection sites, and storage requirements for insulin, as well as how to manage hypoglycemia, the most common side effect of insulin therapy 1.
- The choice of insulin 70/30 may be influenced by factors such as cost, patient preference, and the need for flexibility in meal planning, with regular insulin and 70/30 NPH/regular insulin mix being less costly alternatives to rapid-acting and premixed insulin analogues, respectively 1.
- However, the pharmacodynamic profiles of these alternatives may make them suboptimal, and providers should consider regimen flexibility when devising a plan for the initiation and adjustment of insulin therapy for patients with type 2 diabetes 1.
From the Research
Insulin 70/30 Dosage
- The typical starting dose for Insulin 70/30 (Novolin, Humulin) in patients with hyperglycemia is not explicitly stated in the provided studies, but it is mentioned that once-daily injections of biphasic human insulin 70/30 can be used in combination with metformin to achieve adequate glycemic control 2.
- A study from 2003 evaluated the clinical effectiveness of starting patients on a regimen of once-daily injections of either biphasic insulin aspart 70/30, NPH insulin, or biphasic human insulin 70/30 in combination with metformin, and found that all three treatment regimens were well tolerated and effective in reducing HbA1c levels 2.
- Another study from 2011 discussed the combination of insulin and oral hypoglycemic agents in diabetes mellitus type 2, and provided practical instructions for initiating insulin therapy, but did not specify a typical starting dose for Insulin 70/30 3.
Management Strategy
- The management strategy for Insulin 70/30 involves adjusting the dose based on the patient's blood glucose levels and other factors, such as diet and exercise 4, 5.
- A study from 2020 discussed the management of hypoglycemia in primary care settings, and recommended optimizing insulin doses and carbohydrate intake to avoid hypoglycemia 5.
- A clinical practice guideline from 2022 provided recommendations for the management of hyperglycemia in hospitalized adult patients in non-critical care settings, including the use of insulin regimens and noninsulin therapies 6.
Key Considerations
- The fear of hypoglycemia is a major barrier to exercise for many patients with diabetes, and insulin dose adjustments and carbohydrate supplementation can help manage blood glucose levels during exercise 4.
- Continuous glucose monitoring (CGM) can be useful for patients with increased risk of hypoglycemia, impaired hypoglycemia awareness, or frequent nocturnal hypoglycemia 5.
- A tailored approach to glycemic management, taking into account individual patient factors and preferences, is recommended 6.