How many times a day should you take Humulin (insulin) 70/30?

Humulin 70/30 Should Be Administered Twice Daily

Humulin 70/30 should be administered twice daily, typically before breakfast and before dinner, to achieve optimal glycemic control. 1

Dosing Schedule for Humulin 70/30

Humulin 70/30 is a premixed insulin formulation containing 70% NPH insulin (intermediate-acting) and 30% regular insulin (short-acting). The recommended administration schedule is:

• Morning dose: Before breakfast
• Evening dose: Before dinner

This twice-daily regimen is supported by the American Diabetes Association guidelines, which specifically recommend administration of premixed insulin formulations like 70/30 before breakfast and before dinner 1.

Timing of Injections

• Administer Humulin 70/30 approximately 30 minutes before meals
• This timing allows the regular insulin component to begin working as food is digested
• The NPH component provides coverage between meals and overnight

Dose Adjustments and Monitoring

• Initial dosing typically starts at 0.5 units/kg/day total, divided between morning and evening doses 2
• Adjust doses based on blood glucose monitoring:
  • Fasting glucose levels (morning)
  • Pre-dinner glucose levels
  • Bedtime glucose levels
• Increase dose by 2 units every 3 days until target glucose levels are achieved 2
• If hypoglycemia occurs, reduce dose by 10-20% 2

Special Considerations

During Ramadan (if applicable)

For patients who fast during Ramadan and are on 70/30 premixed insulin twice daily:

• Use the usual morning dose at the sunset meal (Iftar)
• Use half the usual evening dose at predawn (Suhur) 1

Intensification Options

If twice-daily dosing fails to achieve adequate glycemic control:

• Consider advancing to thrice-daily premixed insulin 1
• Studies show that three daily injections of premixed insulin may provide better control for some patients 3, 4
• In one study, adding a third injection of biphasic insulin aspart 70/30 before lunch improved HbA1c from 8.4% to 7.2% 4

Potential Pitfalls and Caveats

• Hypoglycemia risk: The fixed ratio of 70/30 may not match individual insulin requirements throughout the day
• Meal timing: Requires consistent meal timing and carbohydrate content
• Limited flexibility: Less adaptable to varying schedules compared to basal-bolus regimens
• Monitoring: Regular blood glucose monitoring is essential, especially during dose adjustment periods

Advantages of Twice-Daily Humulin 70/30

• Simplifies regimen compared to basal-bolus (fewer injections)
• Provides both mealtime and basal coverage
• More affordable than many insulin analogs
• Established efficacy in improving glycemic control

Remember that while twice-daily administration is standard for Humulin 70/30, individual response may vary, and dose adjustments should be made based on blood glucose monitoring and clinical response.