From the Guidelines
Switching from Humalog to 70/30 insulin is a viable option for managing type 2 diabetes, but it requires careful dose adjustment and monitoring, as outlined in the 2017 American Diabetes Association standards of medical care in diabetes 1. When transitioning from Humalog, a rapid-acting insulin, to 70/30 insulin, a premixed insulin, it's essential to consider the different action profiles of these insulins.
- The total daily dose of Humalog should be calculated, and then 70/30 insulin can be started at the same total daily dose, typically split into two injections given before breakfast and dinner.
- For example, if a patient is using 40 units of Humalog daily, they can start with 20 units of 70/30 before breakfast and 20 units before dinner.
- Close blood glucose monitoring is crucial during this transition, with checks before meals and at bedtime to prevent hypoglycemia and adjust the dose as needed. The switch from Humalog to 70/30 insulin changes the insulin coverage pattern significantly, as Humalog is used at mealtimes, while 70/30 provides both immediate and intermediate coverage through its mixed formulation 1.
- This transition requires medical supervision, as the fixed ratio of 70/30 insulin may necessitate adjustments to meal timing and content to match the insulin action profile and prevent hypoglycemia.
- Regular insulin and 70/30 NPH/regular insulin mix are less costly alternatives to rapid-acting and premixed insulin analogues, but their pharmacodynamic profiles may make them suboptimal, as noted in the 2017 American Diabetes Association standards of medical care in diabetes 1.
From the Research
Insulin Therapy
- Insulin therapy is a common treatment for both type 1 and type 2 diabetes, with nearly all people with type 2 diabetes requiring insulin therapy at some point in their lifetime 2.
- The choice of insulin regimen depends on various factors, including the type of diabetes, lifestyle, and individual patient needs.
Humalog and 70/30 Insulin
- Humalog is a type of rapid-acting insulin analogue, while 70/30 insulin is a type of premixed insulin that contains 70% intermediate-acting insulin and 30% rapid-acting insulin 3.
- Studies have shown that 70/30 insulin can be effective in controlling blood glucose levels in patients with type 2 diabetes, particularly when used in combination with other glucose-lowering agents 3, 4.
Comparison of Insulin Regimens
- A study comparing the efficacy of an algorithm using 70/30 insulin with traditional sliding scale insulin dosing found that the 70/30 insulin algorithm achieved better glycemic control 4.
- Another study compared the use of NPH insulin four times daily with glargine insulin once daily at dinner or bedtime in patients with type 1 diabetes, and found that glargine insulin resulted in lower mean daily blood glucose levels and improved HbA1c levels 5.
Key Findings
- The use of 70/30 insulin can be an effective way to control blood glucose levels in patients with type 2 diabetes 3, 4.
- The choice of insulin regimen should be individualized based on patient needs and lifestyle 2, 5.
- Studies have shown that the use of insulin analogues such as Humalog and glargine can result in improved glycemic control and reduced risk of hypoglycemia 6, 5.