70/30 vs NPH

Harold Harvey Sr. wrote in message ...

Quoted message said:

I was hospitalized a few days ago and the hospital gave me
NPH insulin

rather

Quoted message said:

than the 70/30 I take at home. I didn't suffer any
adverse effects but I am curious as to the differences in
the two types.

Harold

70/30 is a mixture of 70% NPH and 30% Regular Insulin. The
"Regular"
component of that mix kicks in a bit earlier than the
NPH fraction.

Thus, the 30% Regular gives you a fighting chance to handle
the meal which immediately follows the injection. The 70%
NPH gives you some basal coverage, and a peak at 4-6 hours
later which covers the meal 4 or so hours after the
injection.

IOW, If you shoot 20 units of 70/30 just before breakfast,
you will receive (20 x 0.30) = 6 units of R insulin to cover
your breakfast and (20 x 0.70) = 14 units of NPH insulin to
give you some basal throughout the day-time hours and a peak
to cover lunch.

I'm not surprised that they didn't give you the pre-mix in
the hospital.
71/30 is very difficult to use well. Since folks in
hospitals are generally sick or injured or whatever,
using that mix sort of complicates matters. If they only
give you single component injections, they have full
control of when the peaks occur and can thus time them
for best effect.

In general, medical folks are really nervous about sending
their insulin-using diabetics hypo. Thus, they don't like
complicated insulins, especially insulins with a fast-acting
component for folks who may or may not be feeling well
enough to eat their next scheduled meal.

When you leave the hospital, you can manipulate your daily
eating schedule to fit the timing of the peaks from the
70/30. Err. . .that is very, very difficult to do properly
by the way. Many folks can't handle it but don't realize it
since they don't test enough.

FWIW, a Type 2 diabetic on insulin should have a fighting
chance to hit an HbA1c of 5.2, maybe even 5.0 They should be
able to beat 6.0 without a lot of effort. . .if they are
using a modern single component insulin regime; or have
figured out how to jump through the hoops needed to
accomodate 70/30.

Type 1 aren't supposed to use 70/30 after they leave
Honeymoon.

Regards
Old Al

On Tue, 08 Jun 2004 23:29:01 GMT, [email hidden] (Harold

Harvey Sr.) said:

I was hospitalized a few days ago and the hospital gave me
NPH insulin rather than the 70/30 I take at home. I didn't
suffer any adverse effects but I am curious as to the
differences in the two types.

Harold

70/30 is 70% NPH, 30% regular. It means you get some
activity before 2-3 hours it take to see much from the
NPH, which peaks something in the 4-6 hour time frame.
For a hospitalized patient I would regard NPH as an
exceptionally poor choice, bordering on malpractice. You
have 24x7 care, there is no reason that tight control
cannot be maintained with the Use of Regular, or Humalog
or Novolog insulins.