About Diabetes & Nutrition : Insulin Regimens for Diabetes

About Diabetes & Nutrition : Insulin Regimens for Diabetes

November 23, 2019 1 By Jose Scott


There are various types of insulin regiments,
and the older type of regiments usually include what we call regular insulin and then MPH
which is a long acting insulin that lasts about twelve to fourteen hours. The new insulin
regiments attempt to be more what we call physiologic, and that is to match what a person
who doesn’t have diabetes would experience. So the new regiments include an insulin that
is very long acting, in fact twenty-four hours, that has a very flat peak, so it kind of is
insulin there in the background that keeps your sugar from going up too high, and that
is an insulin that is effective between meals, when you have not eaten something. And then
on top of that, you would take what we call a short acting insulin, like Novolog or Humalog,
that would be there to cover the carbohydrate that you consume during meals. So typically
a person would take one shot of a long acting insulin before bedtime, that would last a
full twenty-four hours. And then in addition to that, whenever they eat, they would take
insulin to cover their meal. For example, let’s say someone decided for breakfast to
have a couple pieces of toast, and they knew that they needed to take four units of insulin
to cover the amount of bread that they were eating and they would take the four units
of insulin, and then they would eat their bread. Come lunchtime, they have two slices
of bread again; they would take another four units of insulin to cover that. And if it’s
working right, their blood sugar should be normal in three to four hours after that meal,
if they’re taking the right amount of fast acting insulin. The thing about fast acting
insulin though, that’s important to know, is that it is fast acting but it’s not long
acting. Usually lasts about two to four hours, which means if you ate a snack two or three
hours later and didn’t take more insulin to cover that, the sugar would go up too high.
So unlike the old insulin regiments like Regular that lasted six to eight hours, and it would
cover a snack, the new types of insulin that are short acting won’t do that. And so you
have to take insulin every time you eat when you take short acting insulin. Right now when
children are newly diagnosed, most of the time we try to get them on an insulin pump
because an insulin pump matches the body probably more closely than taking the shots do. And
the insulin pumps are so sophisticated now that you can program very, very closely at
every hour what the insulin needs are. Oftentimes there are more or less at night, and that
is programmed in, and then what will do and the parent, is they will just count the amount
of carbohydrate that is in the meal and they will program that into the pump, and the pump
will just give to the person exactly how much insulin would cover that amount of carbohydrate.