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From America On Line:

I am going to be going on Humalog and Ultralente this next week. So I am full of questions -- I was lead to believek. So I am full of questions -- I was lead to believe that being on the Humalog/Ultralente combination you would not have to eat a bedtime snack. Also, that you wouldn't have to eat snacks every 3 hours (at least that is how often I eat). What do you know about this? Have I been misinformed?


Physiologically, the rise and fall of insulin in the blood should correspond to the rise and fall of glucose. In the days when the commonest way to administer insulin was to give a twice daily shot of conventional Regular and NPH, this meant that if you tried to give enough regular to cover the post breakfast peak of blood sugar you might have too high a concentration of insulin later in the morning when the tail of the morning regular would overlap the beginning of the NPH. Hence the need for a mid-morning snack. In the afternoon the NPH might peak after the lunch time sugar rise; but before supper, hence the need for the afternoon snack especially with afternoon exercise. With the shorter and more abrupt effectiveness of lispro insulin [Humalog®] and the ability to give it after a meal and hence to adjust the dose to pre-meal blood sugar and appetite, the Humalog can be more exactly adjusted to cover all three meals and Ultralente covers basal insulin needs primarily during the night. Before too long there is likely to be another substituted insulin available that provides an even steadier basal level. Anyway you are correct in supposing that you should now not need snacks between meals or at bedtime; but you must check blood sugars meticulously after the change over just to be sure.


Original posting 4 Jul 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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