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What is a better insulin a 75/25 or 70/30 mix. I currently

 
Dr Eisenbud's Avatar
  • Answered by:Dr Eisenbud
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Customer Question

What is a better insulin a 75/25 or 70/30 mix. I currently take metformin and Levimir insulin. I need to get my spikes under control. And do you need to continue with a long acting insulin while on a mix?

 

Optional Information:
Person's Gender: Female
Person's Age: 51

Already Tried:
I became a type 1 after a kidney stone surgery injured my pancreas. (lithotripsy)I was on Lantus, didnt do well, now on Levimir and metformin. Continually having to increase amounts every year. Suar spikes are very common occurrance, so that is why I am looking for alternative treatments.

Submitted: 341 days and 22 hours ago.
Category: Endocrinology
Value: $45
Status: CLOSED
Expert:  Dr Eisenbud replied341 days and 21 hours ago.

The 2 insulins are very similar with Novolog mix 70/30 being margionally more reliable. However using long acting Levemir at bedtime is also excellent and it should be controlling your fasting sugars. I would not use mixed insulin with it as it contains a long acting insulin which you are already using. Best bet is to control fasting sugars with Levemir and use only short acting insulin(Humalog, Novolog or Apedra) 10 min before your largest meal in a dose large enough to keep the sugar 2 hours after that meal less then 140. If that does not get your HbA1c to goal(<6.5-7%) then use the fast acting insulin just before your next largest meal.

Customer replied341 days and 20 hours ago.

The main reason for wanting to switch to a mixed insulin is that I dont use my short acting insulin enough. I ended up throwing at least 65 percent or more away, my insurance doesnt cover much of my insulin charges, so I really can't afford this much waste. So is it safe for me to switch? And if I do, you would recommend a 70/30 instead? My dr only had a 75/25 sample, that's why we chose this one.

Accepted Answer

Expert:  Dr Eisenbud replied341 days and 18 hours ago.

75/25 is more or less the same as 70/30. The 70 refers to long-acting insulin and 30 to short-acting insulin. They should be taken before breakfast and before dinner. If you started these mixed insulins you should stop your basal insulin as you don't need two basal insulins.You might consider using a pen for the NovoLog or Humalog as this is a much smaller amount than in a vial and might be more efficient. If you do switch to the mixed insulin and stop the Lantus be sure to follow fasting sugars to see if they remain under control with the shorter acting basal insulin in the mixed insulin. If the fasting sugar goes up you may need to use a small dose of Lantus or Levemir at bedtime to control it.

Expert TypeBoard Certified Physician
Category: Endocrinology
Pos. Feedback: 90.1 %
Accepts: 166
Answered: 6/12/2012

Experience: Endocrinology and metabolism practice for 35 years

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