Management of diabetes by Insulin Humalog Mix

What is it about?

Recently it has been observed that some research trials conducted and demonstrated to prescribe premixed biphasic insulin analogs three times a day. Although such studies have proved better control with HbA1c reductions. However this technique is neither standard nor fits to all diabetic patients as this may cause hypoglycemia (30-40%) before bedtime or late night due to insulin stacking (i.e., protamine insulin). This has been observed in our clinical practice where older patients, those with renal impairment, or erratic meal patterns experience hypoglycemia. Recently, it has also been observed that most of the physicians prescribe premixed biphasic insulin analogs three times a day after failure to achieve good glycemic control. Although their patients are experiencing hypoglycemia, but health care professional is unaware of that because lacking of patient education and self-monitoring of blood glucose (SMBG). In spite of hypoglycemia, their HbA1c remains elevated. Only 20% of patients will achieve the target with difficulty (or with high dose of insulin). Current paper is focusing such problems and has invented a techniquewhere premixed insulin analogs can be prescribed in a basal bolus format, with an example of only one case report summary (out of hundreds of such similar case studies since last ten years of our clinical practice).

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Why is it important?

Management of diabetes by insulin in basal bolus format