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Dr. Andrew Rynne

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Diabetic and having BP in the morning. Changed from Lantus insulin back to Novolin N. Should I take regular insulin before going to bed?

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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6225 Questions

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Posted on Wed, 30 Oct 2013 in Diabetes
Question: I am a diabetic. I recently lost my insurance and so had to change from Lantus insulin back to Novolin N. I have some Humalog left for meals but I am having high blood sugars in the morning. Do I need to add Regular insullin before I go to bed ? I will also have to eventually go back to Regular insulin instead of Humalog as it is very expensive and will need advice for when that happens.
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Answered by Dr. Chobufo Ditah 3 hours later
Brief Answer:
Take advice, talk to your doctor

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about this insurance crisis and all the changes this would bring in your treatment regimen. When times get tough, we need to make the tough decisions and sure this is what you are about doing. I wish you well with this and proise to stand by you until we figure out what works best given your current changes.

High early morning blood glucose readings indicate that the insulin overnight is not enough to control the blood sugar. This cannot be corrected by a regular insulin dose as this only works for a few hours after administration. What you need is to increase the dose of the long acting insulin so that it can cover your nocturnal requirements. If you take Novolin N at night, then what you need is an increase in this dose to cover for nocturnal insulin requirements.

Humalog/Regular insulin all do the same work. the difference in price comes as a result of the quality of the product and not what the difference in action is. However, when you make that change please do well to monitor the blood sugars and we shall adjust your insulin requirements being guided by this.

I cannot end without saying the best person to initiate this transition and stabilize you on the new product is is your doctor. You would need regular visits and follow up to ensure that you get the best treatment on these new products. Please, XXXXXXX and lay down this problem with your treating doctor. My advice cannot replace a regular doctor close follow up.

I hope this answers your question fully. Feel free to ask follow up questions for clarifications if need be. I wish you well and all the best as you make the necessary adjustments to cope with difficult times.
Thanks.
Dr. Ditah, MD


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chobufo Ditah 3 days later
I take Novolin N in the Morning, not at night, does this change the answer ?
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Answered by Dr. Chobufo Ditah 21 minutes later
Brief Answer:
Novolin N is typically taken twice

Detailed Answer:
Hi and thank you so much for following up with me.

Novolin N is an intermediate acting insulin which should be taken twice a day for a 24hour coverage. Taking it just once means it cannot cover the entire 24hours and explains why the blood sugars in the morning are persistently high. Please, talk to your doctor so that you guys can add an evening dose to keep your needs covered over night.

I hope this helps. Thanks for using our services. I wish you well.
Dr. Ditah, MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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