Thursday, July 14, 2011

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Best insulin regimen

We have 2 classic regimens that have been used on a large scale.

1) Multiple component insulin regimen

Here, usually a basal insulin level is maintained by a long acting insulin like glargine insulin (lantus) injected at night. Then short acting insulin analogues are injected just after breakfast, lunch and supper. In total the patient has to do 4 injections per day.

2) Twice a day pre-mixed insulin

This is more commonly used. It consists of twice daily injected mixture of an intermediate acting insulin like NPH insulin and a short acting insulin or regular insulin in a ratio of 70:30.
2/3rd of the total insulin requirement is given in the morning and the remaining 1/3rd at night. The total number of injections is 2 per day.

For the patients' convenience, the second regimen seems better as he/she has to do only 2 injections but the first regimen i.e multiple component insulin regime is actually the better of the two. Studies have recently shown that a better HbA1c goal is reached with this regimen and that the risk of hypoglycemia is 10% less if carried out properly.

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