Went to my daughters Endo appointment today , well we got sent to the ER. High ketones in urine, rapid heart rate, and blood pressure drops a lot when standing. They want her to go on the 70/30 insulin. Anyone have experience with this? I am skeptical, but my daughter is 18 and told them she wants to try
By 70/30 I’m assuming a mixture of 70% background or long-lasting (N) and 30% faster-acting ® insulins. That sounds like the regimen I was on 50 years ago, but back then before pens and disposables I had to draw up some of each type insulin [hopping I added correctly] into a single syringe to inject.
Using a pen with this mixture is a proven method for managing diabetes but not the most effective management tool for Type One. But if her endo has a reason, and thinks it is the best treatment for your daughter then so be it. And how often or when would she use this mixture? Is she newly diagnosed?
I personally feel that a true background insulin such as Lantus injected once each day along with a very fasting short duration insulin such as Humalog at each meal is proper treatment fir Type One - the DCCT study of about 1980 proved this method to be most effective. Of course if she goes this route she will need to count carbohydrates, calculate doses at each meal and regularly check Body Glucose Levels - more work for her.
so here’s my guess from my living room, the endo thinks she’s skipping enough shots to put her dangerously close to DKA. the Endo might have sensed that she does some shots but not all. 70/30 is a way to get some background insulin into you in just 1 shot. with that NPH background, the likelihood of DKA is greatly reduced.
I injected NPH (as I assume also did @Dennis), many years ago. it has a half life of between 8 and 16 hours. it has a funny peak at 3-4 hours after injection, it is still present in your body at 16-20 hours. in the old days, it was a much better long lasting than Protamine Zinc insulin. It works, it’s insulin, I survived, it’s just a bit old school. The endo is likely suggesting this as combat strategy for high ketone/high glucose and no insulin. in my opinion, it’s a short term strategy until she wants to feel better.