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Which is the best form of insulin for me?

Q: I am 24 years old, having type-1 diabetes. I have diabetes from the past 5 years. Earlier I was using Human Mixtard 70-30. Recently my doctor has changed the Insulin to Humalog with Lantus. Now the problem is that after having any meal, my sugar level will drop to 200 (before 1-2 hours). If I check it after 3-4 hours, it crosses 300. When I was taking Human Mixtard, the after meal sugar level goes high above 250-300 and comes down after 2-3 hours. Please suggest me the Insulin, which can control my sugar levels the whole day.

A:Your problem is genuine and not uncommon. It is happening because humalog not only has a quick onset of action, but also a quick offset of action. It is therefore controlling the immediate post meal spike but the effect wears off in a couple of hours. It is the reverse with mixtard - late onset and late offset. Lantus plus humalog is clearly the best combination for you. One option is to increase the lantus slightly to get over this problem. This requires some fine tuning which I am sure your endocrinologist will be able to do for you.

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