Using Insulin Effectively

Rapid-acting insulin analogue regimens

Anticipate different diurnal profiles of blood glucose control and hypoglycaemia than for human insulin, and thus a need for different dose regimens and different monitoring schemes

Give careful attention to these details, as any improvement in glycated haemoglobin concentration will be dependent on this

Make the following changes when using rapid-acting analogues compared to unmodified human insulin :
		monitor the effect of a short-acting analogue post-prandially ( at 1-2 h ), and always less than 4 h after injection
		expect to use lower pre-meal insulin doses than with human insulin
		use combined NPH + analogue injection before meals, if the between-meal interval is to be greater than 5 h
		use a higher late-evening NPH dose ( unless the aim is specifically to deal with a problem of night-time hypoglycaemia )
		use late-evening NPH no longer than 4 h after the evening analogue injection

Our knowledge of the optimal use of rapid-acting ( and new long-acting ) analogues is evolving month by month – we anticipate a need to modify this advice early on

Using Insulin Effectively -
Insulin dose adjustment