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Old 12-31-2008, 12:45 PM
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Default Insulin Profiles - Lilly's Graph of Actions of Insulin

When you see R and NPH mixes like 70/30 and 50/50, the insulin is a pre-mix of R and NPH. 70/30 is 70% NPH and 30% R--50/50 is half NPH and half R. Not many animals need that much R as a rule, so when R is called for, it is usually much less than that.

If someone with diabetes needs to use cortisone-type meds for any reason, those can drive the bg's up and then there are times when some R is used to keep the bg's down while you're using the medication.

If someone's needing to use R, I believe you need to be blood testing and you need to be doing it more frequently than you might if there's no R in the picture. R works fast because there's no suspension to it. It leaves the system quickly because there's no suspension to it, but making a mistake with R can easily lead to a hypo incident.

Back in the old days when insulin was first isolated for use in controlling diabetes, R insulin was all there was. There were no suspended insulins until Hagedorn came up with PZI in 1936. Until then, if you needed to use insulin, you had to make sure you set an alarm to wake you up for a middle of the night shot. So the real diabetes pioneers used R all the time, each and every day for their total bg control.


Kathy


Take a look at the time action profiles--the one for Humulin R, the one for NPH without any R added, and then look at the Humulin 70/30 which is 70% NPH and 30% R, then the Humulin 50/50 which is half NPH and half R. You'll see the type of "punch" R can pack when you compare that action profile to NPH alone.