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  • Q&A with Australian Health Practitioners

    Why has my insulin changed?

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    Endocrinology Type 2 Diabetes
    HI I have prednisone Diabetes caused by being on high dose of prednisone since 2011 sadly still on prednison hence so I still take insulin. At the time I was prescribed novo mix insulin which I take once each morning and I was unable to take metaform due to other health issues. My endocrologist has decided to change my insulin now to use prataphane insulin. He sort of explained the difference that because I am on prednison they normally give mix insulin but I am still on pred and now he wants me to take this type of insulin so now I am more confused why he has changed it and would like to understand a bit more if any one able to assist. thank you
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    • Dr Stephen Leow
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    Thanks

    Dr Stephen Leow

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    Whilst I understand the need to be treated with Insulin, the choice of insulin is very much individual. The mixed insulins have a long acting component and a rapid acting component. The long acting component takes care of the insulin that is normally secreted by the pancreas continously, while the rapid acting component takes care of a single meal. The ratio of the two insulins is fixed. As diabetes tends to worsen with time, it is possible that the requirements of the two insulins start to differ and that increasing one insulin might mean that you get too much of the other. It is then prudent to split the insulins and tailor make each dose separately. Protophane is closest to the long acting compnonent of the mixed insulin. However, there does not seem to be a replacement for the rapid acting insulin at the monent. This may be added in later. The regime is called “Basal Bolus”. Normally, the analog insulins (Lantus/Determir) give a flatter profile than Protaphane, but there can be reasons to prescribe Protaphane. Hope this helps.

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