drawing up regular and nph insulin

Nph Insulin: Mixing Is Critical For Best Results

With commentary by study author Geremia Brunetto Bolli, MD, professor of endocrinology, Perugia University School of Medicine, Perugia, Italy Patients on insulin known as NPH (Humulin N, Novolin N) are often reminded that they need to re-suspend it before use by shaking it or rolling it in the palm of their hand. However, doctors know that patients often hurry and don't take the time to mix up this kind of insulin before using it. Now, a new study suggests how crucial that step is. Italian researchers compared the effects of mixing or not mixing NPH insulin on the insulin concentrations in the blood. "It is well known that NPH insulin needs resuspension prior to its use," says Geremia Brunetto Bolli, MD, professor of endocrinology at the Perugia University School of Medicine in Perugia, Italy, who led the study. "However, the different glucose lowering effect of re-suspended versus non-resuspended NPH was not known," he says. In his study, he found that non resuspended NPH insulin ''may result in an approximately twofold difference" in the effect on insulin levels in the blood. His study was published online Sept. 10 in Diabetes Care. So it is important that NPH is properly resuspended prior to its use, says Dr. Bolli. Other insulins that don't require mixing have often replaced NPH. Ideally "people with type 1 diabetes should not use NPH," he says, but be switched to newer types. "However, NPH is still used a lot in type 2 diabetes, either as NPH or mixed with rapid insulin," he says. Two common reasons people are still using NPH: "Limited health insurance coverage, or lack of insurance," says EndocrineWeb Advisory Board Member Amy Hess Fischl, MS, RD, LDN, BC-ADM, CDE, an advanced practice dietitian at the University of Chicago Kovler Diabetes Center. She adds tha Continue reading >>

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