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switching insulin types

I have been taking novolog for several years now but have lost my insurance and can't afford the novolog so while have to buy regular insulin to replace the rapid acting insulin.  My doseage of novolog is 4 units before meals so is that how much regular insulin I should take?  i no longer have a doctor and want to research all this before I run out of novolog so I can try to prevent any compliations in my blood sugar levels during the change
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Avatar universal
JackieJo,
As you may know, we're not physicians here.  While we have considerable personal experience with diabetes, we don't know you or your particulars, so it will be very important for you to meet with a doctor or a certified diabetes educator (CDE) to tailor your transition.

As a start, I'd recommend you check in with your local JDRF chapter or branch.  They sponsor this Forum and have physical offices all over the US and in several other countries.  Navigate to the JDRF website:  http://www.jdrf.org and click on the link to Locations in the top menu bar.  Call or visit the branch nearest you and ask them who in your area will work with you at low/no cost.  Sometimes there are group sessions hosted by JDRF branches that bring wonderful medical professionals to present ideas and answer questions.  Those sessions are always free.

In general, Regular insulin starts acting much more slowly than Novolog and it has a longer "tail" of activity than Novolog.  Many of us long-timers took Regular before the analogs were invented.  Typically, we would take our shot 30 minutes or so before our meal so that by the time our carbos started to be metabolized our Regular had also started working.  The "tail" from Regular means that it works a few hours longer.  

Typically, a unit of Novolog is "active" for about 5 hours, while a unit of Regular is active for closer to 8.  Novolog has its peak much sooner than Regular also.  

I've read some research articles that suggest that we can achieve equivalent levels of control with either Regular or the rapid-acting insulins.  They key is to understand the activity profile of whichever insulin we use, to understand how to correct highs and avoid lows, and to understand how to adjust our dose for our food, exercise, stress, illness, etc.  Here is one reference that describes the activity of insulins:
http://www.medscape.com/viewarticle/449887_4
The article is written largely for professionals and aimed at Type 2s, but there are sections that make perfect sense to the rest of us!  You'll quickly figure out what info you can use & what is meant for others ;-)

The significant differences between Novolog & Regular mean that you really must find a way to discuss your transition with a qualified diabetes medical specialist.  Followup with JDRF locally and investigate if you're eligible for Medicaid or can access a public, teaching hospital or or or.  It's simply imperative that you work with someone who can help you make the many adjustments.  It would not be surprising to find that you may need to change your doses, your timing and perhaps even your long-acting insulin.

You didn't mention which long-acting insulin, but I'm assuming you have Type 1 and that you are using some longer-acting insulin also.

It seems you may be overdue for some good diabetes training since you mention that you take "4 units before meals."  For some years now, diabetes experts generally suggest that we test before our meals and that we use a "correction factor" to accommodate a high or low before our meal and also that we learn to adjust our dose for the amount of carbohydrates we will eat at that meal.  You can learn about these concepts from books, too.

The best coverage of these topics I've seen is in books taht also help folks prepare to use a pump.  The "lessons" on correction factors and the "lessons" on carbohydrate counting are excellent and can benefit all diabetics even those who never plan to use a pump.  Look for a book called "Pumping Insulin" at your local library or browsing-friendly bookstore (so you can relax and read without buying!).

Last but not least, there is a "sister" initiative by JDRF that complements our very public forum.  This sister program is called JDRF's Online Diabetes Support Team.  If you visit the JDRF website (see the link above), you'll see the LEFT-HAND column is for "Newly Diagnosed."  Really it's for all of us who may need refreshers or new motivation.  The very first link in that column will bring you to the Online Diabetes SUpport Team.  Why visit that site?  There is at least one person there who specialized in insurance issues (or lack thereof) and programs to help defray the enormous costs of managing diabetes without insurance coverage.  That site will put you in touch with an individual (by email) who will work with you 1:1.

Good luck.  I'm sure the circumstances around losing insurance are quite stressful and I hope I've given you enough leads that some will bear fruit for you.
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Avatar universal
A long time ago it seems I was put on a regimen using regular and a longer acting insulin (lente) before breakfast.  The arcs in the peak activity levels of the insulins resulted in covering breakfast and lunch with regular and dinner with the lente.  I had a horrible time with it because of my unpredictable lifestyle - insulin reactions were common when the timing of lunch was off.  I also found some books that calculated the amount of insulin to use and gave the peak arc and life span of each type of insulin.  My most recent one was Dr. Bernstein's - although I now dispute his protein diet as red meat does horrible things to my gut.  I find that humalog is nifty but that regular did a better job on the longer-digesting proteins and fats (unless you use Lantus as the long-acting insulin with humalog).  Hope that helps.
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