Even when a long-acting insulin is taken at breakfast and bedtime with Humalog, some find their blood sugar rises around bedtime or during the early night. Because there is no dinner Regular left to cover the bedtime hours, a small amount of long-acting insulin is needed at dinner to keep the blood sugar from rising near bedtime. This is a time when the dinner Humalog has disappeared, the morning long-acting insulin is no longer active, and the bedtime insulin has not yet begun to work. One current trend is to use smaller, more frequent doses of long-acting insulin to provide a more stable background level of insulin through the day. Either Lente, Ultralente, or NPH can be used depending on their effectiveness for a particular person.
Some people use two injections, but many are going to three injections a day.
Many research studies have reported that insulin doses remain the same when people switch from Regular to Humalog. However, there are several reasons to be alert for changes in insulin doses. Because meals are covered more precisely with Humalog, look for less insulin needed for meals. Because Humalog has less action time between meals than Regular, with Humalog there may be more need for long-acting insulin during the day. So be alert if a unit of Humalog seems to go farther.