Humalog

I have in the last week started injecting Humalog, the first insulin product I have tried. Humalog is fast-acting insulin to be injected just before a meal or immediately after. The amount to be injected varies with the individual and with the meal that is to be eaten, or has just been consumed. The insulin offsets the blood sugar level that otherwise develops when the carbohydrates in the meal are digested and are turned into sugar. The effect lasts only 3 or 4 hours ... by which time you're probably ready for your next meal.

My doctor has me logging my injections, the carbs I eat, and my pre-meal and (2-hr.-later) post-prandial blood glucose measurements.

If you inject too little Humalog, your post-prandial blood sugar reading will be too high: above the target range of 100 to 140 mg/dL.

If you inject too much Humalog, you could end up with low blood sugar, a.k.a. hypoglycemia, with its unpleasant symptoms, or even insulin shock (going into a coma). There is real danger in that case, so it's a good idea to have glucose tablets on hand to speed extra sugar into your blood stream if your blood sugar drops too far.

Humalog is "bolus" insulin, as opposed to "basal" insulin: it does its work quickly and exits your system rapidly. You use it only at mealtimes. As a result, it doesn't "fix" too-high glucose levels during fasting periods or between meals. My doctor has told me that after I get accustomed to Humalog use, I'll probably have to augment it with a longer-acting basal insulin, possibly Lantus.

I have been given Humalog already loaded in an injection pen, rather than using a syringe with a separate vial of insulin. The pen is designed to let me easily set the number of units of insulin to deliver through its short, fine needle into the subcutaneous fat of, say, the belly. I find it works well. There is virtually no pain when I jab myself with the needle. I have to be careful not to press on the area of the injection after removing the needle, though, lest some of the payload leak out.


Before going on Humalog, I tried three oral medications: Metformin (glucophage), Actos, and Januvia. All seemed to make me feel "funky." Januvia was the worst, seeming to give me a headache within 24-48 hrs., every time I tried to start taking it — even with the dosage level halved!

Metformin took longer — 2 or 3 days — to start making me wish I didn't have to take it. No headache, but I was feeling decidedly out of sorts.

Actos took even longer to put me in a blue funk ... but after 3 wks. it hadn't brought my blood sugar down appreciably.

Both my general practitioner and the endocrinologist I consulted were of the opinion that my body — especially my brain — was reacting to lower blood sugar with false symptoms of hypoglycemia, which would go away if I kept taking the medicine. I felt so bad on Januvia, however, that I just couldn't get over that hump.

On Humalog, I'm having few if any such side effects.

But when my blood sugar spikes after a meal, presumably because I injected too little Humalog, I feel "funky." Which makes me think some of the problems I subjectively identified as side effects of the oral medications I was using may have been because they didn't lower my blood sugar enough.