Lantus and NPH question

[MDS_Coordinator]

Hi all I'm new to long term care, worked Med/Surg last 13 years, as a MDS coordinator so I'm seeing some things for the first time. I've never used Lantus in conjunction with NPH for blood sugar control but the MDs here are ordering it this way. I know you can't mix them in the same syringe but do they counteract each other in the system? The blood sugars here are a little out of control (avg A1C 8.6) and I'm wondering if this is why? Anyone have any info on this or where I may be able to find some? Any help would be greatly appreciated!

[blondy2061h, MSN, RN]

Here's a little tid-bit I learned in Clinicals one night:

Humulin R: Manufactured by adding human genes to E. Coli. Can be used in an insulin pump.

Novolin R: Manufactured by changing yeast components. Can not be used in an insulin pump.

Main difference is that if someone is on either one of these they should not be switched to a different regular insulin because the action of onset and duration is somewhat different.

I'm not sure where your professor learned that. Humulin and Novolin R are identical insulins.

I've used Novolin R, Humalog, Apidra, and Novolog all in my pump on various points in time. Novolin R and Humulin R aren't really preferred for pumps any more due to their longer action profile.

[Cassaundra]

I'm not sure where your professor learned that. Humulin and Novolin R are identical insulins.

I've used Novolin R, Humalog, Apidra, and Novolog all in my pump on various points in time. Novolin R and Humulin R aren't really preferred for pumps any more due to their longer action profile.

It was actually an assigned research question for a student. He was not told what to find, only to find the difference between the two and why. My instructor has over 20 years and said she learned it by experience.