An increasingly common recommendation for people taking insulin is to split the evening dose into a short-acting form of insulin with dinner and long-acting insulin at bedtime. Researchers in Italy have just published a study that compared the two different ways of handling the evening insulin dose.

In the study patients with type 1 diabetes spent four months on their regular regimen of taking a mixed dose of regular insulin (short-acting) and NPH insulin (long-acting) before dinner. Then they switched to the other method: taking the short-acting insulin with dinner and the long-acting form at bedtime. They measured their blood sugar before meals, at bedtime, at 3 a.m. and whenever they thought their level was low.

Researchers found that patients had better glucose control and fewer episodes of nighttime hypoglycemia when they split the evening dose. Both their fasting blood glucose levels and HbA1c values were lower during the split dose period.

Ask your doctor if that would be a better practice for you. Don’t make any changes in your doses or timing of your insulin shots without checking with your healthcare provider.

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Source:  Fanelli CG, Pampanelli S, Porcellati F, et al. Administration of NPH insulin at bedtime versus with dinner in type 1 diabetes mellitus to avoid nocturnal hypoglycemia and improve control. Annals of Internal Medicine, April 2, 2002;136(7):504-514. (Abs.)