In looking into time-action curves for different dosages of Levemir (thanks @Eric for the data in the other thread) I started thinking about different curves for different dosages of Bolus insulin. I realize this varies from person to person, and even within a person (activity level, temperature, hormones, infections, etc) but this is interesting to me. The first one - Regular insulin dosed at rates from 0.05 U/kg to 0.4 U/kg: source
The second one compares time action profiles for different dosages of Apidra and Regular: source
Many of you have heard Dr. Bernstein describe injection of 70 units of Regular into the arm of a non-diabetic in a clamp study…it took about a week to fully metabolize the insulin!
In looking at this, I wonder if a bolus insulin injection were to be split into several micro doses at different sites (talking MDI here) a shorter action profile could be realized? (sub-Q, Neglecting IM and IV boluses here for the moment).
For example, the concept of mircobolusing. If I give small correction boluses 0.5 units for example) they tend to act quickly and be gone quickly. Larger corrections take a longer time and are around longer.
Also for Levemir - When I started to use levemir (about 2005) I took 1 shot of levemir a day and at the time the U/kg body weigh was enough to make it last for 23 hours. I split the dose in half at some point and took it twice a day and the U/Kg meant it lasted about 11 hours. So I actually did not notice a huge difference between 1 or 2 shots a day early on. When I lost weight, I started to notice that 2 shots was better than 1. I used to take quite a bit of levemir at a time.
I think Bernstein uses a lot of hyperbole (and unsupported anecdote) in book. The 70U example is definitely anecdotal and I suspect it may also be a bit of hyperbole, but it does drive home the point that insulin action is dependant on the size of the dose and the body weight of the injectee.
