In the spirit of putting my money where my mouth is, the next time I have some time off i’ll hapily do a trial of NPH and regular for a while. I’ve never used them before. I’ll post my observations.
The costs associated will be $24.95 for a fresh vial of R and the same for the NPH. I already have syringes.
I’ll set up a gofundme to help get started (kidding)
@Sam, if you do, stock up on test strips first or charge your cgm…R & NPH are a roller coaster combo that demands lots of work riding spikes and trying to manage stacks unless of course you just opt for higher than normal sugars. I say this as a previously long term Walmart over the counter insulin user (due to my need for financial creativity). I greatly prefer when I can afford them (with insurance) the newer analogs…
And now I step out of this convo…
I think my first strategy would be to take 1/4 the daily basal with NPH every 6 hours… hopefully that’ll help to smooth out he basal. And I’ll be eating like times are tough… lots of beans and cheap meats… so hopefully just eating slower foods will match regular reasonably well… We’ll see. Luckily I got an instant pot for Christmas so I think I can make it work out. I always have a ton of strips… debating about whether I should use the cgm… it would be valuable for evaluation purposes and make it easier, but if the point is to prove that you don’t need to have a lot of resources to make it work maybe would be better without?
I think it will be good for my confidence and in he spirit of being Unlimited to give it a whirl…
I used to bolus NPH 4x daily, and R 5-6x daily using Relion Prime meter only when I felt “off”. When I found a CGM on CL and saw the data for the 1st time, I was blown away! All the peaks and valleys oh my! Since i wasn’t testing very much, it was sort of like playing Russian Roulette with insulin.
Do you think a reasonable starting point is 1:1 with your analog basal dose? Divided into 4 daily doses?
I know that DR Bernstein says quite a bit more R is needed than analog bolus
@Sam I would be remiss in suggesting a starting point. Personally I used 80u/day with Lantus and Tresiba. With NPH I was doing 14-16u x 3 daily based on expected food intake. My PM/pre bed shot was the largest by far at 20u. With R is was strictly carb values, with no protein/fat alterations (since I had no idea about that sort of stuff back then). I often chased the insulin, having to feed it unexpectedly because of a stack i didn’t plan for. I was just trying to even out the spikes
I will be very interested to see how this shakes out. Hopefully you try this experiment when you are able to deal with thins like unexpected lows/highs with a minimum of hassle.
@Sam I think you will be surprised…My A1c at its best on R/NPH never went south of 8.5 and was usually 10+. With analogs/pumps I am mid 6s (after mucho work). I can feel my feet again (sort of), I still have GI issues, and have hypo-unawareness after all the years of high BG. Personally I would only go back to R/NPH if I had no other choice. Its like wine or food - once you know the difference between ok and fantastic, you can never unknow the difference. For me R/NPH is survival and nothing else.
We’ll see how it goes… not sure when I’ll get around to starting this, or how long it’ll go on for… hope to have some old school pros for tips… I suppose the smart thing to do would be to use the cgm to get a better picture of what’s going on, at least at first
@Sam, I would truly be delighted if this regimen proves successful. I hope you won’t stick to it too long if it does not work out.
What are your thoughts on expiration dates? I just looked and my freshest stuff expired 3/2016… it’s probably going to be a few months before I could get to a Walmart to restock… otherwise I could use this in as little as a couple weeks… with analogs I wouldn’t hesitate to use, but this is unknown to me with human insulin
I’ll give it a try and see how it goes. I expect it to be somewhat of a hassle but many thousands of people all over the world are making it work with R and NPH, I suspect I can too
@Sam, I can’t speak for others, but when used R & NPH, if the R wasn’t cloudy and the NPH wasn’t crystallized I used it. Dates were a non issue, cost was. IMHO, the expiration dates are set much shorter than need be. I think because of the FDA the mfr’s have to assume a worst case scenario when labelling with use by dates. I never had any huge problems with out of date insulins - in fact I have a vial of R in the fridge right now from that expired -8/16.
I think it is possible, but not with an A1c we all want to go for here 
But I would love to be wrong!
In the spirit of collaboration, I will gladly fund your experiment 50/50 with you. It is truly deserving.
Haha I’ve got a whole bunch of it that expired in 2014 it turns out…
Thanks for the offer guys but I was kidding about the gofundme thing. Not necessary.
Just make sure my kids are taken care of if I “literally die” 
crickets…
The published research doesn’t support that hypothesis. I will be happy to try it… don’t know if I’ll do it long enough to get a valid a1c out of it but I’ll wear the Dexcom and we can watch the averages and SD