Changing Insulin (Type 2 Diabetes) – What Your Doctor May Not Have Told You
Why are insulin regimens changing?
Some people are being switched to Ryzodeg® as part of a broader change in insulin availability in Aotearoa New Zealand.
Older premixed insulins (such as NovoMix® 30) are expected to be phased out over the next year or two. As a result, prescribers are looking for alternatives that can provide both background and mealtime insulin in a simpler way.
Ryzodeg® (recently approved for funding by Pharmac) is one of those alternatives.
For some people, the change makes sense and works well.
For others, it raises new questions about meals, timing, and hypos.
What matters most is not just what insulin is prescribed — but how well it is explained.
If you’ve been changed from one insulin to another and don’t understand why, it’s reasonable to ask:
- What is this insulin doing differently?
- Do I need to eat differently with it?
- What should I watch for?
These are safety questions, not “difficult patient” questions!
Starting on Ryzodeg®
For many people living with type 2 diabetes, starting insulin is a big step.
So is changing it!
Yet insulin changes often happen quietly — a new prescription, a different pen, a quick explanation (or none at all), and life carries on.
Except sometimes… it doesn’t always work out that well for us.
People notice unexpected lows.
Blood glucose patterns feel unfamiliar.
Meals suddenly seem to “matter more”…
Confidence takes a hit.
And many people are left wondering, “What changed? This was was supposed to be better!”
This article is about filling that information gap between what your insulin is intended to do, and how that’s experienced in real life.
Not all insulin does the same job
A key piece of missing information for many people is this:
Different insulins do different jobs.
- Some insulins are designed to provide a steady background level all day and night
- Others are designed to manage rises in blood glucose from food
- And some insulins do both.
If no one explains which job your insulin is doing, it becomes much harder to:
- understand your readings
- predict what might happen
- know what questions to ask
Background insulin
Insulins like Lantus® are usually prescribed as background (basal) insulin.
Their role is to:
- keep glucose levels steady between meals
- support overnight control
- work quietly in the background
They are not designed to cover meals.
That doesn’t mean food doesn’t matter — but timing, size, and variability of meals usually have less immediate impact than with other insulins.
Many people settle into a rhythm with background insulin and build confidence over time. Which is why a change away from it can feel unsettling — especially if the difference isn’t explained.
An insulin change isn’t necessarily just a brand swap. It can change:
- how food affects blood glucose levels
- how timing matters
- how quickly lows can occur
- how long adjustments take to show
Ryzodeg®
This is the new insulin that many people with type 2 diabetes are being put on to.
On 1 May 2025, Ryzodeg® 70/30 became funded and available in Aotearoa New Zealand.
Since then, I have come across quite a lot of people who seemingly have been no information or education around what this is insulin is, nor how it works, or how it might be different …
“Let’s try you on Ryzodeg.”
Often with little explanation beyond:
“It’s a new insulin which might work better for you.”
Here’s the part that really matters if you’ve moved from an injection of Lantus to an injection of Ryzodeg:
Ryzodeg is not just a background insulin.
It is a combined insulin, containing:
- a very long-acting background insulin, and
- a fast-acting insulin that works on food
That means your one injection is doing two different jobs.
Why this matters in everyday life
Because Ryzodeg includes food insulin, it is usually taken with a main meal — often the largest meal of the day.
For many people, this works well and can:
- reduce the number of injections
- better manage food-related glucose rises
- simplify routines
But it also means some things matter more than they used to.
With Ryzodeg:
- meal timing matters
- skipping or delaying a meal matters
- eating much less than usual matters
- unexpected exercise around that time can matter
If insulin is taken but the meal doesn’t happen as expected, low blood glucose (hypoglycaemia) can occur.
This can be surprising — and scary — if no one warned you.
It lasts a long time — which is helpful and tricky
The background component of Ryzodeg works for well over 24 hours.
That long duration can be helpful — but it also means:
- dose changes take several days to fully show their effect
- today’s numbers may reflect decisions made days ago
- “quick fixes” rarely work
If things feel unsettled at first, that doesn’t mean failure.
It often means the insulin is still finding its new balance.
Who Ryzodeg may suit — and who it may not
Ryzodeg can be a good fit for people who:
- eat one or two regular main meals
- prefer fewer injections
- need more help with food-related glucose rises
- were previously using premixed insulin
It may be more challenging if:
- meals are unpredictable
- appetite varies a lot day to day
- recognising hypos is difficult
- support and education are limited
There is no “best” insulin — only what fits your diabetes and your life.
“I was switched, but I wasn’t told it worked differently”
This is something many people say.
If you were moved from a background insulin (like Lantus) to Ryzodeg and thought:
“I didn’t realise food mattered this much now…”
That reaction makes sense.
You could ask:
- What job is this insulin doing now?
- What happens if I don’t eat?
- What should I watch for with lows?
- Who can help me understand food and timing with this insulin?
Ryzodeg is doing two jobs — and one of them needs food
One important difference with Ryzodeg® is that part of the dose is fast-acting insulin.
That fast-acting component is designed to work on the rise in blood glucose after eating — especially carbohydrates.
What this means in real life:
- When you inject Ryzodeg®, your body is expecting a meal
- If that meal is delayed, skipped, or much smaller than usual, your blood glucose can drop too low
- If you exercise hard soon after injecting, the risk of a hypo can increase
This is different from background (basal-only) insulins like glargine (Lantus®), which are not linked to meals in the same way.
Ryzodeg needs appropriate timing + carbs to match.
It’s not “better” or “worse” — just different.
People taking Ryzodeg® deserve clear guidance about:
- eating a carbohydrate-containing meal with their injection
- what to do if plans change
- how to recognise and manage hypos
If you’re unsure how much carbohydrate is “enough” for your dose, asking for support from a diabetes nurse or dietitian is not a failure — it’s part of safe insulin use.
Understanding your insulin can prevent a lot of unnecessary fear, blame, and hypos.
This isn’t about blame
Health systems are under pressure.
Clinicians are time-poor.
Funding decisions affect prescribing patterns.
But none of that changes this truth:
People inject insulin into their bodies every day.
They deserve to understand what it’s doing.
Clear explanation builds:
- confidence
- safety
- and trust
Without it, people are left guessing — and guessing with insulin is not fair.
If your insulin has been changed:
- your body hasn’t failed
- you haven’t “lost control”
- and you’re not asking too much!
You’re simply navigating your own journey with diabetes.
Ask questions.
Seek explanation.
And remember — diabetes care works best when knowledge meets real life.
Learn more!
You can learn more about what insulin is, how it works in the body, and about different insulin regimens from these pages:
Published: January 2026
| LEGAL DISCLAIMER: The information on this website is provided for general educational purposes only and is intended for a New Zealand audience. It is not a substitute for professional medical advice, diagnosis, or treatment. While I strive to ensure accuracy and relevance, please always seek guidance from your healthcare provider for personal medical decisions. Use of the content is at your own risk. Links to other sites are for convenience and do not imply endorsement. |
