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Advice on Basal Bolus regime.

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Highlander

Highlander

Well-Known Member
Relationship to Diabetes
Type 2
Hi Folks,

I am type 2 and have been on Novomix30 for a couple of months, but am getting a lot of high readings after meals, so had a word with my DSN who suggested increasing my evening injection again so see if it makes any difference. If not she is suggesting that perhaps I might be better on a Basal Bolus regime.

So, the question(s) are:

Any advice, tips, information from anyone else, who is on a Basal Bolus regime, particularly type 2.

Will I have to do carb counting, or just be on a fixed dose.

How easy is it to adjust doses.

Does it help control readings after meals, mine are always between 12-18 after meals.

No doubt there are other questions, but any help or advice would be appreciated.

Thanks
 
I think there are a few type 2s on here that use MDI........

You will need to match up your insulin to the carbs you eat.....which is the good, flexible bit........it does add another dimension to your treatment and you will need to get used to it, but as with everything diabetic, you get used to it quickly....

Adjusting your own insulin in response to high and lows will require some training, but mostly experience and trial and error, you should get some training if you are put on the regime....

keeping mid meal spiking down to a minimum can be achieved with dose timing.....

MDI is very good, but hopefully it went come to that......
 
Will I have to do carb counting, or just be on a fixed dose.
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It's up to you. If you're on a fixed dose, you'll have no flexibility at all about what you can eat. That could get boring very quickly.

How easy is it to adjust doses.
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Very easy. Your basal probably won't need changing very much but you can and will be changing your bolus all the time. For instance, yesterday morning I had a omelette, so I only took 2u. This morning, I had muesli, so I took 8u. You change the dose according to the carbs in the meal. My ratio is about 1u of insulin to 5g of carbs. Yours will probably be something different and it will vary throughout the day anyway.

Does it help control readings after meals, mine are always between 12-18 after meals.
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Yes, because you are dosing your insulin according to the meal.

The flipside is this requires a LOT more work on your part. You'll need to know pretty exactly how many grams of carbs are in everything you eat. You'll need to work out your insulin ratios. And you'll need to be testing before each meal and two hours after each meal, all the time, if you want to stay in control. But it is definitely worth it.
 
Hi there Highlander.I am type 2 and went on insulin last September. Initially on a mix - Humalog 25. It was ok BUT I hated that I had to eat to the insulin rather than using insulin to cover what I was eating. I HAD to eat about 12 otherwise I would hypo. Luckily easily identifying symptoms with me - sweating, jelly legs and palpitations.

I quickly learned to check BS if started to perspire. If you have a regular eating regime then a mix is probably easier to start with and they will probably put you on that anyway.
It took me several months to convince my Dr to put me on MDI (mulitple daily injections) where you have 2 insulins - one for background and one for meals. I lov e it as I am in control now and if I don't want a meal it is fine. It does mean 4-5 injections a day but it ally does not hurt - although it took me quite a few minutes to do the first one. Test BS 2 hrs after meals and aim to be close to the pre meal reading. All will be explained and ask any wuastions on here. There is always someone around who has done it before - even the silliest things (like hubby putting hot hard boiled eggs on top of the insulin in the fridge which was my latest!!!)
 
Hi Vic, I won't repeat the advice you've already had, but just wanted to say go for it! It's much more flexible than being on mixed insulin, and you can tailor the meal insulin dose to what you are eating, so hopefully no more 12-18mmol after your meals!

Don't be put off by the thought of carb counting, it's really not that hard. I'd recommend you get a copy of the Carbs and Cals book, also available as a smartphone app. This lets you browse through photographed portions of all sorts of foods and meals, giving the carb content. You'll very quickly learn the carb values for foods you eat regularly. 🙂
 
Thank you all for all your help and advice. I have downloaded the Carbs and Cals to my iPad, very interesting little book. Will have to wait and see what the DSN has to say next week.
 
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