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Advice

Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Hi @LittleSunflower from another late starter. I was 53 at diagnosis.
The slower onset often leads to some confusion at diagnosis. I am very pleased that they have now sorted things out and that you have a good team supporting you.

It is a lot to take in at the start but once you get the hang of adjusting your own doses of insulin life becomes a lot more flexible and you will begin to see a lot more BG values in range.

Two books that I found very useful at the start were

  • Type1 Diabetes in Children Adolescents and Young Adults by Ragnar Hanas (ignore the age reference, just ignore the chapter on starting school!
  • Think Like a Pancreas by Gary Sheiner. Not such an easy read but very useful.
There is loads of help on here drawing on so much practical experience, as well as lots of support.
Just ask any questions that you have.
 
Inka said:
Sounds ideal 🙂
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Dosage is 8 in the morning and 6 in the evening. Only starting on the Levemir to begin with. They believe it is Type 1 and I have to have another HBA1C soon as my symptoms no longer match my previous result.
Spoke about getting a Libre device fitted next week?
 
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LittleSunflower said:
I have been prescribed Levemir and Novorapid.
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I was realllly hoping to hear this. As once you learn how to adjust Novorapid yourself (don’t worry they will eventually teach you how ) it is far far more flexible than the twice a day mixed insulin .

They usually start us off conservatively, although they have a formula to go by, they don’t really know how much insulin we actually need. Also they need to bring our levels down gradually else we suffer from some unpleasant symptoms, which are usually temporary.
I hope you are not too worried about going onto insulin.
 
Great! For MDI purposes I'm a great fan of Levemir - and you can adjust doses of it so quickly - in comparison with such things as Lantus where you need to wait for a full 3 days between even very slight adjustments up or down, to be certain whether it's worked or not. I never expect anything to be instant but with 'my mate' you can generally see what effect you've got after c. 12 hours!

Been using Novorapid since 1998 - and still using it. If it ain't broke, I don't see any need to try and fix it, frankly.
 
trophywench said:
Great! For MDI purposes I'm a great fan of Levemir - and you can adjust doses of it so quickly - in comparison with such things as Lantus where you need to wait for a full 3 days between even very slight adjustments up or down, to be certain whether it's worked or not. I never expect anything to be instant but with 'my mate' you can generally see what effect you've got after c. 12 hours!

Been using Novorapid since 1998 - and still using it. If it ain't broke, I don't see any need to try and fix it, frankly.
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Thank you. With Levemir, I have my first dose of 6 units this evening. I am very nervous about injecting. Do you have any advice? Any side effects that you have experienced or I should be aware of?
 
Bruce Stephens said:
Not for Levemir. I can't remember anyone reporting anything bad with it: there's a reason it's the first line recommendation from NICE.
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Thank you for the reassurance. I’m known for being a worrier, even about the littlest of things so you can imagine the worry that comes with such a shock of life changing information!
 
Well I'd already had diabetes for 30 ish years by the time I gained agreement to swap to it, so it was a blessed relief as far as I was concerned to have my first jab of night-time insulin that didn't sting like Lantus did! - I stress that Lantus doesn't/didn't sting everyone, so I was just unlucky there.
 
My morning levels are surprising after last nights first dose of insulin.. I’m in the 5s! Usually in double figures.
 
Wow! That has dropped you pretty quickly. They normally calculate the dose to bring your levels down more slowly, but you might be quite sensitive to insulin, especially with being so slim. Do keep your hypo treatment close to hand and take it easy today exercise wise, but congratulation on a lovely mid range fasting reading.
 
rebrascora said:
Wow! That has dropped you pretty quickly. They normally calculate the dose to bring your levels down more slowly, but you might be quite sensitive to insulin, especially with being so slim. Do keep your hypo treatment close to hand and take it easy today exercise wise, but congratulation on a lovely mid range fasting reading.
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Thank you
Should I be concerned that it’s dropped quickly after just one dose? I have to have my higher dose of 8 units this morning - will this keep things regulated, not decrease the number?
 
It is very hard to say how any individual will respond to insulin because we are all very different. Do you have the option to speak to your nurse before you take the second dose or perhaps delay it a bit in order to do so? Most people need more basal insulin during the day than at night (for instance I am currently having to take 25 units in the morning and none at night to keep my levels right) so it may be fine to take the 8 but I would have a quick word with the nurse first if you are able.
Are you also going to be using the NovoRapid today? If not, then the Levemir dose this morning should be fine even if you don't manage to speak to the nurse.
 
How did you manage with the injection last night? I am guessing that was your first?
 
LittleSunflower said:
My morning levels are surprising after last nights first dose of insulin.. I’m in the 5s! Usually in double figures.
Click to expand...

I’d speak to your nurse as they might consider dropping your evening Levemir ever so slightly. They might not, but it’s worth checking.

As regards your morning 8 units, I’d suggest taking it and seeing how it goes this first day. Test lots and keep those results for your nurse. Even if the daytime Levemir works ok today, it might be reduced when the Novorapid is introduced.
 
@rebrascora @Inka I managed to get into contact with the nurse and she said to reduce it to 6 for the dose this morning (of which I did) as it seems like I am very sensitive to insulin, like you said.
My level after some breakfast was just over 10 so it had gone back up.
I am struggling to inject myself but it went ok. It’s been a whirlwind couple of days, it’s difficult to draw blood for the readings too as my hands don’t keep the warmth for long after washing prior.
 
You will get better at both the injecting and finger bodging. The saying "practice makes perfect" is a true saying but totally sympathize with getting your head around it in the beginning.
Which part of the injecting process causes you the most difficulty? Is it the actual insertion of the needle? There is something called the "Tickle Flex" which can be purchased and fits on the end of the insulin pen needle to make injecting easier. I haven't used one myself but might be something worth researching if it continues to be a problem for you.
Are you finding injecting painful or is it just the thought of it? There are certainly some sites which are more numb and I don't feel it at all and others where it is really painful and many more sites where it is somewhere in between. Not sure if this is normal as some people say injections shouldn't hurt and some of mine definitely do but nothing I can't cope with. Sometimes I touch the needle to the skin and if it hurts I move it to another location that doesn't before I push it in and inject. Sometimes I find pinching the flesh helpful, even though the current guidance is that you don't need to.

Anyway, pleased you spoke to the nurse and got some guidance. Did she say anything about reducing your night time dose or is that to stay the same for now? Will she be checking in with you again tomorrow?
 
rebrascora said:
You will get better at both the injecting and finger bodging. The saying "practice makes perfect" is a true saying but totally sympathize with getting your head around it in the beginning.
Which part of the injecting process causes you the most difficulty? Is it the actual insertion of the needle? There is something called the "Tickle Flex" which can be purchased and fits on the end of the insulin pen needle to make injecting easier. I haven't used one myself but might be something worth researching if it continues to be a problem for you.
Are you finding injecting painful or is it just the thought of it? There are certainly some sites which are more numb and I don't feel it at all and others where it is really painful and many more sites where it is somewhere in between. Not sure if this is normal as some people say injections shouldn't hurt and some of mine definitely do but nothing I can't cope with. Sometimes I touch the needle to the skin and if it hurts I move it to another location that doesn't before I push it in and inject. Sometimes I find pinching the flesh helpful, even though the current guidance is that you don't need to.

Anyway, pleased you spoke to the nurse and got some guidance. Did she say anything about reducing your night time dose or is that to stay the same for now? Will she be checking in with you again tomorrow?
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Insertion of the needle is the main one, it can hurt when inserted but my nurse said this was because I am so anxious, my body is tensed up (we did a few dummy tries together). Finger pricking, again, pressing the button is a big thing for me. It’s funny how I can manage setting everything up but the main part, I struggle with currently. No mention of any change to night time dose and I am expecting to be contacted tomorrow for a check in which is nice to know.
No mention of starting Novorapid either as they’d like to see how I react to Levemir first. I’m not a big meal eater, more of a snacker so the nurse said Levemir is fitting for me.
 
LittleSunflower said:
Insertion of the needle is the main one, it can hurt when inserted but my nurse said this was because I am so anxious, my body is tensed up (we did a few dummy tries together). Finger pricking, again, pressing the button is a big thing for me. It’s funny how I can manage setting everything up but the main part, I struggle with currently. No mention of any change to night time dose and I am expecting to be contacted tomorrow for a check in which is nice to know.
No mention of starting Novorapid either as they’d like to see how I react to Levemir first. I’m not a big meal eater, more of a snacker so the nurse said Levemir is fitting for me.
Click to expand...

Hmmm... Apologies if it was you I said this to already, and I’m repeating myself, but Levemir is a basal/background insulin. It’s purpose is to keep your blood sugar in range in the absence of food. It is not to deal with food.

Even if you only need small amounts of insulin, it’s better to have the two separate kinds because they do different things.
 
I find the pain is much more down to the nerves at the site as I don't suffer anxiety with my injections and finding a place where I can't feel it when I just touch the needle to the skin makes a big difference. Are you just using your stomach at the moment? Just wondering if you might be less uptight injecting into your thighs or buttocks. I tend to inject my Levemir into my thighs or buttocks and keep my abdomen for my bolus insulin as it seems to absorb a bit more rapidly there, whereas it doesn't matter with the Levemir as it is slow release anyway. Just something else to consider.
 
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