Hi

Status
Not open for further replies.
I wonder if there has been some mix up or confusion about either the insulin he was supposed to be prescribed or when he was supposed to take it. It is veryunusual to take Novomix 3 times a day because the slow release element of it is only supposed to be taken twice a day and obviously you can't separate out the slow release, so he is getting slow release 3 times a day and those doses will all be overlapping and making things less predictable. Do you have anyone that you can contact and confirm that you have the correct insulin or have been given the correct instructions for using it. That said, it sounds like his levels are still high but taking it 3 times a day could put him at risk of a nasty nocturnal hypo as that lunchtime slow release dose will be overlapping with the evening dose.

I believe we had a member here recently who was wrongly dispensed Novomix instead of NovoRapid when they were away on holiday abroad, so mistakes can and do happen and it would be best to check if you can.
What are his levels like and when are you testing?
How many units of Novomix is he using?
I can't comment on him still having ketones as I have no real experience of them but following a low carb diet can cause dietary ketones and I think you said you had been cutting down on his carbs, so it may be wise to serve him normal meals. This will also allow the doctors and nurses to see how his body and the insulin he is using respond to a normal diet.
 
Mom of Type 1 said:
Blood sugar is still high...but sometimes go down below 5, then shoot up 17...hard to predict...coz doctor still adjusting his novomix
Click to expand...

Is this a major hospital? It would be easier if he was taking separate insulins. I can see on that list I posted that there are a few options available for slow insulins and for fast. Is he doing his own injections? If not, is he sure it’s Novomix they’re giving him at lunch?
 
rebrascora said:
I wonder if there has been some mix up or confusion about either the insulin he was supposed to be prescribed or when he was supposed to take it. It is veryunusual to take Novomix 3 times a day because the slow release element of it is only supposed to be taken twice a day and obviously you can't separate out the slow release, so he is getting slow release 3 times a day and those doses will all be overlapping and making things less predictable. Do you have anyone that you can contact and confirm that you have the correct insulin or have been given the correct instructions for using it. That said, it sounds like his levels are still high but taking it 3 times a day could put him at risk of a nasty nocturnal hypo as that lunchtime slow release dose will be overlapping with the evening dose.

I believe we had a member here recently who was wrongly dispensed Novomix instead of NovoRapid when they were away on holiday abroad, so mistakes can and do happen and it would be best to check if you can.
What are his levels like and when are you testing?
How many units of Novomix is he using?
I can't comment on him still having ketones as I have no real experience of them but following a low carb diet can cause dietary ketones and I think you said you had been cutting down on his carbs, so it may be wise to serve him normal meals. This will also allow the doctors and nurses to see how his body and the insulin he is using respond to a normal diet.
Click to expand...
Thats why till now, we had difficulty in identifying the right amount. I had asked the doctor to try out the basal/bolus method. Lets see..
 
Inka said:
Is this a major hospital? It would be easier if he was taking separate insulins. I can see on that list I posted that there are a few options available for slow insulins and for fast. Is he doing his own injections? If not, is he sure it’s Novomix they’re giving him at lunch?
Click to expand...
Yes, Novomix. I see it myself from the pen
 
Ok, doctor switched to Novorapid 10 units to start with and his glucose level is 14...lets see
 
Is that 10 units before each meal?
Being switched to NovoRapid definitely seems like a step forward, but I would expect/hope that a basal (long acting) insulin is added at some point in the near future too.
 
rebrascora said:
Is that 10 units before each meal?
Being switched to NovoRapid definitely seems like a step forward, but I would expect/hope that a basal (long acting) insulin is added at some point in the near future too.
Click to expand...
Yes, 10 units first and will see after 2 or 3 hours. He just ate his meal. 15g of rice, 3 chunks of tofu and some vege.. before he sleeps tonight, doctor supposed to give him a basal..lets see
 
Mom of Type 1 said:
Yes, 10 units first and will see after 2 or 3 hours. He just ate his meal. 15g of rice, 3 chunks of tofu and some vege.. before he sleeps tonight, doctor supposed to give him a basal..lets see
Click to expand...
15g rice seems like a tiny amount for a teenager, actually a tiny amount for anyone! Was he not very hungry or is that a typo. If he is having NovoRapid then he needs to eat plenty of carbs.

For me with 10 units of NovoRapid insulin, I would need nearly 100g of carbs which probably would be somewhere near 200g of cooked rice maybe more.... I don't eat rice so I am very much guessing at that, but others who eat rice regularly will hopefully correct me.

If he doesn't eat normal meals the doctors will not be able to work out his carb to insulin ratio and he does need to eat plenty as he will likely have lost weight as a result of his diagnosis. Also, if he doesn't eat enough carbs with that amount of insulin, he is at risk of a hypo which is far worse than his levels being a bit high.

Is your son in hospital still or is he at home? If in hospital, are you preparing food for him and taking it into the hospital?
 
rebrascora said:
15g rice seems like a tiny amount for a teenager, actually a tiny amount for anyone! Was he not very hungry or is that a typo. If he is having NovoRapid then he needs to eat plenty of carbs.

For me with 10 units of NovoRapid insulin, I would need nearly 100g of carbs which probably would be somewhere near 200g of cooked rice maybe more.... I don't eat rice so I am very much guessing at that, but others who eat rice regularly will hopefully correct me.

If he doesn't eat normal meals the doctors will not be able to work out his carb to insulin ratio and he does need to eat plenty as he will likely have lost weight as a result of his diagnosis. Also, if he doesn't eat enough carbs with that amount of insulin, he is at risk of a hypo which is far worse than his levels being a bit high.

Is your son in hospital still or is he at home? If in hospital, are you preparing food for him and taking it into the hospital?
Click to expand...
Still in hospital. I have prepared a wholemeal bread for him in case he is hungry..
 
Mom of Type 1 said:
Yes, 10 units first and will see after 2 or 3 hours. He just ate his meal. 15g of rice, 3 chunks of tofu and some vege.. before he sleeps tonight, doctor supposed to give him a basal..lets see
Click to expand...

I agree with @rebrascora that that seems a tiny amount of food. If he’s not eating properly, that will cause ketones too. They’re known as ‘starvation ketones’ and people develop them when they haven’t eaten or haven’t eaten enough.

Also, presuming he lost weight prior to his Type1 diagnosis, then he needs to eat well to put that weight back on. I hope he’s ok after the 10 units of Novorapid. It seems a lot to start with.
 
Inka said:
I agree with @rebrascora that that seems a tiny amount of food. If he’s not eating properly, that will cause ketones too. They’re known as ‘starvation ketones’ and people develop them when they haven’t eaten or haven’t eaten enough.

Also, presuming he lost weight prior to his Type1 diagnosis, then he needs to eat well to put that weight back on. I hope he’s ok after the 10 units of Novorapid. It seems a lot to start with.
Click to expand...
I Just got the reading. It went down from 14.9 to 7.7. Now the doctor had given Toujeu 8u for the night. Lets see tomorrow. Pray hard. Will continue to monitor
 
Hope things begin to settle for him now he’s on a more usual insulin regimen @Mom of Type 1

Must be very worrying for you both :(
 
Can u wake up late in the morning ? Eg, weekends, kid wanted to sleep more and wake up around 9am to 10am...late breakfast...
 
On a basal bolus insulin regime you can get up when you like and skip meals altogether if you like or stay up half the night partying. That is the beauty of it, that you can be flexible whereas with the mixed insulin you need to be more discipled and regimented with dose times and meals.

I go to bed early some nights and get up early the following morning or I go to bed late like tonight and will be getting up later than usual tomorrow. I might skip breakfast and just have lunch or have breakfast and skip lunch. Some days I just have one meal a day and that is fine too.

The only important thing is to try to take your basal (long acting) insulin around the same time every day, although I find an hour or two different with my basal doesn't cause too much problem but wouldn't want it to go much further adrift than that deliberately. That said, there are times when we all make mistakes or forget to take a dose and you just learn how to deal with that.

Short of having an ambition to be an astronaut, his diabetes should not stop him from doing anything he wants to in life, but he will need to give things more thought and planning to achieve them.
 
rebrascora said:
On a basal bolus insulin regime you can get up when you like and skip meals altogether if you like or stay up half the night partying. That is the beauty of it, that you can be flexible whereas with the mixed insulin you need to be more discipled and regimented with dose times and meals.

I go to bed early some nights and get up early the following morning or I go to bed late like tonight and will be getting up later than usual tomorrow. I might skip breakfast and just have lunch or have breakfast and skip lunch. Some days I just have one meal a day and that is fine too.

The only important thing is to try to take your basal (long acting) insulin around the same time every day, although I find an hour or two different with my basal doesn't cause too much problem but wouldn't want it to go much further adrift than that deliberately. That said, there are times when we all make mistakes or forget to take a dose and you just learn how to deal with that.

Short of having an ambition to be an astronaut, his diabetes should not stop him from doing anything he wants to in life, but he will need to give things more thought and planning to achieve them.
Click to expand...
Got it. Thank you so much all of you. Your advice has helped me so much during these difficult times...love and hugs and gratefulness..
 
The bolus is only needed to match the carbs that we eat. So if no meal then no insulin is needed.

This is the joy of the basal/bolus regime. Life can be a lot more flexible. As @rebrascora said it is good to have the basal insulin at around the same time each day. Then the bolus insulin is just needed for when you eat carbs. We should aim for a good balanced diet, but like people without diabetes we all have days that are better/worse than others. However so long as we know how many carbs we are eating we can then match the insulin that we need for what we choose to eat when we choose to eat.

This does all get easier.
 
Status
Not open for further replies.
Back
Top