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insulin change help?

delta

delta

Well-Known Member
took my 9 year old son to his three monthly checkup today they have moved
him on to lavimir and novarapid how do they work out how much to give as i've
been told to start him on 10 units of levimir and 3 units of novarapid for breakfast 3 for dinner and 4 for tea but how can they know how many units without knowing what carbs he will have at meal times i thought they all-ways
started you on a ratio like 1:10 or somthing plus he allways has supper would he need another novarapid injection then im a little confused:confused:
 
Hi!

My son is 10 and was diagnosed 12 weeks ago. He is on Levemir and novorapid. At first they just had him on 5 units for every meal and 12 levemir at night.
Then as his body requirements changed , exercise growth and honeymoon period etc, he was gradually introduced to the 1:15 1:20 1:15 ratio , which he is just starting to 'settle' with. We do carb counting and it seems to be working ok (apart from the odd blip).
Your son can have supper , he just needs novorapid if the carb content is over 14grams. But, if he has his supper late on - you need to have a space of 1 hour between the supper and the levemir!:)Bev
 
I am on levemir and novorapid and when they gave me my starting amounts i then was in contact with the diabetic nurse who looked at what my blood sugars were doing and then told me whether to up my units. Since I have been on levemir (July 08) I have been in contact with her since december trying to get the correct dose to keep my sugars good. I have been on novorapid since 2003. I am speaking as a 45yr old, they may do it differently for a 9 yr old.
 
what i suspect they have done is taken into account how many units he was taking of the mixed insulin and then worked out equivalent basal and bolus doses.

Did you ask about being taught how to carb count? basal bolus regiemes work best when the novorapid is matched to carb intake. it may be that they want to start you on fixed doses to start with and then move onto adjusting it.

if the basal is well set then if having a significant amount of carbs at supper then yes, would probably need to be covered with novorapid. But until you know how well the basal dose is working I think you should be cautious about injecting fast acting insulin right before bed. Speak to your DSn about this.

Bev- just wondering why you are advising not having snack at same time as levemir?
 
Hi sofaraway,

We havent been advised to give Alex a snack with his levemir - he will sometimes have a snack if he is extra hungry- but as far as i know there is no requirement to have one? Bev
 
I agree that there is no requirement (generally) for a snack, I don't need to have one but often choose to have one.

"But, if he has his supper late on - you need to have a space of 1 hour between the supper and the levemir!'

This is what i was asking about?
 
I dont think i have explained myself properly!

Alex eats evening meal at about 6.30ish and takes his novorapid with it. Then later on at 9 he has his Levemir just before bed time.
But, if, for some reason, his evening meal is late , then we have to leave it 1 hour after injecting his novorapid before we can inject his levemir. Hope i have made sense this time? Or am i missing the point?lol. Bev:)
 
sofaraway said:
what i suspect they have done is taken into account how many units he was taking of the mixed insulin and then worked out equivalent basal and bolus doses.

Did you ask about being taught how to carb count? basal bolus regiemes work best when the novorapid is matched to carb intake. it may be that they want to start you on fixed doses to start with and then move onto adjusting it.

if the basal is well set then if having a significant amount of carbs at supper then yes, would probably need to be covered with novorapid. But until you know how well the basal dose is working I think you should be cautious about injecting fast acting insulin right before bed. Speak to your DSn about this.

Bev- just wondering why you are advising not having snack at same time as levemir?
Click to expand...

my son is on mixtard 30. 11 and a half units at breakfast and 9 and a half at tea i know how to carb count a little i understand that the novarapid is giving after the meal
 
bev said:
I dont think i have explained myself properly!

Alex eats evening meal at about 6.30ish and takes his novorapid with it. Then later on at 9 he has his Levemir just before bed time.
But, if, for some reason, his evening meal is late , then we have to leave it 1 hour after injecting his novorapid before we can inject his levemir. Hope i have made sense this time? Or am i missing the point?lol. Bev:)
Click to expand...

I queried whether I could take both insulins at the same time as I take a split dose of levemir 66u am and 26u pm.. when I asked I was told as they both work differently you can take them together, so that is what i do in the morning and at night if I have eaten late before going to bed.
 
bev said:
But, if, for some reason, his evening meal is late , then we have to leave it 1 hour after injecting his novorapid before we can inject his levemir. Hope i have made sense this time? Or am i missing the point?lol. Bev:)
Click to expand...

probably I am! :confused:

So the issue is injecting the 2 types of insulin at the same time? I don't see where the problem is in that? have you been advised not to?
 
Yes we have been advised that its better to leave 1 hour between the novorapid and the levemir - do you think thats wrong? Bev
 
The dr who put me on levemir and the nurse both said it was fine to take levemir at the same time as novorapid, as they work differently.
 
I'd definitely check with a diabetes team member about insulin timings, but basically, I try to have my basal doses around the same time each day, but have my bolus doses whenever I eat, so I sometimes have my breakfast bolus dose before my morning basal (eg setting off to airport for very early flight), may even have 4 meals in a day, and may have a very late tea after my "bedtime" basal dose - and not sleep then, either. OK, not too relevent to children, but the possibility of flexible timing is there, provided you've discussed with diabetes team. I usually use different sites for basal (thighs) and bolus doses (abdomen), but that's not essential, either, unless you've been advised on specific sites at specific times.
 
Timings

Hi

You can have levemir or Lantus at the same time as a Novorapid injection. Some people get confused when told they can't mix them. You cannot mix them together in a syringe but you can take the injections in separate pens at the same time.

The Levemir or Lantus have to be taken at the same time every day regardless of when Novorapid is taken.

Not sure why you have been told otherwise Bev, that is wrong.
 
If you want to learn to carb count and there is no course for you to go on, you can always learn on-line from a couple of places - either BDEC (Bornemouth and District Endocrinology Centre) who have a form of their excellent BERTIE course online, or a website run by a Scottish doctor, called 'dsolve'. The latter website has lots of eating etc info for T1's too.

For adults the norm to start from is 1u rapid-acting to 10g carb; but you could need more or less; or differing amounts at ifferent times of day.

But first get your basal level right - over a period of a few days (not necessarily consecutive you either miss a meal or have a completely no carb meal. No Novorapid, no snacks. So if you start with breakfast (ie by missing breakfast) your BS should be more or less exactly the same pre-lunch as when you got up, and so forth.

Then when you've got that right, you can start to play with your mealtime jabs.

Tells you all about it during either course.
 
the advise I had is that it is fine to have both injections at the same time but as a few people have said, they shouldn't be mixed so I was told to use a different 'area' for each injection is doing them close together (time wise)
 
Yes that's true Aymes. On my daughter we used to use legs for Lantus, arms for Novorapid. I have a thing about needles yet was fine injecting my daughter but I could not inject her tummy!!!

Novorapid in arms is good for pasta but not the tummy for pasta ;)
 
would of thought by time the lavimir kicks in the novarapid would be out of the system or am i wrong
 
bev said:
Yes we have been advised that its better to leave 1 hour between the novorapid and the levemir - do you think thats wrong? Bev
Click to expand...

I do think it's wrong and agree with the others that it's fine to inject them at the same time. i wouldn't use the same site though for both, i usually do my lantus in my legs or buttocks and novorapid in my arms or stomach.

I would ask your DSN what the reasoning is behind what you've been told.
 
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