insulin change help?

[delta]

hi again could anyone let me know do you inject novarapid before or after meal
gonna need a lot of help with this changing over tonight

 

[bev]

We were told definateley BEFORE the meal. Some people on here will say do it after - but i prefer doing it before as that is what we were told to do by his Consultant.Bev

 

[Northerner]

I have personally always injected novorapid before a meal.

 

[tracey w]

probably I am!

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?

I was not advised of this. I was told that if i need extra dose for supper then to do so, nothing about not taking with my humulin I??

 

[aymes]

I always inject before a meal which is what i've been advised. The novorapid will start working in about 15 mintues so you want to inject it right before.

 

[delta]

ok so checked my son 1:30 hours after meal and was 13 checked again after 3 hours and he gone up to 16 so gave him 10 units of levimir as advised before bed he also had a bowl of cornflakes 30gram so gave him an extra 1 unit of novarapid will check him again through the night

 

[bev]

Sounds like your doing the right thing - but i would say the check after 1.30 hrs may have been a bit too soon to get a true reading - and it really depends on what he has eaten - was it a fatty meal? - as this will take a longer time to be absorbed - but checking him through the night is a good idea until your used to the new insulin's. Let us know how he gets on. Bev

 

[delta]

yea was a bit had home made spam fritters and chips will keep you posted as it really help to get get the advice of those on here

 

[Northerner]

yea was a bit had home made spam fritters and chips will keep you posted as it really help to get get the advice of those on here

Right, I know what I want for tea tomorrow night! Hope all is well through the night.

 

[Adrienne]

When to inject

Hi

Once you work out what certain food does, you can then choose when to inject. ie pasta - best to inject after and in your leg or arm not tummy. The tummy is too fast for pasta, you need a slower area. For particularly sugary stuff and things like mashed potato inject before as they start working quickly. Basmati rice - inject after, the rice doesn't start working for a while and if you inject beforehand then the insulin will work before the rice starts and you have possible hypo situation.

With Novorapid you can inject before, during or after.

 

[bev]

Adrienne,

Having read your reply - it seems i need to do a dafne course or something similar - i havent been told about this at all! Good information - thanks!Bev

 

[Copepod]

Diabetes Self-Management courses

Vanessa has just posted this link in "In the news" http://www.diabetes.nhs.uk/work-areas/support-for-self-management/supporting-self-care-of-diabetes
It describes the 4 main types of self-management courses:
DAFNE (Dose Adjustment For Normal Eating) - A skills-based structured education programme in intensive insulin therapy (IIT) delivered by specially trained diabetes specialist nurses and dieticians. www.dafne.uk.com
DESMOND (Diabetes Education and Self Management for Ongoing and Newly Diagnosed) ? a structured group education for people with Type 2 diabetes www.desmond-project.org.uk
Diabetes X-PERT Programme - A 6 week professional led programme for people with Type 2 diabetes, based on the theories of patient empowerment and patient activation. www.expert-diabetes.org.uk
Covering other local education programmes: The Diabetes Education Network (formerly the Type 1 Education Network) exists to provide support and information to diabetes teams who deliver local education programmes. It runs workshops to equip teams to help them meet NICE criteria when developing programmes to meet the needs of people with diabetes. For further details, visit www.diabetes-education.net.

What isn't made clear in this webpage is which courses are for adults with diabetes, and which are for parents of children - so worth checking when you ask your local centre.

 

[bev]

Hi Copepod,

Thanks for the link. Just yesterday i spoke with Alex's DN (after me contacting the patient liason worker) and she is looking into maybe referring Alex to do the kids 'kick off' course in a different area (pilot scheme) or me going on the dafne course - in his place as its geared towards adults rather than children. So hopefully we will have a better knowledge of foods and their absorption rates etc and how to change ratios etc..Bev

 

[Vanessa]

There's also a link to the bdec carb counting course on the diabetes uk web site. It is aimed at Type 1 diabetics and I don't know if any one on here has done it or whether it would be suitable for Bev as Alex's mum?

 

[tracey w]

Hi

Once you work out what certain food does, you can then choose when to inject. ie pasta - best to inject after and in your leg or arm not tummy. The tummy is too fast for pasta, you need a slower area. For particularly sugary stuff and things like mashed potato inject before as they start working quickly. Basmati rice - inject after, the rice doesn't start working for a while and if you inject beforehand then the insulin will work before the rice starts and you have possible hypo situation.

With Novorapid you can inject before, during or after.

Adrienne, i didnt know different sites had different absorption rates? I presumed you just had to rotate sites for the other reasons. Interesting what you said about pasta and rice, will certainly try this. I presume i am right giving my humulin i in my thighs then? What about buttocks? are they fast or slow, lol, you know what i mean/

 

[sofaraway]

I presume i am right giving my humulin i in my thighs then? What about buttocks? are they fast or slow, lol, you know what i mean/

yeah basal is better in thighs, i find buttocks slow, I usually use for my basal.

In terms of rotation it's also generally more conveinient to inject in thighs/buttocks. As I don't tend to drop my trousers in the middle of a restaurant to inject, wonder what the balance nurse would think of that!

 

[Northerner]

yeah basal is better in thighs, i find buttocks slow, I usually use for my basal.

In terms of rotation it's also generally more conveinient to inject in thighs/buttocks. As I don't tend to drop my trousers in the middle of a restaurant to inject, wonder what the balance nurse would think of that!

My goodness, I'm a nurse,
And you won't guess what I've just seen!
That girl just dropped her trousers,
And I think it's quite obscene!

And now she's got a needle!
And she's stuck it in her rear!
I'm feeling so disgusted
That I might explode right here!!!

Cough! Splutter! Choke!!!

 

[Copepod]

zip off trousers

By accident, while marshalling on the Hebridean Challenge adventure race in Outer Hebrides / Western Isles in 2006, I discovered that my new trousers (from Aldi, so only about ?12, if I remember correctly) with zip off legs to leave shorts, had an additional advantage - easy access to thighs for insulin injections. We had fantastic food on the race, cooked by communities in village halls - better than anything I've ever eaten in a restaurant, although we don't go very often, and never to very expensive places. Also, the only time I've ever had a shower in a fire station! (I know that's off the point, but it might raise a chuckle)

 

[Adrienne]

Hi

The food thing you have to work out how it works for you. Lots of foods are the same for everyone ie a pizza you will generally spike about 5 to 8 hours after eating!!!!! The fattier the food the further away the spike which is why a glass of full fat milk at night is good for overnight levels.

I have friends when rice does work quickly but the majority not. It took my daughter going on a pump for me to learn all this as we changed hospitals. Our hospital now is one of the best in the UK and is getting referrals from all over now. I am talking about paediatrics here though.

It makes a huge difference to one girl I see a lot when she has pasta as to where she injects. It has to be a slow release place, no good in the tummy at all, she will go hypo or if not hypo then the spike will be horrendous as the insulin was used quicker.

 

[aymes]

i didnt know different sites had different absorption rates? I presumed you just had to rotate sites for the other reasons.

I think it can vary from person to person but usually the stomach will be the quickest absorption site. I usually use stomach or arms for novorapid and thighs lantus. One other thing to bear in mind is you'll speed up absorption from a site if you exercise that area after injecting, for example you'd probably not want to inject into your legs before going running as the insulin will absob quicker than expected.

Hi

The food thing you have to work out how it works for you. .

I was just about to add something like that, it's not an exact science by any means (what to do with diabetes is!) I find that pizza is the only thing that seems to delay food absorption for me, rice, pasta etc doesn't seem to have any different effect from other foods.