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Novomix 30 - what to do if blood glucose is high

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Keely

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Parent of person with diabetes
Hiya, my 22yr old nephew was diagnosed with type 1 on Friday. The hospital discharged him today with very little info and he has been given novomix 30 to use at mealtimes. My question is what should he do if his blood glucose is high a few hours after his meal? I know quite a bit about type 1 as two of my children have had it now for a few years and they are both on novorapid and levemir. So when they’re BG levels are too high they can use a unit of novorapid to bring them down a bit. But with novomix 30 because it has slow acting insulin in it as well, I’m worried that using it outside of a meal will mean my nephew is getting too much slow acting insulin. Any advice would be great, thanks
 
Keely said:
Hiya, my 22yr old nephew was diagnosed with type 1 on Friday. The hospital discharged him today with very little info and he has been given novomix 30 to use at mealtimes. My question is what should he do if his blood glucose is high a few hours after his meal? I know quite a bit about type 1 as two of my children have had it now for a few years and they are both on novorapid and levemir. So when they’re BG levels are too high they can use a unit of novorapid to bring them down a bit. But with novomix 30 because it has slow acting insulin in it as well, I’m worried that using it outside of a meal will mean my nephew is getting too much slow acting insulin. Any advice would be great, thanks
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I don’t think you can use it for corrections, just have to take the doses advised and work with your team to adjust your diet to match the insulin and vice versa
 
It is very unusual to be prescribed Novomix in this day and age, where you will need to eat to match the insulin doses and need to be careful about the timing of your meals as your insulin is already set for the day. This is not an insulin with which you can do corrections, so if you staid on that you would need to adapt your diet to match the insulin. Is your diabetes managed by a GP/nurse at your local Practice, or are you under the hospital team?

A much more flexible system is to use two different insulins. One quick acting (Bolus) to match the carbohydrates you choose to eat, and the other a slow release (basal) to deal with the insulin that your liver is dribbling out throughout the day and night to keep you going. This is often called a Basal/Bolus regime or Multiple Daily Injections (MDI). This allows you to eat what you want and when you want. It takes time to adjust the doses but is well worth the effort. It would make sense for you to ask about changing your management to this as it then enables you to do corrections if you are high and you can also learn how to make changes to an individual insuoin dose to take account of planned exercise.
 
Keely said:
Hiya, my 22yr old nephew was diagnosed with type 1 on Friday. The hospital discharged him today with very little info and he has been given novomix 30 to use at mealtimes. My question is what should he do if his blood glucose is high a few hours after his meal? I know quite a bit about type 1 as two of my children have had it now for a few years and they are both on novorapid and levemir. So when they’re BG levels are too high they can use a unit of novorapid to bring them down a bit. But with novomix 30 because it has slow acting insulin in it as well, I’m worried that using it outside of a meal will mean my nephew is getting too much slow acting insulin. Any advice would be great, thanks
Click to expand...

If he has Novomix 30 then he can’t correct with it. It’s usually taken twice a day not at every meal. Have you seen the insulin? Are you 100% sure it’s Novomix (not doubting you just that the names all seem similar and confusing initially to the newly diagnosed).

If he’s running really high, he needs to speak to his team. If it’s just moderately high, then next time he speaks to them he should let them know so they can adjust his insulin if needed. Novomix is a very inflexible insulin. I was on it for a day or two when in hospital. It was soon realised it wouldn’t work for me (this was years ago when we only had two injections a day).
 
Thanks everyone, this pretty much is what I thought. The hospital where he was admitted were absolutely useless - they forgot to give him any insulin at all last night and then today he was discharged by a nurse with no knowledge of type 1 who gave him the novomix 30 and said to take 8 units with each meal. Thankfully he has an appointment with the specialist diabetes department tomorrow so should be switched to novorapid and levemir. It’s been so stressful for him and his family, the hospital have been totally appalling and negligent in sending him home with no clear guidance or help….grrrrrrr
 
That sounds awful - and scary @Keely It’s great he has the appointment tomorrow. Hopefully everything will be sorted properly then.
 
Thanks, hopefully he’ll get proper knowledgeable help and support tomorrow &his BG will be ok till then
 
Sorry to hear about the tricky start your nephew has had to his life with T1.

Hopefully with some more specialist support, and a switch to a more flexible and precise insulin regimen he will see things begin to settle.

He shouldn’t worry if his levels aren’t straight back into normal range. If they were running high for a while before his diagnosis it can be easier on the fine blood vessels and nerve endings to taper down gradually into his target range. 🙂
 
aagh - that's nowhere near what the NICE Guidelines for T1 say, at all. @Keely - I hope to hell he's on a decent T1 regime by now?
 
Hi @trophywench, thankfully he’s been changed by the specialist diabetes team to novorapid and levemir which has made a big difference.
I was shocked that the hospital put him on novomix30 but as the doctor who discharged him didn’t know how to do a finger prick test (my nephew had to Google it on YouTube for this doctor), I’m not at all surprised - it seems outside of specialist diabetes departments, knowledge & support for people with diabetes is patchy and in some cases (my nephew wasn’t given any insulin during his second night and was instead offered biscuits) actually dangerous.
 
Keely said:
Hi @trophywench, thankfully he’s been changed by the specialist diabetes team to novorapid and levemir which has made a big difference.
I was shocked that the hospital put him on novomix30 but as the doctor who discharged him didn’t know how to do a finger prick test (my nephew had to Google it on YouTube for this doctor), I’m not at all surprised - it seems outside of specialist diabetes departments, knowledge & support for people with diabetes is patchy and in some cases (my nephew wasn’t given any insulin during his second night and was instead offered biscuits) actually dangerous.
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That sounds like a complaint would be appropriate to the hospital PALS team, to hopefully ensure it does not occur again and put lives at risk. I suspect he would have to do it as he is an adult.
 
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