Question

[jtg1964]

Hi
Sorry I've not posted for a while...
On Friday I was taken off Nova30 which was 6 units am and started on Friday 4 units of longlasting insulin and 2 units short acting.
Now I'm going up to 17 and 18 after eating and feeling horrid.
They are reviewing it on Monday on a call...to me this is not working.
Trying not to panic as sadly I do.
Any thoughts welcomed.
Jill

 

[Inka]

What insulins are you taking now @jtg1964 (ie the names)? It’s very likely that you’ve been started on less insulin than you’ll end up needing, purely for safety reasons. This will then be adjusted as needed, hence your callback.

 

[mashedupmatt]

You will have a lot more flexibility going on to basal/bolus regime but it sounds like you've been advised to have a very conservative dose to start with when starting it so that you and your healthcare team can work out what doses work for you and safely - can't advise on specific doses but keep a track of it and speak to them on Monday, where it sounds as if they will adjust your doses accordingly

 

[jtg1964]

You will have a lot more flexibility going on to basal/bolus regime but it sounds like you've been advised to have a very conservative dose to start with when starting it so that you and your healthcare team can work out what doses work for you and safely - can't advise on specific doses but keep a track of it and speak to them on Monday, where it sounds as if they will adjust your doses accordingly

Thank you...that does make sense. I do feel it needs adjusting.

 

[jtg1964]

The transition between the two types of insulin regimes may take a bit of tweaking to get the doses right for how your body behaves and what you are eating. Your Nova30 was a mixed slow and fast acting insulin but you are being moved to a more usual basal (slow acting) which keeps you level in the absence of food so getting the dose of that is important and a fast acting bolus insulin which you take to deal with your meals. Getting both the dose for the amount of carbs you have and the timing is what is going to be important going forward. Your nurse/clinic may be being cautious initially but at least you have a review quite soon so do keep your reading however you do those as well as what you are eating so they can see what adjustments you will need.
Are you carb counting as that will be helpful to get things right.
Do you have a contact number to use sooner than Monday.

Thank you.Its early days but the advice is truly helpful. No the DNs do not work weekends. Roll on Monday.

 

[Inka]

Thank you.Its early days but the advice is truly helpful. No the DNs do not work weekends. Roll on Monday.

You’re ok @jtg1964 Monday will be fine. What you’re seeing is very normal - as people on insulin will tell you 🙂 What you could do, which might be helpful, is note down what you’re eating at each meal. This will be useful information when you speak to the nurse on Monday.

 

[Inka]

The transition between the two types of insulin regimes may take a bit of tweaking to get the doses right for how your body behaves and what you are eating. Your Nova30 was a mixed slow and fast acting insulin but you are being moved to a more usual basal (slow acting) which keeps you level in the absence of food so getting the dose of that is important and a fast acting bolus insulin which you take to deal with your meals. Getting both the dose for the amount of carbs you have and the timing is what is going to be important going forward. Your nurse/clinic may be being cautious initially but at least you have a review quite soon so do keep your reading however you do those as well as what you are eating so they can see what adjustments you will need.
Are you carb counting as that will be helpful to get things right.
Do you have a contact number to use sooner than Monday.

It’s Novomix 30. Have you ever used insulin? It almost looks like you’ve cobbled together bits others have written, which isn’t wise.

 

[rebrascora]

Hi Jill.

Hope you had a great holiday!

Good to hear you have now been transferred onto a basal/bolus insulin regime, but as others have said it will take time to adjust the doses and figure out your insulin:carb ratios, so starting conservatively with lower doses than you will actually need is fairly typical and gradually adjusting them so that your levels come down steadily into range is important.

When are you testing and seeing these high levels and do they come back down again?

If you are testing 2 hours after your meal and going that high but then coming down more or less into range before your next meal, then it is usually more a timing issue than an insulin dose issue. If you are still in the teens 4-5 hours after injecting when you are preparing for your next meal, then you probably didn't have enough insulin and doses will need adjusting.

If you want to post a photo of your Libre graph for a typical day with these high readings on, then we may be able to reassure you or suggest things you can try to reduce those high levels.

 

[trophywench]

There's a Novomix 30, which is a mixture of 30% of one and 70% of the other, but whether it's 30% fast and 70% slow or vice versa, I haven't a clue since the use of mixed insulins is very old fashioned now.

I don't believe there has ever been, and still isn't, anything called Novarapid 30.

 

[Bruce Stephens]

There's a Novomix 30, which is a mixture of 30% of one and 70% of the other, but whether it's 30% fast and 70% slow or vice versa, I haven't a clue since the use of mixed insulins is very old fashioned now.

From https://www.medicines.org.uk/emc/product/1600/smpc#gref

NovoMix 30 is a biphasic insulin, which contains 30% soluble insulin aspart. This has a rapid onset of action, thus allowing it to be given closer to a meal (within zero to 10 minutes of the meal) when compared to soluble human insulin. The crystalline phase (70%) consists of protamine-crystallised insulin aspart, which has an activity profile similar to that of human NPH insulin.​

 

[trophywench]

Not any insulin I have ever used.