• Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
  • We seem to be having technical difficulties with new user accounts. If you are trying to register please check your Spam or Junk folder for your confirmation email. If you still haven't received a confirmation email, please reach out to our support inbox: support.forum@diabetes.org.uk

Question

jtg1964

jtg1964

Well-Known Member
Relationship to Diabetes
Type 1
Pronouns
She/Her
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
 
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.
 
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
 
mashedupmatt said:
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
Click to expand...
Thank you...that does make sense. I do feel it needs adjusting.
 
Leadinglights said:
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.
Click to expand...
Thank you.Its early days but the advice is truly helpful. No the DNs do not work weekends. Roll on Monday.
 
jtg1964 said:
Thank you.Its early days but the advice is truly helpful. No the DNs do not work weekends. Roll on Monday.
Click to expand...

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.
 
Leadinglights said:
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.
Click to expand...

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.
 
Last edited:
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.
 
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.
 
trophywench said:
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.
Click to expand...
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.​
 
I think it’s worth sticking with it @jtg1964

As @mashedupmatt says, once you have your basic balance sorted out on the new system you’ll be able to adjust from there, and it’ll be much easier to adjust things as you go along, eg to eat larger or smaller meals than usual by increasing or decreasing the meal dose to match.

Hopefully it won’t take long to get a basic set of starting doses working, and then you’ll be able to adjust from there over coming weeks/months.
 
everydayupsanddowns said:
I think it’s worth sticking with it @jtg1964

As @mashedupmatt says, once you have your basic balance sorted out on the new system you’ll be able to adjust from there, and it’ll be much easier to adjust things as you go along, eg to eat larger or smaller meals than usual by increasing or decreasing the meal dose to match.

Hopefully it won’t take long to get a basic set of starting doses working, and then you’ll be able to adjust from there over coming weeks/months.
Click to expand...
Thank you.Absolutly.
 
rebrascora said:
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.
Click to expand...
rebrascora said:
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.
Click to expand...
Hi Barbara
Been trying to send you a direct message...im not good at IT lol.
Ive had a very emotional time trying to accept my diagnosis. Been up and down
Golf was fab. Family holiday challenging...2 sensors came off lol.
Im glad I'm starting the change. I'm on Toujeo 4units a day and before breakfast Trurapi 2units.
Early days. I have a review on Monday via a call to DNs hoping they will change things.
My readings. Just since 15th July. I started the above on 18th July. I go high after eating but ok in between and I do come down. Evening it takes 3 to 4 hours to drop.
Hope alls good with you.
Kindest regards
Jill
 

Attachments

  • Screenshot_20250720_130859.jpg
    Screenshot_20250720_130859.jpg
    21.9 KB · Views: 3
Inka said:
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.
Click to expand...
I have not cobbled anything together!
 
So pleased you enjoyed the golf on holiday even if other things didn't quite go to plan.

That looks like a really consistent graph and the meal peaks are not going overly high, so for the length of time you have been using insulin and particularly that you are just changing insulin regime this week, it looks really good and nothing to be overly concerned about. Can you confirm wether you are just injecting Trurapi before breakfast or before every meal?

You could perhaps fine tune the timing of your mealtime insulin (Trurapi) and experiment with giving it a bit longer between injecting and eating (ie extend the prebolus timing) to lower the spike a little, if you are concerned about it, but considering you are not carb counting and adjusting your doses,, I think that is really good! Yes, there is room for improvement and fine tuning but that all comes with carb counting and experience.
It is also important to know that we could all improve our diabetes management if e put infinite time and thought into it but we will never get it perfect and if getting better results comes at a sacrifice to our mental health and/or enjoying life, then you have to weigh up if it is worth it. We could live a very boring and quite neurotic life by fussing about every single thing which can impact our levels and how to try to overcome each fluctuation but we would end up being mentally unwell and probably not very nice to live with and not have much any fun, so it is a balancing act and you have to reassess it regularly in case you are becoming overly fastidious or obsessive about it and if you are, then to learn to ease off a bit. Good enough is good enough!
You are working towards achieving 70% time in range. If you can achieve that most of the time then you are doing great. If you are not achieving that yet, then perhaps look at carefully working on the timing of your mealtime insulin to reduce the peaks a bit and that should get you to 70%. If you are striving for 90% TIR but it is costing you mentally trying to achieve that, then you probably have the balance wrong. If you can achieve 80 or 90% TIR without too much effort at the moment then great but you have to remember that life isn't always smooth sailing and be prepared for it to drop down to 70% TIR or even lower if/when life throws a spanner in the works due to illness or injury or family stress or work stress or whatever. 70% means that you are doing incredibly well and is all you need to achieve. Anything above that, you are possibly putting pressure on yourself unnecessarily, so feel free to take your foot off the pedal if you need to ease the mental load.
 
jtg1964 said:
I have not cobbled anything together!
Click to expand...

@jtg1964 I didn’t say you did. It wasn’t your post I was referring to.

A diabetes diagnosis is a big shock. Food is in every part of our life, from necessity and socially. It’s hard to deal with at first, but it does gradually get easier and recedes a little more into the background.
 
You must log in or register to reply here.
Back
Top