Switch to new insulin

[BoeingBonkers]

Hello all

My mother has type 1 diabetes. She's 72 and been diabetic for 4 years. She currently takes Semglee (28 units) and Novorapid (Usually around 8 units with a meal as per BGs).

She has been having trouble getting her semglee and they have switched her to Lantus. The doctor mumbled something about taking 20% or about 4 units less and that's it. But she's been put on new medication for blood pressure (Ramapril) and Pain (Gabapentin) and her numbers are all over the place.

We don't have a diabetes nurse currently at our surgery and we feel a bit lost. Is it OK for her to start on 24 units of Lantus once a day and just stop semglee? If anyone is on Lantus could you tell me how you got on with it?

She's kept a record of her BGs for 4 years ( She just loves filling in her books lol) I've attached a pic. What's your opinion on her numbers. A little reassurance would be greatly appreciated as GP isn't helpful.

Matthew

 

[Dave W]

I'm type 3c which means my pancreas does produce a little insulin compared with that of your mother whose pancreas probably produces little or none.
24 units of Lantus does seem to me at least to be excessive, though I can only speak from personal experience and other folk may have other stories to tell.
I currently take13 units, having recently reduced from 14 units as I was tending to go a bit too low during the night. Your mother's fasting glucose levels do seem to trend a bit on the high side though her post-prandial levels are not too bad so it looks like she's judging her Novorapid dose pretty well.
Unfortunately I can't compare the impact of Semglee with Lantus but hopefully someone else will and be able to offer better advice. I do know from experience that plus or minus one unit of Lantus can have a significant on MY blood glucose level.
Edit: Just Googled Semglee and it seems to be pretty much the same as Lantus, so perhaps you mum should start and keep a close eye on overnight levels.

 

[Satan’s little helper]

Hello all

My mother has type 1 diabetes. She's 72 and been diabetic for 4 years. She currently takes Semglee (28 units) and Novorapid (Usually around 8 units with a meal as per BGs).

She has been having trouble getting her semglee and they have switched her to Lantus. The doctor mumbled something about taking 20% or about 4 units less and that's it. But she's been put on new medication for blood pressure (Ramapril) and Pain (Gabapentin) and her numbers are all over the place.

We don't have a diabetes nurse currently at our surgery and we feel a bit lost. Is it OK for her to start on 24 units of Lantus once a day and just stop semglee? If anyone is on Lantus could you tell me how you got on with it?

She's kept a record of her BGs for 4 years ( She just loves filling in her books lol) I've attached a pic. What's your opinion on her numbers. A little reassurance would be greatly appreciated as GP isn't helpful.

Matthew

Hello, firstly. Your mother should be entitled to a sensor on prescription. This will help to identify trends in between the testing.
Is your mother seeing an endocrinologist or her GP?

It would be advisable for your mother to follow the current advice given by this doctor, but up her frequency in monitoring BGs. Including the nights. But that’s where a sensor could help with alarms if she went low.
You can also be a “follower” as a carer on your device too for peace of mind.

I know my body and metabolism with this basal insulin. I couldn’t go as far as advise on a dosage.
Sorry.

 

[everydayupsanddowns]

She has been having trouble getting her semglee and they have switched her to Lantus. The doctor mumbled something about taking 20% or about 4 units less and that's it. But she's been put on new medication for blood pressure (Ramapril) and Pain (Gabapentin) and her numbers are all over the place.

Unfortunately we aren’t really able to give specific dose advice (members of the forum aren’t medically qualified, and don’t know your mum’s medical history).

The suggestion to start cautiously with a new insulin and adjustung doses by a percentage does seem to be quite common though, and is a suggestion that other forum members (including me!) have heard from their Drs.

Changing insulins can mean a little dose adjustment to begin with. Even apparently quite similar insulins can need a tweaked dose rather than a straight swap. And as @Dave W and @Satan’s little helper have suggested, an increased frequency of checks when switching can help to keep your Mum safe.

 

[everydayupsanddowns]

She's kept a record of her BGs for 4 years ( She just loves filling in her books lol) I've attached a pic. What's your opinion on her numbers. A little reassurance would be greatly appreciated as GP isn't helpful.

Does your Mum not eat lunch?

There are some good before/after pairs in the results you have shared, and some of the higher levels seem to come back into range fairly swiftly.

Good that your Mum knows the recommended levels. Current advice seems to be for people to allow levels to run a little higher in older age (as they do in people without diabetes naturally anyway), so it might be helpful to get some advice from her Dr about more tailored and individualised recommendations for glucose levels?

 

[Satan’s little helper]

Does your Mum not eat lunch?

There are some good before/after pairs in the results you have shared, and some of the higher levels seem to come back into range fairly swiftly.

Good that your Mum knows the recommended levels. Current advice seems to be for people to allow levels to run a little higher in older age (as they do in people without diabetes naturally anyway), so it might be helpful to get some advice from her Dr about more tailored and individualised recommendations for glucose levels?

Looking at the log. @BoeingBonkers mum seems to do a “brunch” on quite a few days? Which may explain the no show on the midday meals.
But I would still personally be interested to know what my Novorapid is doing 4 to 5 hours later.