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- Type of diabetes
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Following a review of his insulin medication my partner (Type 2) is being moved on to Novomix 30 from Humulin 1….his morning bs readings were in the range of 9 to 11 and pre dinner readings in the mid teens 14-17…
…he was currently on 22 units of Humulin 1 in the morning and had recently introduced a pre dinner dose of 6 units by the diabetic nurse…….he is also on Metformin but has been told to stop the Gliclazide (both maximum doses per day) when starting the Novomix30...
It has been suggested that he starts Novomix 30 on 12 units in the morning / effectively at lunchtime as he doesn’t get up early or eat breakfast with another 12 units with his evening meal….
This in my head raises a number of questions….
…firstly he does not believe he will ever have a hypo….in his head he is “hyper, not hypo”….despite my efforts at explaining this (and believe me, I have tried) he still will not accept this….my question is to forum members what is the possibility of him having a hypo on this new regime ….
….secondly, looking at the profile of Novomix 30 it says it has an onset of 10 -20 minutes, a peak of 1 to 4 hours and a duration of 10 -12 hours (hope I have got that right)….on this basis and on my calculations this means that if he is only taking the doses 6 hours apart (with meals) they will clearly be some overlap (say between 6pm and midnight) …..and a period that is not effectively covered (between 6am and midday)….…apologies if I am getting too technical but just trying to get my head round how this will work….
My concerns are over how this will work in practice….he regularly goes out on a daily basis for lunch at a local supermarket café (on his own / whilst I am at work)….this means he will have to take insulin and testing kit etc with him in order to inject with meal (nurse has suggested immediately after is ok in case he ends up in queue or waiting for food to arrive)…so he will need to eat his food and then find somewhere to test and inject prior to doing any shopping I presume…….in theory he should test again after shopping and prior to driving home but personally doubt he will…
…from personal experience of those using Novomix 30 how soon does insulin kick in and is this something I should be concerned about....(his lunch is normally something like two eggs on toast and a latte so am assuming that the quantity of insulin suggested is appropriate to his food consumption at this time)...…or am I worrying unnecessarily…
As stated earlier he is starting on 12 units twice a day ….is this the normal starting point based on his previous insulin experience / dose of Humulin 1 ….am assuming this will potentially increase depending on his readings…nurse has advised to keep more readings (4 times per day rather than current 2-3) and will be contacting him later in week to see how it is going…
One final concern is that no mention was made of what to do about dose if bs levels are already low …..they are unlikely to be but there is always an outside chance or possibility that they could be…..is this something else that needs to be thought of or considered….it sounded as if the dose was fixed and not food dependent (in terms of counting carbs / calculating quantity of insulin)...is this correct...
Sorry for all the questions but any advice as we move into new territory would be welcomed…..
…he was currently on 22 units of Humulin 1 in the morning and had recently introduced a pre dinner dose of 6 units by the diabetic nurse…….he is also on Metformin but has been told to stop the Gliclazide (both maximum doses per day) when starting the Novomix30...
It has been suggested that he starts Novomix 30 on 12 units in the morning / effectively at lunchtime as he doesn’t get up early or eat breakfast with another 12 units with his evening meal….
This in my head raises a number of questions….
…firstly he does not believe he will ever have a hypo….in his head he is “hyper, not hypo”….despite my efforts at explaining this (and believe me, I have tried) he still will not accept this….my question is to forum members what is the possibility of him having a hypo on this new regime ….
….secondly, looking at the profile of Novomix 30 it says it has an onset of 10 -20 minutes, a peak of 1 to 4 hours and a duration of 10 -12 hours (hope I have got that right)….on this basis and on my calculations this means that if he is only taking the doses 6 hours apart (with meals) they will clearly be some overlap (say between 6pm and midnight) …..and a period that is not effectively covered (between 6am and midday)….…apologies if I am getting too technical but just trying to get my head round how this will work….
My concerns are over how this will work in practice….he regularly goes out on a daily basis for lunch at a local supermarket café (on his own / whilst I am at work)….this means he will have to take insulin and testing kit etc with him in order to inject with meal (nurse has suggested immediately after is ok in case he ends up in queue or waiting for food to arrive)…so he will need to eat his food and then find somewhere to test and inject prior to doing any shopping I presume…….in theory he should test again after shopping and prior to driving home but personally doubt he will…
…from personal experience of those using Novomix 30 how soon does insulin kick in and is this something I should be concerned about....(his lunch is normally something like two eggs on toast and a latte so am assuming that the quantity of insulin suggested is appropriate to his food consumption at this time)...…or am I worrying unnecessarily…
As stated earlier he is starting on 12 units twice a day ….is this the normal starting point based on his previous insulin experience / dose of Humulin 1 ….am assuming this will potentially increase depending on his readings…nurse has advised to keep more readings (4 times per day rather than current 2-3) and will be contacting him later in week to see how it is going…
One final concern is that no mention was made of what to do about dose if bs levels are already low …..they are unlikely to be but there is always an outside chance or possibility that they could be…..is this something else that needs to be thought of or considered….it sounded as if the dose was fixed and not food dependent (in terms of counting carbs / calculating quantity of insulin)...is this correct...
Sorry for all the questions but any advice as we move into new territory would be welcomed…..