Christmas Eve and scared stiff!

[Michele01]

I'm so new to all of this and need some reassurance or help please!

Long story - short!

Diagnosed as Type 2 in March 2015. Reacted to Metformin so put on Forxiga. 3 weeks later (June 2015) in hospital with Ketoacidosis caused by the Forxiga. Now injecting Novomix 30 twice daily with 1 or 2 metformins on top. Recent tests show that the damage done during Ketoacidosis (a result of taking Forxiga) I'm now Type 1.

Novomix 30 and Metformin doesn't seem to be getting my levels under control. Today I peaked at a blood sugar reading of 30 and panicked as I'm thirsty. Went to doctors and there are ketones in my urine. So, he's added Levemir to my injections. I need to take 4 units once a day at night (to be adjusted if my levels don't come down). He says the cocktail is unusual as it's adding another long acting insuling to the long acting side of Novomix but with it being Christmas Eve he doesn't want to do anything drastic which is understandable.

The doctor said not to panic (I am) and to just get over the Christmas period and he's going to see about getting me into see a consultant with a view to injecting 4 times (and something about basal routine?).

Does anybody here take Levemir with Novomix please and do you have any quick tips on getting rid of the ketones and lowering my levels - I know to drink lots of water and to eat carbs (too get rid of the ketones). Is there anything else that I might be able to do? Thanks in advance.

 

[azure]

Did the doctor give you advice about what to watch out for over the Christmas holiday? Did he mention the ketones and what level they were?

 

[Michele01]

Did the doctor give you advice about what to watch out for over the Christmas holiday? Did he mention the ketones and what level they were?

@azure - the ketones are at 2+. I took the Levemir 3 hours ago and my levels have already come down from 29 to 16. Just about to have dinner (pasta to try to get rid of the ketones) and I've injected the Novomix so I'm hoping that the background Levemir will help with the levels after food.

Unfortunately, having had ketoacidosis before, I know what to watch for - which is why I went to the Doctors today.

Thank you very much for replying x

 

[rachel162]

Are you on set amounts of novomix or varying your dose depending on the carbs? I'd watch out with things like pasta if you're on set doses; yes carbs will help break down ketones, provided you have sufficient insulin. If you don't compensate for the pasta as well as the correction you may end up higher again. But novomix with levemir is an unfamiliar combination to me, so don't take my words as gospel!
Try not to stress too much (always makes my levels worse!) and just enjoy the next few days. Your levels (and probably ketones) are coming down which is a plus, and if your doctor was worried he'd have changed your routine there and then. Maybe just call 111 or another out-of-hours number as a backup if you're unsure/have any more issues.
Good luck!
R x

 

[Michele01]

Hi @rachel162 - I haven't had much input on how to adjust my insulin levels to suit and so have been winging it (increasing by a maximum of 2 if my levels were high before food) but it hasn't been working. I may not have compensated enough for the pasta tonight but not sure how my body will react to the Levemir so am taking it slowly.

My GP was very good today and said I probably need to have a base insulin and then inject before food and he mentioned injecting 4 times a day. He said the mix of Novomix and the new Levemir is an odd one but I had Lantus before (without the Novomix) and I didn't get on with it at all, hence moving to Levemir with the Novomix.

I'm going to see how my levels do tonight and when I wake up tomorrow but I may need to increase my Novomix in the short term as well just to get my levels to an acceptable level.

Thank you for your help and kind words x

 

[azure]

@Michele01 I'm pleased your levels have come down Keep testing and keep hydrated.

Injecting four times a day sounds like a basal/bolus regime. That's what most Type 1s are on and it gives flexibility. Hopefully, you should find that good once you start on it.

Once you do, you could ask your DSN for a correction ratio - ie how much 1 unit of fast acting insulin will lower your blood sugar. Everyone's is different so you'll need to find out what works for you. Knowing that means you can correct high blood sugars with more confidence as you'll know what dose of insulin to take to get your blood sugar down.

I understand why you're being cautious and that's sensible. Just keep a close eye on your blood sugar and test lots.

Sorry this has all happened at Christmas time - what a nuisance. I hope you can get your sugars under control and can enjoy Christmas.

Best wishes,

Azure