Wrong insulin?

[sledge121]

Hi guys

I've Been a type 1 for the last 17 years, I was prescribed novomix 30 and have been on it ever since. I was recently referred to a diabetes specialist and they were very surprised I was on novomix 30. They immediately changed my insulin to seperate slow acting (Abasaglar) and fast acting (NovoRapid) with instant great results. I've found Novomix 30 really difficult to control day to day and just assumed it was difficult for everyone. I'm pretty ****** off that I appear to have been on the wrong insulin for years.
I'm interested in the thoughts of others in this forum.
Thanks
Rick.

 

[MeiChanski]

Hello, welcome!
When I was first diagnosed back in 2001, they used a mixed insulin on me - mixtard 30, it's been discontinued and I think novomix 30 is similar to it. It didn't work, I was in DKA for several years. Basal-bolus regime is much better, more work but it gives you more room to fine tune things and flexibility, it is less rigid. I was on Novorapid and Levemir, but now I am on Fiasp and Tresiba.

 

[therower]

@sledge121 . Welcome to the forum.
You say that you were recently referred to a diabetes specialist. Who have you been seeing regarding your diabetes management prior to this?
It would appear you have slipped under the radar for some reason OR because you haven’t complained/queried/ asked about diabetes management the assumption has been you’ve been doing okay.
It’s good to hear that things are looking up and becoming easier and hopefully you’re new specialist will give you more heads up with the latest stuff on offer. If not then ask the T1 guys and gals here. We’ll be more than happy to help you.

 

[Scott-C]

Hi, @sledge121 , I agree with @therower and @MeiChanski on this, it seems unusual you were on a mix for so long, as therower says, you might have slipped under the radar.

I'll tag @urbanracer , if memory serves, he was on mix for a fair bit before switching to basal/bolus, so may have some tips on how to manage the change.

I was on mix too for a while but the change to basal/bolus was so long ago I've forgotten the details.

 

[urbanracer]

Hi guys

I've Been a type 1 for the last 17 years, I was prescribed novomix 30 and have been on it ever since. I was recently referred to a diabetes specialist and they were very surprised I was on novomix 30. They immediately changed my insulin to seperate slow acting (Abasaglar) and fast acting (NovoRapid) with instant great results. I've found Novomix 30 really difficult to control day to day and just assumed it was difficult for everyone. I'm pretty ****** off that I appear to have been on the wrong insulin for years.
I'm interested in the thoughts of others in this forum.
Thanks
Rick.

I was diagnosed quite late in life at age 54 and the hospital put me on Novomix 30 which got changed to Humalog Mix25 at the first GP prescription without any explanation.

If course I went off on a fact finding trip and along the way I learnt about MDI. I then asked the Endo' on 3 separate occasions to go on MDI but he refused saying it was 'harder to manage.'

Thankfully he moved on to pastures new but before he went he (out of the blue) offerred to give me Abasaglar which I of course accepted.

I never did understand the Endo's position on MDI but I am aware of somebody else on this forum who was diagnosed around same time as me, was seeing the same Endo' and was on the same insulin.

Mixed insulin was OK for me up to a point but very difficult to cope with lunch, or even skipping lunch if work patterns demanded.

I am much happier now with MDI but now on Levemir and Humalog.

 

[EllieM]

Back in the day (1970s) mixed insulin was pretty standard. I was on it for the first twelve years of my life and only got changed to basal/bolus when I transferred to Addenbrookes hospital in Cambridge in my early twenties. (They also gave me my first glucometer, which was even more life changing.) I guess some consultants/doctors are just much more old fashioned than others, though I can understand why some leave basal/bolus management to when a new diabetic has had a bit of a chance to get used to the illness.

 

[sledge121]

Thanks for all the answers, it looks like I have slipped under the radar and life could have been a lot easier for a few years. I have only ever seen my GP over my diabetes until the recent referral. Guess I'll just suck it up and crack on with the new stuff.
I got my type 1 at an unusual age as well, 32.

 

[Scott-C]

Forgot to say, @sledge121 , it's worth spending time experimenting with getting the basal dose right.

Too little and bg will inexorably rise after the last bolus shot wears off, too much and it will glide slowly down needing a regular nudge up with a few dextrotabs every so often. And it will make calculating bolus ratios trickier because you're having to adjust for incorrect basal.

Get it right, though, and the whole show becomes much smoother.

I'll sometimes just have a long lie till late afternoon, so there's no food or bolus involved, and the idea is that if basal is correct, bg shouldn't move around by more than about 1 to 1.5.

 

[becca59]

@sledge121 sorry you fell under the radar. Onwards and upwards now. Two things, 32 is not an unusual age, lots of us on the forum were diagnosed later in life. It is common. Secondly all Type 1s should have access to a hospital team. (It is in the clinical guidelines somewhere) Not just a GP. I’m afraid GPs are not up to date enough as you have unfortunately found out.

 

[kerrygold59]

Hi guys

I've Been a type 1 for the last 17 years, I was prescribed novomix 30 and have been on it ever since. I was recently referred to a diabetes specialist and they were very surprised I was on novomix 30. They immediately changed my insulin to seperate slow acting (Abasaglar) and fast acting (NovoRapid) with instant great results. I've found Novomix 30 really difficult to control day to day and just assumed it was difficult for everyone. I'm pretty ****** off that I appear to have been on the wrong insulin for years.
I'm interested in the thoughts of others in this forum.
Thanks
Rick.

I’d lower carbs. Look up Dr Bernstein. I’m seeing good results.

 

[Rokaab]

I’d lower carbs. Look up Dr Bernstein. I’m seeing good results.

Though if @sledge121 doesn't know how to properly adjust insulin for lower amounts of carbs yet this may lead to a lot of hypos, so care must be taken when on insulin if lowering carbs.

 

[sledge121]

The Abasaglar and NovoRapid are really working well for me, feels like I have total control. I can tell immediately that my hba1c will be lower next time.

 

[Snapsh0t]

Apologies for waking up an old thread but I'm about to switch from Novamix30 to NovaRapid and Abasaglar so the experiences here are very helpful.
I was initially diagnosed as T2 in 1985, aged 31; started on Humalin M30 in 1998; switched to Novamix30 in ~2005 but, like the OP, never felt comfortable with it. Fast forward to a couple of months ago when I started self-funding Freestyle Libre. The graphs it produced clearly showed large spikes after each meal so I showed them to the diabetes nurse at my surgery and he referred me to a specialist nurse. She looked at the graphs and immediately switched me across so I'm just waiting for the prescription to come through.

One thing that immediately comes to mind is how does one dispose of used Abasaglar Kwikpens? They certainly won't fit in my sharps box.

 

[Struma]

Disposal of pens is via the 'general rubbish' bin - just bung it in.
I get through 13 pens a month, it's impossible to get them into Sharp's bins even though I have a 7l one.
There's no Sharps issue, there's no body fluid issue.

 

[Snapsh0t]

Thanks for that. In the bin they'll go. A pity they can't go back to the manufacturer for re-use, just like the ridiculous amount of waste from the Libre.

 

[Antje77]

Thanks for that. In the bin they'll go. A pity they can't go back to the manufacturer for re-use, just like the ridiculous amount of waste from the Libre.

I think you can get a refillable pen, the Savvio, to use with Abasaglar penfills, just like the Novorapid pen.
Ask your consultant or do a google search. (I tried to find a link for you, but despite using English to search, my computer insists I want to see Dutch results, not useful to you )

 

[Snapsh0t]

Yes, you're right and it's in the booklet I was given. But, for reasons that weren't clear, the Kwikpen is preferred.

 

[Antje77]

Yes, you're right and it's in the booklet I was given. But, for reasons that weren't clear, the Kwikpen is preferred.

Preferred by whom? They don't have to use the pens, do they? If it's important to you, please state you'd prefer a refillable pen. I did, and my consultant didn't really see the point but was happy enough to prescribe me one.

 

[Snapsh0t]

Forcing the remains of my brain cells to remember the conversation, if I wanted cartridges and a re-usable pen it would have been a different insulin and another Novapen. This may mean that Abasaglar cartridges and/or the Savvio pen are not available for prescription. I'm not that worried as long as I'm on the best solution for me and it's just not worth getting worked up about the mysteries of our NHS processes.

 

[novorapidboi26]

Yeah, its not necessarily a bad insulin, its just an old regime that isn't suited to the knowledge and understanding we have now...

my brother is still on it and keep bugging him to get it changed.....they want to see him testing more though, which makes sense I suppose but I believe the benefits outweigh the risks...