Changing insulin

Paul-c

Member
Messages
7
Type of diabetes
Type 1
Hi everyone , I have been T1 for 10 years & been on novo mix 70-30, but my doc wants to put me on humalog says it's better ,what do use think?
 

Paul-c

Member
Messages
7
Type of diabetes
Type 1
Can be quite high at times above 12, sometimes Hungary but can't eat because it's high,can't exercise to bring it down sometimes because I'm working, but my last checkup I'm averaging about 8.5 the check up before that was7.9 , doc says this insulin will be better(humalog)
 

Silas

Member
Messages
24
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
pasta.
Hi everyone , I have been T1 for 10 years & been on novo mix 70-30, but my doc wants to put me on humalog says it's better ,what do use think?
I was on a mix of two insulins for many years. I used to mix them manually rather than having a pre-mixed insulin. That is what one had to do in the early days. I have had type 1 for over 43 years now.

For the last 20 years I have been on a basal dose of Lantus and bolus doses for each main meal. I have been on the DAPHNE (Dose Adjustment For Normal Eating) course and have been estimating my carb intake on a daily basis for many years.

The advantage of this regimen is the flexibility that this gives. Your basal dose should drip feed you with enough insulin to keep you healthy even when you are fasting. The bolus dose should top you up with insulin and deal with the carbs you eat at each meal. I use the ACCU-CHEK Expert meter which does the hard work of calculating my doses.

The bolus dose can be adjusted to match the number of carbs consumed (estimated). The dose can also be tweaked to deal with correction doses (when you are higher or lower than ideal) and you can also add/subtract insulin to deal with exercise or inertia, illness and menstrual cycles.
This gives a great deal of flexibility but comes with the responsibility of calculating or estimating dose adjustments and fluctuating carbs.

The regime you are currently on will give you two insulin peaks per dose. One to deal with your current meal and another a fixed number of hours later. I found that the second peak of insulin meant that I had to have a consistent lunch time or risk going hypo some hours after my earlier jab.

The nice thing about having a basal/bolus (background combined with top-up doses) is that you inject the bolus with your meal, whatever time that might be. You could also skip a meal or have an extra one or even deal with an unexpected high BG result. Your basal dose can be a single daily dose taken at a consistent time of day (e.g. bedtime).

One downside is that you have to do multiple injections. Much closer BG monitoring is also required.

When travelling across time zones you can adjust your basal dose to cope with longer or shorter day lengths.I shall be going to Mexico later in the year and will increase my basal for the longer outgoing flight and reduce it for the return.

If you decide to make this change you will need the support of your diabetes team and education to ensure you can take control of your condition.

Good luck.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. NICE recommends that all T1s should be on the Basal/Bolus regime. As your blood sugar control is not ideal with your mixed insulin I would ask (insist?) that you are moved to Basal/Bolus. Although many split their Basal as it doesn't last the full 24 hours, I just have one injection at night which means one less injection.
 

Paul-c

Member
Messages
7
Type of diabetes
Type 1
I was on a mix of two insulins for many years. I used to mix them manually rather than having a pre-mixed insulin. That is what one had to do in the early days. I have had type 1 for over 43 years now.

For the last 20 years I have been on a basal dose of Lantus and bolus doses for each main meal. I have been on the DAPHNE (Dose Adjustment For Normal Eating) course and have been estimating my carb intake on a daily basis for many years.

The advantage of this regimen is the flexibility that this gives. Your basal dose should drip feed you with enough insulin to keep you healthy even when you are fasting. The bolus dose should top you up with insulin and deal with the carbs you eat at each meal. I use the ACCU-CHEK Expert meter which does the hard work of calculating my doses.

The bolus dose can be adjusted to match the number of carbs consumed (estimated). The dose can also be tweaked to deal with correction doses (when you are higher or lower than ideal) and you can also add/subtract insulin to deal with exercise or inertia, illness and menstrual cycles.
This gives a great deal of flexibility but comes with the responsibility of calculating or estimating dose adjustments and fluctuating carbs.

The regime you are currently on will give you two insulin peaks per dose. One to deal with your current meal and another a fixed number of hours later. I found that the second peak of insulin meant that I had to have a consistent lunch time or risk going hypo some hours after my earlier jab.

The nice thing about having a basal/bolus (background combined with top-up doses) is that you inject the bolus with your meal, whatever time that might be. You could also skip a meal or have an extra one or even deal with an unexpected high BG result. Your basal dose can be a single daily dose taken at a consistent time of day (e.g. bedtime).

One downside is that you have to do multiple injections. Much closer BG monitoring is also required.

When travelling across time zones you can adjust your basal dose to cope with longer or shorter day lengths.I shall be going to Mexico later in the year and will increase my basal for the longer outgoing flight and reduce it for the return.

If you decide to make this change you will need the support of your diabetes team and education to ensure you can take control of your condition.

Good luck.
Thx for your info , my team said to me this insulin (humalog ) is the way to go & they will try & get me on a DAPHNE course but they said it could take up to 3 years to get on this course, meanwhile they are going to have a one to one with me & put me on humalog come October But I was just wanting some reassurance that I was doing the right thing by changing !! Thx again
 

Paul-c

Member
Messages
7
Type of diabetes
Type 1
Hi. NICE recommends that all T1s should be on the Basal/Bolus regime. As your blood sugar control is not ideal with your mixed insulin I would ask (insist?) that you are moved to Basal/Bolus. Although many split their Basal as it doesn't last the full 24 hours, I just have one injection at night which means one less injection.
Thx daibell just wanting some help & to make sure I was doing the right thing by changing, it seems as if it will be better on the humalog.
 

azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
Thx daibell just wanting some help & to make sure I was doing the right thing by changing, it seems as if it will be better on the humalog.

Do you count carbs?

There's nothingbwrong with mixed insulin (I was on it when first diagnosed) but it means coynting carbs and sticking to the same carb amounts for meals. It's also inflexible regarding meal times.

Humalog and a basal insulin will be more flexible. The Humalog will also allow you to do correction doses. But you'll have to carb count still.
 

Paul-c

Member
Messages
7
Type of diabetes
Type 1
Do you count carbs?

There's nothingbwrong with mixed insulin (I was on it when first diagnosed) but it means coynting carbs and sticking to the same carb amounts for meals. It's also inflexible regarding meal times.

Humalog and a basal insulin will be more flexible. The Humalog will also allow you to do correction doses. But you'll have to carb count still.
 

Paul-c

Member
Messages
7
Type of diabetes
Type 1
It sounds as if , I'll be able to eat more instead of feeling Hungary a lot , just have to learn carb counting better , thx for your advice my friend !!
 
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azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
It sounds as if , I'll be able to eat more instead of feeling Hungary a lot , just have to learn carb counting better , thx for your advice my friend !!

Yes, you'll be able to vary the amount of carbs you eat for meals - both more carbs and fewer carbs :)

You'd have one (or two possibly) injections of a long acting (basal) insulin a day, then 3 (or more) injections of a fast acting insulin before you eat.

Most Type 1s are on a basal/bolus regime like that - mainly because it's more flexible :)
 

Paul-c

Member
Messages
7
Type of diabetes
Type 1
Look forward to giving it a go azure & will keep in touch, may need a few tips on carb counting !!