Mixed Insulin

[BitOfARunner]

Hello Everybody!

Though I've been browsing for a while this is my first post!

I've been Type 1 for about a year now and have been on Levemir twice a day, 6 to 8 units.
My last HBA1c was 8.0.
The consultant I saw at my annual review suggested a change to a mixed insulin, 30/70, with the 30 being rapid, the suggestion being that it would give better post meal control.
However I disagree.
1) assuming my morning bg is normal, then if find that the breakfast peak is taken care of by the cycle to work and morning swim.
2) as its only 2 dose a day, then its not going to help the lunchtime bg peak.
3) ok, ok, it might help in the evening.

I think I need to take rapid insulin as required to match the carb intake.
My sister is a dietitian and teaches DAFNE courses, so I have been getting carbo counting advice!

What do you think?

 

[noblehead]

Unsure of what you are actually asking here. As your sister is a dietitian and teaches on the DAFNE courses, I would ask her to ask the diabetes nurses that run the course for their opinion and advice. I did the DAFNE course last year, and the tutors are very knowledgeable on all matters to do with insulin profiles and dose adjustment.

Regards

Nigel

 

[timo2]

Hi BitOfARunner,

If I were you, I'd be tempted to hone the basal/bolus regimen rather than go retro with the premix. I was on 30/70 mix for around ten years. I can look back and laugh now, but it wasn't very funny at the time.

All the best,
timo.

 

[SophiaW]

When you say you're on Levemir twice a day, are you also using Novorapid (or similar) to cover your meals?

My daughter was on Novomix 30 before we switched to basal/bolus last year. Her readings were Okay, not brilliant. We found that the morning injection to cover breakfast wasn't enough, but if we increased the dose then the afternoon drop was too great. We had to be very strict about what time she ate lunch, just a 15 minute delay meant she ran into hypo territory. We found the mixed insulin to be incredibly limiting both with what and how much she ate at meal times and what time meal times had to be. It offered us very little flexibility. The plus side is that she could take just two injections a day as opposed to the 5 or 6 injections she has now. For us the mixed insulins offered a very restrictive way of life, we felt that diabetes controlled our lives whereas now we feel that we are more in control of it (not always but most of the time!). I would assume that for some the mixed insulins possibly work well but not for us.

 

[BitOfARunner]

Thanks for the replies,

To clarify, I'm not on a basal/bolus regimen, but I think I should be.
As suggested, I think a mixed insulin would be a backward step.

 

[jopar]

It's not that often that you get a T1 using just a background insulin for as long as you have not unsual though at the very begining and throught the honeymoon period...

My persons view on the insulin you suggested..

Mixed insulin

The pro side of this is the 2 injections a day, but saying that it only really effective if the persons leads a very regimented lifestyle, both in activity and food intake, greatest advatange to the older generations within a selected group, not really for the active retired

Basal/Bolus

Cons.. Requires more injections per day, and have to learn good carb counting and monitoring/data regimes to get the most from..

But the pro is that with good carb counting, good monitoring/data regime and understanding this becomes a very flexible regime to use, enabling the person to match control to their daily needs and as required..

Given the choice I would never go back to the mixed insulin regime, this was the first type of regime, didn't have the pre-mixed insulin but used to mixe background/quick twice a day, following the regimented regime of the now pre-mixed insulin..

If you feel happier gping down the Basal/Bolus route, I would enlist your sister help, so that you then explain to your consultant the 'whys' you feel this is better for you than mixed insulin..