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Can Novomix 30 and Novo Rapid be taken together?

J

jnathan

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Hi

My Mom has type 2 diabetes. she had a weight of 61-62 kilos over the last few yrs but for over a year she has gained 5-7 kilos and now 67KG. her diabetes shots up rapidly soon after taking the meal. it goes up to 23.4

She has been taking 26 units of Novomix 30 before her breakfast and 20 units before supper.
but this has not been able to reduce her sugal level below 10.0 rather she had a fasting sugar level of 6.0-8.0 when she was 62kilos but now she has fasting sugar level of 13-14 in the morning. moreover, her aftermeal sugar level shots up to 21.0.

I have been giving her 15 units of Novorapid with 15 units of Novo mix 30.
is there any problem? can she take both? can she take more insulin if her sugar level does not come down with the units she is taking now?

H1C (Glycated Hemoglobin) : 10.3 %
S.Creatinine : 0.8 mg/dL

Triglyceride : 230 mg/dL
HDL : 38
LDL : 121
 
Hi jnathan

Can I assume your mum has quite a bit of carbohydrate in her diet?

There's often two ways of looking at things. Either more insulin can be taken, or less carbohydrate eaten.

Personally, I'd go for the second option.

If a shorter acting insulin needs to be taken, the advice needs to come from a doctor.

I hope this helps a bit
Ed
 
alaska,

thanks for your reply.
The problem is there is no meal meter to measure how much calories are there in each meals.
This is what she eats round the clock.

Morning: 3-4 bread slices with some vegetables. 1 cup of lemon tea with or without splenda
Afternoon: at 1 pm, she takes 1 plate of rice with fish, some vegetables, lentils.
Evening at 5pm: 1 cup of tea with milk+ 1 sachet of splenda, biscuits. sometimes some puffed rice
Evening meal at 9pm: Same as lunch.
at Invitations or smetimes we cook something good like meat, chicken and other dairy items. I guess her sugar level goes very high to 24.0 even .

a year ago she used to have fasting sugar level of 6-7 but now it stays at 17-19 which is alarming as she has gained 6-7 kilos of more weight in the last 1 year after she started taking insulin twice a day.

As I think most of the insulin brands are same coz they produce same type of DNA hormones but the difference is some of them work for shorter/longer hours.

1st question is : is there any device which could show her blood glucose level round the clock? this lancet and the glucometer system is troublesome as every time you have to poke the diabetic with the needle.

2nd Question: Doctors here are heavily manipulated and directed by the meds industries. as she has been taking Novomix 30 for quite sometime, I think the GP is getting some $$$ from that from NovoNordisk. this could be the reason why GP has not decided to switch to another insulin.
mom has always experienced rapid shot of sugar level soon after she took afternoon and evening meal. I have always been monitoring her sugar level and have read a lot about diabetes and its meds. I have got the feeling that she needs short acting insulin more than than what Novomix 30 is doing which is short acting+long acting.

Final question: is she doing any harm to her body by taking Novo Rapid and Novomix 30 together?
I have just checked her sugar level before her lunch, and its lowest in 2 months now at 12.4. she took 26 units of Novomix 30 before her breakfast this morning.
 
I can see by what you are saying that you are not based in the UK, so different rules apply on medicines.

Her diet to me sounds like it has way too many carbohydrates to me.


I've highlighted the high carb foods. To get her blood sugar down, she needs to reduce or cut out these foods.

I'd agree with everything that Alaska said


You can get a continuous glucose measurement (CGM) machine but they are very expensive and each sensor only lasts about a week and I'm not sure what difference wearing one of these would make, seeing the high levels all the time.

I'm also mentioning that you should use the side of the fingers for the blood tests for the meter, as this is much less painful.
 
Denise

thanks a lot for your reply.
I am not sure what she should eat round the clock which could keep her satisfied with no feeling of hunger and at the same time she'd get the taste and be able to keep her sugar level down.

its two hours now after she has taken her lunch. she took, 2 cups of rice, 50 grams of mashed chickpeas, 50 grams of fish curry, a kinnow (a kind of Citrus).
Before lunch : 12.4
2 Hrs after lunch: 15.3 now. what should be done now to bring this below 10.0?
She took 26 units of Novomix 30 before Breakfast.

She will take a biscuit, Lemon tea now.
at 7pm, she will take some puffed rice

please comment.
 
Hello Jnathon

I used twice daily insulins for many years and can see straight away from looking at yr above message that your mum is eating way way toooooo many grams of carbohydrate at her meal times.

With twice daily insulins you have got to eat to your meter and stabilise bg levels more with adjusting carb than with adjusting insulin.

Ideally your mums bg level should be no more than 7.0mmol before you eats a main meal and then about 9-10mmol 2.5hrs later. A level lower than that will require her to eat a snack of about 10g carb (approx) in order to stop her going hypo before lunch but if her bg is higher then she will probably be ok to miss out the snack and just let the insulin lower her till she eats another main meal which should be roughley spaced 5hrs part.

Get your mum using a bg meter 6 times a day for a while and then she/you will see just how high or low her bg levels are going and then you will be able to adjust the food correctly.
 
Your culture and cusine is very different from mine. I am not on insulin so can't comment on that. I do not eat any of the foods that I highlighted and I am not hungry between meals. It is the carbihydrates that make you feel hungry.

Increase the amount of vegetables and these will fill her up.
 
Hi

I also agree a bit with Denise. Carbohydrate does cause people to want to eat unfortunately so if your mum was to cut down a bit on the carb and add more vegetables (which are mainly lowish in carb) her plate would be full and her brain would be fooled a bit into believing that she was eating a large meal.

Eating loads of carb and injecting more insulin is just going to cause yr mum to gain more weight and need more and more insulin because of the resistance. It becomes a bit of a nasty viscous circle and the only way of breaking it is by cutting down on the carb which should then start to lower bg levels and with some mild to moderate exercise (walking) she will then be able to lower bg levels a bit more and then will be able to reduce the insulin a bit.

Mind over matter works wonders plus determination to get slimmer.
 
Hi jnathan

Denise points out that your mum is taking in what seems to be quite a large amount of carbohydrate for someone with diabetes to be having.

Bread, rice and biscuits tend to push blood sugar up quicker than insulin can bring sugar levels down.

This will be one reason why your mum has consistently high levels.

When we with diabetes have high levels, it means that there's not enough insulin in our bodies to allow the sugar in our blood to get to where it's needed -ie into our cells to give us energy.

So whilst your mum has loads of sugar in her blood, she's being starved of energy and so she feels hungry.

As your mum is also putting on quite a lot of weight, I would consider gradually reducing the carbohydrates and replacing with a little more protein based foods.

She could halve the portions of rice she's having for instance and include an egg to make up for it. This should help to reduce the high sugar levels and keep her hunger down too.
 
ihs,

thanks for your reply.
1. I am concerned with her weight now at 67 KG which was 61 KG only 1 year ago. I am
worried that taking insulin twice a day is making her overweight. good news is she does not
have high Blood pressure but docs suspected she had Ischaemic heart disease but she never
underwent further investigation about that. she feels foamy feeling in her left leg for
which she has been taking Gri
2. as you said she is taking way too much carbs during her meal times but she does not see
this the same way you do.
3. I am trying to persuade her to take no mean in span of 5 hours.
4. I wish I could get a Continuous glucose monitoring system which would show her the sugar

level increment as she'd take the the foods she wanted. She's kinda a lady of skepticism.


))Denise((,

thanks for your reply again. I am giving her more vegetables in her meals and strictly
giving her only 50-60 grams of rice in her lunch. she came from a culture where people eat 2-4 slices of bread with mixed vegetable curry or soft potato fries in the morning as
breakfast.
https://encrypted-tbn1.google.com/images?q=tbn:ANd9GcTW2tM9oIn1HdVF58FRcQ7VfKNafdwSlzT7BAQVVYzPqN6W-nwX

Yes, I am giving her more vegs during the lunch and dinner.
I wish I'd get a decent meal plan for her which would keeep her sugar level down yet kept
her happy.
How much does the Continuous Glucose monitors cost? I want my mom to use one for a week to
let her see by herself that she is the one who is making her sugar level higher by eating
the carbs more. I said before, She is a lady who believes what she sees.


Hi Alaska,

taking rice and breads is the meal of her culture.
She comes from an area of Asia where people eat breads+Potato soft curry/soft fries in spices.
during lunch they take rice with fish, lentils, vegs. sometime beef, chicken, mutton.
and at the supper the same. These are the meals they have been taking since they were kids.
Now being a diabetic now, its hard to eliminate those foods and with less in quantity.

as I mentioned above in this post, she is scared of heart and stroke related diseases if she replaces protein based foods in place of the current carb based foods. she does take Lescol, Galvus, Starlix once a day before her meal in either before lunch/dinner.

I am still looking for a 24 hrs meal plan for her. if anyone of you could help me finding out.
Another thing is , what should I do to lower her sugar level at any stage of the day?
Say it could be 19.3 two hrs after lunch or 21.7, two hrs after supper. Shouldnt I use Novorapid and Novomix 30 together? is there any hard using them both or stopping using anyone? I am really not satisfied with my Endocrinologist's insulin management with my mom. he says she should increase 2 units of insulin per day but I have seen sometime if she is used to take 26 units of insulin before supper, it doesnt bring her sugar level below 10.0 after 2 hrs. what can be done then?
 
In answer to your main question, its quite safe to use both insulins together - I have in the past. Type 1 for 40 years, no complications yet. Getting the blood sugar levels down is important so if using both insulins does that, continue.

As others have said, the carbohydrate needs to be vastly reduced but we all know its difficult. good luck to you both.
 
Hi jnathan

I'm going to start off a little blunt, so please forgive me. Breads and rice are part of Asian culture but diabetes is also now a big part of Asian culture too* and I don't think this is necessarily coincidence.

It may be worth adapting your mum's diet gradually over time to be healthier. It is possible to have healthy Asian meals without so much reliance on carbs.

If your mum has white rice, you could replace it with basmati rice as this more fibre, which makes it more blood sugar friendly.

I hope I've not been too blunt and only wish to be helpful.

With best wishes
Ed

* diabetes has been shown to be noticeably more prevalent in Asians
 
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