confused as to best insulin for my daughter...help！！

[Rox000]

Hi everyone...
my 19yr old was diagnosed t1 3mths ago...the specialist put her on novomix 30/70 assuming that 2 injections would be best given her diabilities. I really wasnt consulted at the time and we were sent home to stringently carb count and hope for the best.
Im 3 months into this journey and im constantly asking myself if this is truly the right insulin for her...its very restrictive...she spikes with it is limited to where she can go its quite terrible to be honest.
She cant use a pump due to her intellectual disability but had no issues with her injections via pen and no dramas with her bsl.
I am her primary carer and will have to give her injections...i will need to go to work in a month.
What other insulin types could she use and how many injections a day would it imvolve...
My gut is just telling me this aint the best one for her...is it too early to change or should i soldier on with the novomix...
Please help....many thanks rox

 

[Daibell]

Hi. T1s will normally be given what's called the Basal/Bolus regime (aka MDI Multiple Daily Injections) which uses two insulins i.e. a daily one (Basal) and a mealtime one (Bolus). This means 4 to 5 injections but 4 would normally be fine for many. Mixed insulin is a compromise but only needs 2 injections. The problem is you can't adjust the dose for variations in mealtime carbs so the control is not as good as Basal/Bolus. I guess the medics thought it was best to stick with 2 injections due to the disability. If you're happy, I would ask to move over to Basal/Bolus as it gives much better control although twice as many injections.

 

[Rox000]

thanks daibell could you tell me.when these injections if we were working on 4 when they would be given ...
the reason i ask is ill be back at work in a month ...i am the only person that can give these injections ...i can give morning doses dinner and bed but will struggle to get home for the lunchtime dose if one is required...any thoughts muchly appreciated x

 

[Rox000]

im a high school english teacher ...the school is 10min from home fortunately...i need to sort this out before i start working in a months time...just wanted to clarify...thanks for input always appreciated x

 

[Daibell]

Hi again. Normally with Basal/Bolus the Basal which is a 24 hour insulin is given once or twice a day. The daily dose is sometimes split making it two to smooth it as it doesn't last the full 24 hours. If given once day you can choose morning or evening and you give the Basal daily dose amount (I only inject my Basal once a day so have 4 injections per day). The meal-time Bolus might give you some problems for the lunchtime one. It is usually given just before a meal. The best control is when the Bolus is adjusted for each meal to match the carbs using a ratio determined thru experience (called carb-counting). If the lunch is very light in carbs you might be able to skip the lunchtime Bolus is no one is available to do it. It would cause a degree of blood sugar spike. For example I never inject a Bolus if my carbs are below 30 gms in a meal. You obviously need to discuss all the options with the specialist.

 

[Rox000]

thnx as it is now she is on a strict carb counting regime with the novomix so her lunch does not exceed 30g ...shes eating about 21g...at lunch...
thnx so much a call to my diabetic nurse monday to discuss these options is in order ...but at least if shes on the basal bolus regime the lunch carbs can be changed according to events birthdays as long as i am there to give the bolus dose. so much less restricting in my eyes....thankyou