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General question about starting on tresiba+novorapid

Discussion in 'Insulin' started by OptimisticT1D, Jan 15, 2021.

  1. OptimisticT1D

    OptimisticT1D Type 1 · Member

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    Hi!

    I’ve been diabetic for 23 years now, with fairly good blood glucose levels. I was on 2 daily injections of actrapid+insulatard , and then novomix 30.

    I’m moving to novorapid and tresiba from this weekend, and was prescribed 100iu pens, but unfortunately I’m only getting 200iu pens.

    Is it alright to the the 200iu pen and just divide my dose by 2?

    Also, for my understanding and clarity, how do i do the actual switch? I intend on taking tresiba at night.

    Should I take my novomix 30 in the morning as usual, and then before dinner (8pm) take the novo rapid and then before sleeping(midnight) take the tresiba?

    I’m sorry if these questions sound basic but I have a doctor with the assumption that if you’ve had diabetes for 23 years you can manage on your own :)

    Thanks in advance!
     
  2. Seacrow

    Seacrow LADA · Well-Known Member

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    Umm. I wasn't aware novorapid came in 200iu cartridges, but whatever. Do not start multiplying/dividing by different numbers depending on the size of the pen cartridge. 1iu is 1iu whether it comes out of a 1ml cartridge (100iu) or a 2ml cartridge (containing 200iu).
    The pens are calibrated in iu, so whatever the pen size, you dial up the number of insulin units you want and inject.
    Your plan for switching over sounds fine. Your diabetes team should have told you to slightly reduce the doses you are taking, and then gradually bring them back up when your bg stabilises.
    May I ask why you are changing insulins? It sounds like you were fairly settled on the previous regime.
     
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  3. OptimisticT1D

    OptimisticT1D Type 1 · Member

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    My sincerest apologies . I just downloaded the app for this forum in the morning and then got into a meeting with the post typed (pending corrections), and somehow posted it. Let me try again :

    I’m 32 now and I’ve been diabetic since I was 9 years old. I was on actrapid + insulatard till about two months ago (I know I know...but it suited me and I could get these in India). I live in France now, and since I haven’t been able to visit India in forever, I got on the medical system here and they put me on novomix 30. The 30/70 ratio doesn’t suit me and to be honest I prefer to be flexible with my life a little bit, so I asked to be put on novorapid and trésiba instead.

    My doctor agreed and gave me the prescription. For novorapid, there is no issue.

    For tresiba , I asked for 100units/ml, however they don’t have that in the 10 pharmacies I visited .. all of them had 200units/ml. (In the earlier post I wrote “iu” and I’m so embarrassed now :/)

    So there were two questions:
    1) can I use the 200units/ml tresiba and just half the dose I would normally have had with the 100units/ml?

    2) the transition approach:

    I take my novomix in the morning as usual. Take novorapid for dinner, followed by tresiba for the basal (3-4 hours after dinner).


    My apologies again and thank you for responding :)
     
  4. OptimisticT1D

    OptimisticT1D Type 1 · Member

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    Ok so after a lot of research this is the conclusion:

    If I take 20units On a u100 pen, I should continue taking 20units on a u200 pen. The pen will automatically half the volume of insulin injected into my body , thus maintaining the balance.

    To be tried tomorrow! Correct me if I’m wrong please.
     
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  5. Seacrow

    Seacrow LADA · Well-Known Member

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    That sounds right. The pens are calibrated to give the dose they read - the dose you dial up is the dose you get.. So the u200 pen will provide the same number of units of insulin (same dose) in half the volume of liquid.

    The confusion comes when you try to use a u100 calibrated syringe on a vial that is u200 strength, but the pens work around that.

    I hope this is clear enough.

    I was put on novomix 30 after I was diagnosed. It took a whole ten days before I was desperate to try something, anything else. 20 years on and I still haven't met anyone novomix works for.
     
  6. OptimisticT1D

    OptimisticT1D Type 1 · Member

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    Wonderfully clear!!! Thank you so much :)

    Infact I’m quite sure I can make novomix work but it requires a rigid schedule which I’m confident I’m incapable of keeping :/
     
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