Help! hubby ill

urbanracer said:

He said I don't need it as my a1c is 6.5/6.7 %, I'm obviously coping with the mixed insulin quite well.

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Yeah but if you ever feel like having to match your food to your insulin like you mentioned is annoying the NICE guidelines are very clear that multiple daily injections on basal bolus should be offered to all adults with type 1 rather than mixed insulin. So it doesn't matter if you need it, if you want it, it should be available and your endo certainly shouldn't be dead set against it. There should be a clinical justification for going against nice guidelines, the fact that you hba1c is just about on target isn't a justification for not giving you the treatment option nice has decided should be available to all type 1s.

Just going back to OP.. should an Insulin Dependent Diabetic on Humulin 3 be also offered a bolus injection to take on sick days to bring levels down a bit?

What is the normal advice in this sort of situation?

donnellysdogs said:

Just going back to OP.. should an Insulin Dependent Diabetic on Humulin 3 be also offered a bolus injection to take on sick days to bring levels down a bit?

What is the normal advice in this sort of situation?

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That's why I was originally given an RA pen, but I was later told "you can use it to bolus for meals if you want to."

Mmmm, I think a small amount extra of humulin does need to be taken and to find out if he can get rapid acting insulin for sick days.... I would give a little extra.. but what dosing etc have you been advised to do for sick scenarios?

Rapid acting could be used to correct high levels..
Based on the "average" person it would be to give 1 unit to bring down levels by 3mml but..... that is only for average joe bloggs....
it would be better than highs like these.. I would also advise that you must leave 5 clear hours before any more extra fast acting insulin in these scenarios...

I think it is very important that proper advice is gained from medical people...

Dosing, under eating, higher levels etc.... its difficult to give exact advice but I would recommend that sick day rules are sought from medical people.. to me it makes sense to add in a quick acting insulin... but I do not know what the NICE guidelines state for sick rules etc....

urbanracer said:

That's why I was originally given an RA pen, but I was later told "you can use it to bolus for meals if you want to."

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That's your endo offering you seperate basal/bolus, surely?
I can see why a type1 needs RA. Type2s are normally not so volatile without the artificial insulin. Insulin inj or gliclazide causes hypos for insulin resistant type2s. Type2s traditionally are hyper without medication or strict diet and exercise. Normally not as severe in bouncing hyper to hypo and vice versa.
However, natural insulin burn out from the pancreas in type2s can occur over time which makes the type2 insulin dependant as well as insulin resistant.
Mixed insulins are a more stagnant insulin therapy. Slow change but can be good for regime. Good eating regime settles type2 symptoms in a gentler fashion, which settles the bgs for longer, or should. Most type2s are on mixed insulins but a few are on seperate due to mixed insulin not as effective, for them or no natural insulin produced anymore.
Well that's my experience, to date.

daisyduck said:

Phew.. on it's way down 13.2 now.

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Get him in to see gp as an emergency appointment this morning hun! Too many high bgs are damaging.
Let us know how he gets on. He will settle once insulin covers his illness appropriately. It may never be perfect till infection does one. See what gp says.