How does Novomix 30 work? (The idiots guide)

[robert72]

Hey tx @robert72 could you expand a little on what you mean by a flat profile as compared to Lantus or Levemir?

All insulins have an onset, peak and duration. If you can imagine this as a graph - the longer the duration, the flatter the graph would be (less of a peak).

 

[Spencer67]

All insulins have an onset, peak and duration. If you can imagine this as a graph - the longer the duration, the flatter the graph would be (less of a peak).

I like its profile it will be one i will definitely ask about.

Tresiba® (insulin degludec) (NN1250)
:Type 1 and 2 diabetes
A new-generation once-daily basal insulin analogue with a duration of action beyond 42 hours and a flat and stable action profile that compared with insulin glargine reduces the rate of hypoglycaemia and increases dosing flexibility when needed. Launched in the EU, Japan and other markets. Additional data required by the US FDA are being generated for the planned resubmission.

How does a basal like this effect and interact with exercise, any problem or issues to think about? sorry for so many questions.

 

[robert72]

I like its profile it will be one i will definitely ask about.

Tresiba® (insulin degludec) (NN1250)
:Type 1 and 2 diabetes
A new-generation once-daily basal insulin analogue with a duration of action beyond 42 hours and a flat and stable action profile that compared with insulin glargine reduces the rate of hypoglycaemia and increases dosing flexibility when needed. Launched in the EU, Japan and other markets. Additional data required by the US FDA are being generated for the planned resubmission.

How does a basal like this effect and interact with exercise, any problem or issues to think about? sorry for so many questions.

I don't do any strenuous exercise - just a bit of mild circuit training which I picked up from cardiac rehab. I also follow a low carb diet so mostly fuelled by fat, but I would expect to take carbs if needed.

 

[Spencer67]

Lantus and Levemir are around £42 per 5 carts whilst Tresiba is around £72.

You mentioned the price of the basal, do you know how much Novomix 30 is?
I heard it was £26 but can't find any real data to confirm.

 

[robert72]

Novomix 30:
5 x 3ml Penfill cartridges=£28.79 (for NovoPen 4, NovoPen 5 or NovoPen Echo
5 x 3ml FlexPen pre-filled pen=£29.89

 

[Spencer67]

I thought it was cheap, i'm suspecting the doc is keeping me on Novomix for his budget. He is making it difficult to change for some reason other than he actually cares about me, so much for the Hippocratic Oath.

 

[robert72]

I thought it was cheap, i'm suspecting the doc is keeping me on Novomix for his budget. He is making it difficult to change for some reason other than he actually cares about me, so much for the Hippocratic Oath.

Yep - this is why you'd be better of seeing a consultant

 

[iHs]

Novomix 30:
5 x 3ml Penfill cartridges=£28.79 (for NovoPen 4, NovoPen 5 or NovoPen Echo
5 x 3ml FlexPen pre-filled pen=£29.89

Any chance of you listing the price of Levemir cartridges and Novorapid cartridges please ?

 

[noblehead]

I thought it was cheap, i'm suspecting the doc is keeping me on Novomix for his budget. He is making it difficult to change for some reason other than he actually cares about me, so much for the Hippocratic Oath.

Spencer, I take it you mean your gp here, if so and your not happy with the level of care and advice that you are receiving from your Dr then you can ask to be referred over to your local hospitals diabetes clinic.

 

[Spencer67]

Spencer, I take it you mean your gp here, if so and your not happy with the level of care and advice that you are receiving from your Dr then you can ask to be referred over to your local hospitals diabetes clinic.

Yes i did mean my gp, i've got a telephone appointment tmos for a chat so will be asking him about a referral to a good db team and a change in basal.

 

[robert72]

Any chance of you listing the price of Levemir cartridges and Novorapid cartridges please ?

NovoRapid:
5 x 3ml Penfill cartridges=£28.31 (for NovoPen 4, NovoPen 5 or NovoPen Echo
5 x 3ml FlexPen pre-filled pen=£30.60 (for use with NovoFine or NovoTwist needles).
1 x 10ml vial=£14.08.
5 x 3ml FlexTouch pre-filled pen=£32.13 (for use with NovoFine or NovoTwist needles).
5 x 1.6ml PumpCart cartridges=£15.10 (for use with Accu-Chek Insight insulin pump).

Levemir:
5 x 3ml Penfill cartridge=£42.00 (for NovoPen 4, NovoPen 5 or NovoPen Echo
5 x 3ml FlexPen pre-filled pen=£42.00 (for use with NovoFine or NovoTwist needles).
5 x 3ml InnoLet pre-filled delivery device=£44.85 (for use with NovoFine or NovoTwist needles).

 

[Spencer67]

I found the below table helpful for dealing with dosage as Novorapid is easier to work out because of ratios but Novomix is harder to estimate because of the 30/70 mix.

Source:
http://www.medicines.org.uk/EMC/med...enfill+100+U+ml,+NovoMix+30+FlexPen+100+U+ml/

 

[iHs]

NovoRapid:
5 x 3ml Penfill cartridges=£28.31 (for NovoPen 4, NovoPen 5 or NovoPen Echo
5 x 3ml FlexPen pre-filled pen=£30.60 (for use with NovoFine or NovoTwist needles).
1 x 10ml vial=£14.08.
5 x 3ml FlexTouch pre-filled pen=£32.13 (for use with NovoFine or NovoTwist needles).
5 x 1.6ml PumpCart cartridges=£15.10 (for use with Accu-Chek Insight insulin pump).

Levemir:
5 x 3ml Penfill cartridge=£42.00 (for NovoPen 4, NovoPen 5 or NovoPen Echo
5 x 3ml FlexPen pre-filled pen=£42.00 (for use with NovoFine or NovoTwist needles).
5 x 3ml InnoLet pre-filled delivery device=£44.85 (for use with NovoFine or NovoTwist needles).

Cheers..........it looks like the Novomix30 is cheaper to prescribe because there is no long acting basal to be added.

 

[urbanracer]

Delighted to hear someone else who's happy with Humalog Mix 25. I inject the same amount of units as you, except mine is 8 in the morning and 10 at night. I'm totally content with my regime and like you, don't want to change to basal/bolus for the moment. I notice you are in Worthing, so am I. Our hospital obviously favours Humalog Mix 25 as it produces good results.

I take it you've been to the endo unit and met Dr C then?

 

[June_C]

Haven't had that pleasure, just the Registrar and am not looking forward to seeing her again !