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Insulin changing help needed

Discussion in 'Type 1 Diabetes' started by Ahsandon007, Jan 25, 2020.

  1. Ahsandon007

    Ahsandon007 · Newbie

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    Hello, I am new here on this forum. I'm 25years old with type 1 since I was 10yrs. I used mixtard 30(2 times a day) from previous 8yrs. But i had to change it because of poor control. But doctor gave me novolog 50 and three times a day. But it requires so much dosing about 40+10+20 a day. I went to another physician he diagnosed me with hypertension and put me on ACEs and humin insulin split dose therapy. It controlled very well my glucose level but syringes prick 3times hurts. Now my doctor suggested me novolog 30 morning+evening. I started 2days ago with units 32+26 but premeal glucose level is >300 . Any suggestions should i increase units further or try other regime like lantus etc.
     
  2. Diakat

    Diakat Type 1 · Moderator
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    So you have only been on mixed insulin, is that right?
     
  3. EllieM

    EllieM Type 1 · Well-Known Member

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    We're not allowed to recommend doses, but we can talk a bit about regimes.

    It sounds like you have always been on a mixture of short and longer acting insulin, so as to minimise your injection number. Unfortunately this results in a regime where you have to have fixed amount of carbohydrates at fixed times of day, and gives you very little flexibility to cope with high (or low) blood sugars. (I was on this for my first 15 years of T1).

    A basal/bolus regime typically requires 4 injections a day: one basal or long acting (eg lantus), which lasts in the background for 24 hours, and bolus or short acting insulin which you take before meals. The advantage of doing this is that you can adjust your basal to keep your levels steady during the day (and night) when you are not eating, and use the short acting bolus insulin to compensate for meals. This allows you both to eat when and how much you like (midnight snack or skip a meal, no problem) and to adjust your long acting insulin so that your blood sugar in the morning is the same as your levels before bed. This is probably the most common regime for T1 diabetics, at least in the last 20 years.

    Insulin pumps: probably not the way to go if you're nervous about injections because you have a needle permanently connected, requires quite a lot of effort to get the doses right, but people who use these often have the best control of their diabetes, because they have the most control over how much insulin is injected. Apparently 40% of US T1s use pumps, though UK usage is only about 12% (figures in 2016).

    Honestly, I'd recommend a basal bolus regime if you can tolerate the injections - can you take advise on injection technique to see if they can be made less painful???

    As regards to your original dosage question, can you contact your diabetic team/doctor? Really they should not give you insulin without instructions on how to modify it if your levels are too high or low, or contact details so that you can ask for help. Can I ask which country you live in, as medical practice does vary by country....?

    Good luck.
     
    • Like Like x 2
    #3 EllieM, Jan 26, 2020 at 12:25 AM
    Last edited: Jan 26, 2020
  4. Ahsandon007

    Ahsandon007 · Newbie

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    Yes
     
  5. Ahsandon007

    Ahsandon007 · Newbie

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    Basal/Bolus 4 times a day is difficult for me as I cannot manage it due to busy routine. And in my country only 30G 8mm syringe is available, I'm looking for 31G or 32G 6mm which is less painful so I'll switch to human insulin split dose therapy (R+Nph) as it has better control over lunch meal than rapid acting one.
    I'm from Pakistan and my yea my doctor told me to check premeal glucose if its higher add +2unit to previous dose until you get targeted results.
    One more thing can I use novolog 30 in moring and evening with novorapid at lunch time? Total 3 injections per day pre meals. Is it better than lantus regime.?
     
    • Informative Informative x 1
  6. urbanracer

    urbanracer Type 1 · Moderator
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    It is possible. I survived for a few years on Mix25 and then a healthcare professional told me that I could use additional (rapid acting) Humalog to effectively increase the dose of the rapid acting component in the Mix25.

    I did this for a while before switching to Multiple Daily Injections. You might save yourself one injection per day but could be the same as MDI depending on what and when you eat.
     
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  7. Ahsandon007

    Ahsandon007 · Newbie

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    Ok I will try it novolog 30 breakfast+Dinner and novorapid at lunch time
     
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