moved to lantus and novorapid help needed now please!

Ive been using Novorapid and Lantus for about 5 years now , by the looks of it , hes using the correct amount of lantus , but seems to be using alot of novo if he is having a hypo pre meal time , maybe he needs to be contributing a few carbs in between meal times that are slow releasing , something like a few digestives. Give it a go , but dont keep relying on having to lower lantus , im on 24 units at night , and have been steady for the last year , and found adjusting it lower just gives me a struggle later in the day. Hope you can find this information useful.
Does he have any figures to stick too ?

Maybe 5-7 morning , 5-8 pre dinner , 6-8 pre dinner , remember him snacking on slow releasing carbs will help his levels.

Hi mirrormirror and welcome to the forum I'm not sure how old your son is but if he is young you might find it useful to look at the Diabetes Youth Club where mums discuss their problems with other mums and you might find more help there:

viewforum.php?f=16

Hopefully he shouldn't , I just hope he remembers to snack on a little biscuit every so often so he doesn't have a risk of a hypo , is he armed with gluo gel ? Dextro tabs I find are easier , without the nasty taste. Good luck to your son , hope he manages to adapt and live a healthy life

Hi,

If he is hypo just before meals it's likely it's the fast acting insulin thats causing those.

Do you carb count and match insulin accordingly?

If he has a hypo at night lower the next days long acting insulin immediately. Hypo's at night need to be addressed immediately so don't wait for a pattern to emerge if thats the case.

When does he have his injection of lantus? if he has it in the morning it could be that it's wearing off in the early hours and not quite lasting a full 24 hours. alot of people split lantus injections one in the morning and one at night as this seems to give a better coverage. This can also work better as people's needs of background insulin can vary especially in the morning it tends to be higher so splitting the background dose can enable you to have more in the day and less at night. It does take some tweaking to get this right though.

My son Khaleb is much younger and on Levemir (split morning and night) and Novorapid (3 X with meals).

This is just what happens with us...

If I put the long acting insulin up I end up often having to change the carb ratios for food also and sometimes the amount of carbs for morning/afternoon tea and supper. I find for about 3 days from a change I could also get hypos but then it settles and I get a better picture of whether I've done the right thing or not. I only change the doses by half a unit but it makes a huge difference to his levels.

It can be a hassle tweaking things when you also have to manage family commitments, exercise activities and life in general. I always worry about Khaleb at daycare if I've been messing with his doses so I try to do it when there is the longest gap starting at the weekend.

You sound like your going really well with the change over. I think as a mum I can always feel when I might be feeding the insulin or when the diet has become too restrictive and manage to find some middle ground.

Chucking extra carbs to avoid hypos is only feeding insulin and not resolving the problem..

Basal/Bolus regime combined with carb counting is a very good system that enables good control.. But it does require a good knowledge not only on carbs types and how they adorb, but also how other factors like exercise etc impacts on control.. And the ability to read your data..

It can be extremely difficult to determin whether it's the background insulin or quick acting insulin causing the problem.. And if the bacground insulin is out then nothing else will fall into place and work..

The only way to find out if your background insulin is correct is by doing a fasting test! with ensuring that you haven't got any carbs or quick acting insulins still impacting on your system..

In this case it seems that the quick acting insulin (carb to insulin ratio) are out but it is probable that the background insulin is also slightly out, so you need to do a fasting test to find out how far out the background it, then work on the quick acting carb ratio's afterwards..

mirrormirror said:

My son has been moved from novomix 30 to multiple daily injections - lantus and novo rapid.

His readings had been in the teens waking so after being on it since Thursday night the diabetic nurse who i spoke to yesterday said to increase by 2 units last night. He started on 20 units and last night he injected 22 units.

She said with lantus you dont change the dose if it is not right for about 6 days, but although it is day one after the first injection today he has been hypo 3 times. I wonder whether i should reduce it down tonight or wait and give him 22 again tonight and ring her tomorrow morning.

What do you think?

Also he has had a higher morning bm but good levels pre meals etc when on 20, but when on 22 he came down to 13 in the morning (from 18 - 20) but is hypo pre meals etc.

Any ideas?

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Hi There

My Son who was 14 in April was on the same Novomix up until Feb this year and we are still trying to get to grips with things. We also have the problem of them going into puberty which does not help with raging hormones. My Son is of slight build weighing in at 7st 2lbs and 5ft 2" tall. His ratio for breakfast is 1:10g carbs, lunch 1:15 carbs and back to 1:10 for tea. He also has supper which he does not inject for then has his 15 lantus before bed. His meals consists of 70g for breakfast, 60g for lunch and anything up to 12g for tea and as I said he does not have insulin to cover his supper which is again 70g. His consultant said that he is not taking on enough insulin for his body weight and should be having more food to grow and insulin which we are now trying to do, but these past few days he has again been waking with bg readings around 10-12 so I am this evening going to adjust his lantus to 17 units and keep a check on his BG's.

We seem to be experimenting and learning all the time. Good luck with your son.

Noticed your new post again. As far as I am aware, Lantus does not get split, but I may be wrong (we don't split and he has it around 10.30. Do you know how the nurse has calculated the amount of Lantus your son is on and is he of slim build?

Hi

I've had diabetes for the last 25 years and have been on the same insulin as your son for the last 7 years. I have alot of problems with my blood sugar levels while being on this insulin.
I was finding that I was waking up and my sugars were aroud the 2-3. Then mid afternoon they would be in the region of 19-22.
My doctor suggested to me that I take the lantus twice a day. So I tried it out. I reduced the amount I gave myself at night by 2 units, then in the morning (about 12 hours after the night injection) I gave myself the same amount of lantus that I'd given the night before. This has helped so much. I now wake up around the 5 mark and in the afternoon I'm hitting much lower than I was. It's still not perfect but it has helped so much.