Novamix 30 questions

[daffy1]

After having Metformin diareah for the second time I was told to stop it so for two months I was dependant on Levmere insulin but it wasn’t having any effect and my bg was high teens and twenties eventually I saw my diabetic nurse and she prescribed novamix 30 2 x 36 units to get my sugars down and a dexcom sensor. So far my sugars have come right down but what I’m not sure about is the timings of the dose.
If I went for a big meal at lunchtime should I inject early or wait till I had a snack in the evening. And if I hadn’t eaten a lot in the evening should I reduce the amount of novamix. I’ve already phoned the nurse twice today but don’t want to keep bugging her withe little questions

 

[EllieM]

Hi @daffy1 I have to be a little careful what I say as we can't give dosing advice here.

https://www.pinnaclepractices.co.nz/assets/Resource-files/Novomix-30-guide.pdf

If you look at the above guide you'll see that novomix 30 is a mixture of short and long acting insulin. So the idea is that when you inject before a meal the short acting part covers the rise in bg from the meal and the long acting part covers your background insulin needs when you aren't eating.

That's all well and good, and it sounds as if it's working better than your previous regime, but it doesn't give you that much flexibility in changing you food amounts. If you increase the novamix for a big meal you risk having too much insulin on board when you aren't eating.

Now I suspect you may have a lot more freedom in your dosage than a T1 such as myself who isn't producing any insulin at all, as hopefully your own insulin will cover some of the fluctuations caused by changing the amounts of food you eat. But I think you really really need to ask your (very good) questions to your nurse. Changing insulin types is a big deal and they aren't "little" questions - they are very relevant.

Good luck with it all.

 

[urbanracer]

After having Metformin diareah for the second time I was told to stop it so for two months I was dependant on Levmere insulin but it wasn’t having any effect and my bg was high teens and twenties eventually I saw my diabetic nurse and she prescribed novamix 30 2 x 36 units to get my sugars down and a dexcom sensor. So far my sugars have come right down but what I’m not sure about is the timings of the dose.
If I went for a big meal at lunchtime should I inject early or wait till I had a snack in the evening. And if I hadn’t eaten a lot in the evening should I reduce the amount of novamix. I’ve already phoned the nurse twice today but don’t want to keep bugging her withe little questions

Hi @daffy1
I started on mixed insulin and lunchtime is tricky.
I either had to have a very low carb lunch or accept that my blood glucose would be crazy high by late afternoon.
You could ask your doctor for some rapid acting insulin and take a few units at lunchtime - which is the method I ended up using.

 

[daffy1]

Hi @daffy1
I started on mixed insulin and lunchtime is tricky.
I either had to have a very low carb lunch or accept that my blood glucose would be crazy high by late afternoon.
You could ask your doctor for some rapid acting insulin and take a few units at lunchtime - which is the method I ended up using.

I’ve been using the novamix for 4 days now and it’s just not working. I’ve just looked t my sensor and it’s 84% very high 14% high and 3% in range and I’m up,at16 when I wake up. I’m barely eating any carbs apart from shreddies or Greek yougurt and a few blueberries on a morning no sugar 2 boiled eggs for lunch and meat at veg no potatoes in the evening. I’ve not touched a sweet or crisps in weeks my only fruit I eat is a few blueberries I’m keeping a food diary as well. I’m fed up with having a permenant headache
My DN has said it can take a few weeks to get the right dose and is in regular contact with me. I’m taking 38 on a o morning and 40 in the evening. She’s put it up twice already
Just another thing I was shopping the other day and felt unwell I was sure it was a hyper

and I’m really ill when it’s a hypo but had forgotten my sensor so I I went into boots pharmacy and told them I thought my sugars were high and could they test them. Nope the don’t have testing kits and offered me 2 glucose tablets. I just laughed and asked if they wanted me in a coma. I said I’ll,go and get some water and they bought me a lire bottle which I downed and started to feel better. But I couldn’t believe that a pharmacist didn’t know how to treat something so common

 

[EllieM]

But I couldn’t believe that a pharmacist didn’t know how to treat something so common

I suspect that pharmacists normally see diabetics with hypoglycemia not hyperglycemia, and a couple of glucose tablets is the right treatment for that. If you are actually about to go into a coma from hyperglycemia then you probably need insulin, and even ambulances don't carry that (according to my daughter, who is a paramedic, they test blood sugar and treat hypos but insulin waits for the hospital).

It sounds like hydrating did the trick for you (assuming you were high). The trouble with moving onto insulin is that everyone needs different amounts and you have to increase the amounts slowly because of the risk of going hypo from too much insulin. (Some people need less than 10 units, others may need 100s).

Having run some extremely high bgs in the past (specially my preglucometer teens) I empathise with how awful you may have been feeling.

Hopefully you will get to the "right" dose soon, whatever that is. Good luck with it all.