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Novamix30 vs Basal Bolus - newly diagnosed

C

Claireypoos

Newbie
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4
Hi there fellow Type 1's.

So I've only recently been diagnosed, 36 years of age & the usual shock & feelings that everyone goes through when finding out. Am desperate to speak to other Type 1's so have joined this forum for all your expert help & advice as there don't seem to be any local groups :D

I was put on the Novamix30 insulin - 2 injections a day & felt i was managing quite well on this (bit needle phobic, so i can cope with this). It definitely wasn't taking over my life as i could inject first thing in the morning, go to work, forget about it (other than eating healthy and finger testing) & then inject again before tea. Have been doing regular finger tests and recording my levels mainly which were in single figures. Any readings 14/16 i could always justify (chocolate, sauce, party/bbq, etc). I was discharged by my dietician and nurse as they were all happy with my management of it. So overall i was feeling as good about as it as i could & that i was in control of my diabetes.

However, I then saw my diabetes dr to go over my HBA1C level (level was 58), which was in the range the nurse had said it should be in. I did have a severe ear infection (& on penicillin) in the lead up to the test which i think may have affected the result. Anyway, it was the most horrible consultation with my dr. He told me it was time i switched to Basal Bolus insulin, so injecting 5 or more times a day with food and a slow release injection. He told me that i would be coming out of the 'honeymoon' period soon, so I need to go on the weeks course, see my nurse again and get back in touch with my dietician. He wasn't really interested in my views, feelings, etc. The appointment wasn't helped by the fact that nurses kept walking in all the time and the dr in the room next door kept sticking his head in to see if he had finished with me. So a pretty **** meeting with a dr that i felt had no empathy skills or 'bedside manner'. Since that meeting i've cried all the time (which i didn't even do when initially diagnosed), i am so confused as i've only been diagnosed for 4 months and I feel like i've just been re-diagnosed. I haven't got a clue about all this carb counting, changing my insulin and the fear of injecting constantly scares the hell out of me. But on the other hand i'm now wondering if being on NovaMix30 could lead to long term health complications which is why they want me to change.

So sorry to waffle on, but i guess this is the first chance i've had to speak to others out there. So my question to you all is....

"am I better of getting a second opinion & trying to stick with the NovaMix30 which i feel i was managing well on and then assess again after the honeymoon period or should I consider switching to the Basal Bolus & try and learn about it & get over my needle issues?"

I would really like to know if there are people happy on the NovaMix30 insulin long-term, and/or if others feel that B.bolus is the way to go and find it easier to manage since switching?

Thanks :-)

Claire
 
Hi Claire

I was on 2 injections a day for the best part of 20 years - well after my honeymoon period was over ;) If you feel you are managing well on NovoMix it should really be YOUR decision and you shouldn't have to put up with bullying from your Dr.

Of course, your doses will need adjusting as your honeymoon ends - but it's not a reason to switch to Basal/Bolus unless you are having trouble keeping you levels under control.
 
Not a very good way to have a meeting, in fact its downright unprofessional having nurses and doctor disturbing you every few minutes. a meeting is a time set aside for a one to one. I would complain or better still at the time of the meeting ask if you can an uninterrupted meeting.

Hope your next meeting would be a better one.
 
If it ain't broke then don't fix it. Saying that I don't know why they don't put everyone on basal bolus straight away, far more flexibility.
 
They can't force you to change, I was put in basal/bolus right away and would hate to change as its what I'm used to, so the same would go for you, just tell them you are managing fine and you won't inject X amount of times (or any other reasons) x

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There are advantages to basal/bolus before you disregard it totally. There is more control because you inject to what you eat. If you just ate an omelette for instance ( no carbs ), you don't inject. Also, you can adjust throughout the day according to exercise, BG levels etc. in my opinion, it's easier to maintain control.
However, as previous posters have quite rightly said, it's your choice. Good luck ;-)


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I think that your doctor forgot his bedside manner, nevertheless I agree with him, once you don't have your own insulin to compensate a mixed insulin may not be the best method unless you have a very regular lifestyle and are prepared to do the same things every day ie same amount of carbs, same amount of exercise at the same times. A basal bolus regime is far more flexible so allows what I consider to be a more normal lifestyle.
 
Claire, for myself basal/bolus was one of the best things to happen as it gives you a greater flexibility to adjust you insulin to the food you eat, so if your hungry you can feast or if you want to skip a meal the option is there, it also allows you to do corrections where necessary rather than running high all day as in twice daily injections.

At the end of the day the choice is yours to switch, if your happy with the way things are then stay on the Novomix and review things 3 months down the line, no one can force you to change but I'm sure they are doing so in your best interests, sadly some consultants do lack patient skills but don't let that get you down.
 
Hi

I agree with what Robert72 has said about using twice daily injections. I myself didn't have wonderfully good control using Novomix 30 as it lowered my bg levels too quickly but got fairly good results from using Humalog Mix 25. I was able to go out with friends in the evening to clubs etc... have a good time and not worry about carrying an insulin pen or bg meter with me wherever I went. The only 'diabetes' thing that I made sure I had, was some glucose tabs (about 4) in a plastic bag in my handbag and when leaving a club to come home, I usually had a hamburger or hotdog from an outside vendor to deal with any overnight hypos that alcohol can cause. I stayed on twice daily insulins from the mid 70's until 2002 and only changed to bolus/basal because I thought that the grass might be greener but unfortunately, it wasn't and I experienced bad hypos during the day and some night time ones as well. It was only when I found out about using carb ratios and changed from once daily basal to twice daily and ditching Lantus in favour of Levemir that my life slowly started to get better.

My advice to you is to think very seriously about changing regimes and if its not broke, there's no need to fix.
 
Doctors can sometimes be massively insensitive. No one should be forced into these changes. Speaking for myself, I started on 1 injection daily 27 yrs ago and after a year (bye bye honeymoon!) was given a choice of a week in hospital to adjust dose or a weekend in hospital to switch to novopenand multi injection regime. At age 13 the weekend option was a no brainer! In the begining the extra injections took a little getting used to but after a while it became "normal". I would never change back. The flexibility was life changing. You give the example of bs of 14 or so after some foods but with multi injections you can allow for the extra carbs and not reach high figures. Change is often difficult but not always bad. A needle phobia is hard to deal with when you have diabetes. If anyone told me I'd get used to injecting I would have thought they were nuts! In the begining it used to take a few minutes of psyching myself up to break the skin but more often than not nowadays I barely look at it when I'm injecting. Usually in a rush so its just a case of inject and move on. Everyone is different I know but it might be worth trying for a while. If you don't like it you can always change back. Doctors can force the issue all they like but it is your decision at the end of the day. Good luck with your progress whatever you decide and don't be bullied into anything

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