Novomix 30 help pls

[Josef1980]

Hi my sister 22 years old just got diagnosed with type 1 diabetes mellitus

The doctor gave her Novomix 30: Dr. told here to take 10 mmol unites before Launch and 10 units before dinner, she does not like to eat breakfast

5 hours after Launch BG is 19 mmol

5 hours after dinner its 15 mmol

Talked to the Dr. again he said add 2 units more for dinner

I am very skeptical about this Novomix 30

why didn't he give here Novomix 50

or

NovoRapid with Lantus

I am diabetic for 15 yeas now type 1 i was on Humalog and Humulin U for long time then the doctor changed it to NovoRapid and Lantus

I am not familiar with the Novomix 30 life style, Remember she is 22

Which is better? Novomix 30 or NovoRapid and Lantus


Thanks in advance

 

[Daibell]

To keep things simple and the number of injections to two a day some GPs prescribe Novomix or just don't think about the best choices. Novorapid with Lantus or Levemir will give much better control and cater for different meals thru carb-counting. It will require from 3-5 injections per day depending on whether the Lantus/Levemir is split and whether you inject for breakfast. I'm on Levemir & Novorapid and inject 3-4 times a day and I'm happy to have the extra jabs. My DN moved me from tablets straight to this Basal/Bolus regime for which I'm very grateful. Do discuss the options with your sister and then ask for the insulin(s) to be changed if you want.

 

[PaulinaB]

As above. Novomix seems to be a first choice, I'm guessing because it's simpler than basal-bolus (like novorapid and lantus/levemir) and it works well for some people.
But if it doesn't work for her and she doesn't mind more jabs, then discuss with a doc/nurse to change
It's not really better-worse thing, it's about what works for a specific person.

 

[Spiker]

For the newly diagnosed they may be trying to keep it simple but proper basal/bolus will definitely give her more flexibility and control.

We can't comment on the specifics because you didn't give her pre-meal BG values, carb contents of the meals, or any pre-meal correction doses. (Can you even do a correction dose with Novomix 30?)

 

[Josef1980]

For the newly diagnosed they may be trying to keep it simple but proper basal/bolus will definitely give her more flexibility and control.

We can't comment on the specifics because you didn't give her pre-meal BG values, carb contents of the meals, or any pre-meal correction doses. (Can you even do a correction dose with Novomix 30?)

Unfortunately Doctors here do not use the carb method unlike the USA where i was first diagnosed,
&
I stopped using the Carb method because it does not take into account whether I skipped a meal which makes me more insulin sensitive (reduces resistance) or the fact that I might be more active which means I need to cut on the Units (dosage) since the blood will be circling even faster which makes the medicine affect starts faster and peaks much faster while food digestion is slow, and other variables that mess up the entire Carb/Units Calculation method

I just want to know upon what factor/s do Doctors choose novomix 25/75 over 30/70 or over 50/50 or over the NovoRapid+Lantus/Levermir

Thanks in Advance

 

[oldgreymare]

As others have said, doctors often start new patients on a mixed insulin (novomix) twice a day to assess the response to insulin (how sensitive - too much/too little? Unfortunately this is trial and error at the beginning of diagnosis) and also assess the patient's ability to follow a set treatment protocol. If the patient struggles to follow instructions for 2-3 daily mixed insulin injections and set meal contents/times, then the doctor may hesitate to recommend the more flexible but more complicated multiple daily injections (MDI) approach using novorapid & lantus/levemir.

In order to decide what is "best" for your sister I suggest she looks at 2 aspects

1) lifestyle - mixed insulin protocol can work best with very regular routines - sleeping/waking and meals at same time every day, also activity/exercise levels consistent day to day - this would not be true for most 22 year olds I know!

2) collect lots of data - a detailed daily eating/activity diary - times of waking, injecting, eating, exercise, what foods (carbs), activity, etc and lots of BG testing - 5-8 times a day. Suggest 1) waking level 2) mid morning -even if no breakfast 3) pre lunch 4) 2 hours post lunch 5) pre dinner 6) 2 hours post dinner 7) at bedtime Collect at least one week's (7 days) worth of data.

Having this detailed information to discuss with your sister's doctor will give you all a much clearer idea of how much insulin she may need per day as well as how sensitive to carbs in her meals. It will also give your sister a chance to try out the discipline she will need to use for MDI treatment - does she feel more in control by systematically monitoring her food and BG levels or is it stressful, too overwhelming?

I suugest this level of information would be extremely helpful to decide between 75/25 70/30, 50/50 or whether move to MDI ( novorapid and lantus/levemir). Anything else take lots of trial and error and time.

I hope this helps!

 

[iHs]

30/70 mix is the basic start you off twice daily. For some, its action is too fast so they switch to 25/75 which is a tiny bit slower. For some, 30/70 is not fast enough so they switch to 50/50. The twice daily action on bg levels is governed by the insulin action and most importantly, the carbohydrate eaten at set times during the day to balance out.



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[copepod]

Unfortunately Doctors here do not use the carb method unlike the USA where i was first diagnosed,
&
I stopped using the Carb method because it does not take into account whether I skipped a meal which makes me more insulin sensitive (reduces resistance) or the fact that I might be more active which means I need to cut on the Units (dosage) since the blood will be circling even faster which makes the medicine affect starts faster and peaks much faster while food digestion is slow, and other variables that mess up the entire Carb/Units Calculation method

I just want to know upon what factor/s do Doctors choose novomix 25/75 over 30/70 or over 50/50 or over the NovoRapid+Lantus/Levermir

Thanks in Advance

Where is "here"? Where is your sister? Most of us on these boards live in UK, so don't know so much about how health services, doctors etc operate in other countries. It's really down to your sister to ask her doctor why they prescribed Novomix 30, and whether it suits her life.

 

[Deleted member 83869]

When I was first diagnosed I too was on Novomix 30 and novo rapid for correcting! But my Sugars were always high and it wasn't until I had my first case of DKA about 8 months in that they eventually took me off of novomix 30 as it was no good for me and they put me on levemir and novorapid! I would definitely keep on at the doctor that it is not working for your sister ! But yes if you don't live in the UK then it is probably different to wherever you are like copepod said!

 

[Josef1980]

Where is "here"? Where is your sister? Most of us on these boards live in UK, so don't know so much about how health services, doctors etc operate in other countries. It's really down to your sister to ask her doctor why they prescribed Novomix 30, and whether it suits her life.

here is Kuwait; top 10 countries in diabetes (15-25% of the population are diabetic)

http://www.arabtimesonline.com/News...tes-rate-in-Kuwait-very-alarming/Default.aspx

 

[Josef1980]

30/70 mix is the basic start you off twice daily. For some, its action is too fast so they switch to 25/75 which is a tiny bit slower. For some, 30/70 is not fast enough so they switch to 50/50. The twice daily action on bg levels is governed by the insulin action and most importantly, the carbohydrate eaten at set times during the day to balance out.



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Thanks you were spot on i.e. answering my follow up question. It all makes sense now.

"I just want to know upon what factor/s do Doctors choose novomix 25/75 over 30/70 or over 50/50 or over the NovoRapid+Lantus/Levermir"


I like to thank you all for your support and valuable advice