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Message: <blockquote data-quote="oldgreymare" data-source="post: 559948" data-attributes="member: 20373">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!</blockquote>

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