Novorapid question!!

[Jaxx01]

Hey all.

Started my novorapid/lantus routine yesterday. After a scary experience with my first lantus shot lol I'm now on the road ready to get going..

Im confused a little about the dosage advice my nurse gave me...she said take 2 novorapid units and increase every 3days if it's not enough :/ I need to work out my ratio which is fine but her advice baffles me? If I had say for example a bit if pasta 2 units would be nowhere near enough...

Has anyone been given similar advice?

Shall I just work out my ratio and do my own thing? x

 

[robert72]

Hey all.

Started my novorapid/lantus routine yesterday. After a scary experience with my first lantus shot lol I'm now on the road ready to get going..

Im confused a little about the dosage advice my nurse gave me...she said take 2 novorapid units and increase every 3days if it's not enough :/ I need to work out my ratio which is fine but her advice baffles me? If I had say for example a bit if pasta 2 units would be nowhere near enough...

Has anyone been given similar advice?

Shall I just work out my ratio and do my own thing? x

You really need to make sure that your Lantus (basal) dose is correct before experimenting with Novorapid. I'm surprised they've let you loose with insulin without telling you about carb ratios

 

[Jaxx01]

I know about carb ratios which is why I thought it was odd she said take a straight dose of 2 units novorapid

 

[robert72]

I know about carb ratios which is why I thought it was odd she said take a straight dose of 2 units novorapid

Maybe she expects you to eat a set number of carbs at each meal. I think I would try that first until I found the ratio, but you can't really do ratios until the Lantus is correct.

 

[Jaxx01]

Yes I guess that makes more sense. She is ringing me on Wednesday. For now I will stick with the 2 while as you say the lantusmissing being sorted! Thanks

 

[Jaxx01]

Yes I guess that makes more sense. She is ringing me on Wednesday. For now I will stick with the 2 while as you say the lantus is being sorted! Thanks

 

[robert72]

Try and keep away from pasta and pizza whilst you are starting out, as these can give a delayed rise in BGs due to the fat content.

 

[Jaxx01]

Oh yes I know. was on gliclazide before this so have kept a good eye on my readings I can only dream of having pizza

 

[Microbe]

She is probably being cautious whilst the lats is settling.
Good luck, it's not as bad as you may be thinking, just don't expect perfection it's not that straightforward.

 

[Daibell]

Hi. Sounds like she expects you to do carb-counting but has started you off with a low level of NovoRapid so you can find out what your ratio is without overshooting and going hypo. It's one approach and you should find what your ratio is shortly. I was started by my DN at a ratio of 1 unit per 10 gms of carb which is where many of us started. I suspect you will end up in that area. Some carbs are obvious and listed on the packaging; others you may have to guesstimate (what my lovely DN said was eye-balling them). If in doubt underestimate the number of units to avoid hypos and you will soon have the confidence to get it roughly right. The meter will help you if not sure. As others have said do try to get the Basal right first. My DN said to aim for a fasting level between 5 - 7 mmol and only adjust the Basal by 1 unit at time and leave 2-3 days between each change. Just take things easy and you'll get there.

 

[Jaxx01]

Thanks All.

I gave her a quick call to clarify and she said that because the last time I was pregnant when I was insulin my body may react differently this time. So to start with stick to the 2 units and in a couple of weeks when I'm comfortable to start carb counting.

Oddly though she said she had no experience in carb counting as it's more a specialist field for type 1s slightly concerned at that comment but luckily I have the training and knowledge from before!!!

 

[Jaxx01]

Do they just expect you to alter your basal by yourself? She's started me on 10 units but I think that may be too much as I took last night, was 15.1 when I went to bed...but was 12.6 when I woke up...I know its all a bit trial and error but if I wanted to lower my lantus I can without having to run it past them? tbh I don't think they are too bothered somehow

 

[robert72]

Do they just expect you to alter your basal by yourself? She's started me on 10 units but I think that may be too much as I took last night, was 15.1 when I went to bed...but was 12.6 when I woke up...I know its all a bit trial and error but if I wanted to lower my lantus I can without having to run it past them? tbh I don't think they are too bothered somehow

Might be worth trying Lantus at 9u to stop the overnight drop (first rule is to avoid hypos). Although it's not an excessive drop, 'they' say your basal should not change by more than 1.7 mmol/L either way (yours was 2.5). Or again, don't change anything on just one result... better to see a pattern before making adjustments.

 

[Jaxx01]

Thanks Robert...I'm testing overnight at the moment for peace of mind really so will give it a few more nights and see if there's a trend which I'm guessing there will be!

 

[Ali H]

I was given Levemir and Novorapid and just got on with it, no consultations with anybody. If you know what you are doing I would be inclined to figure it out, your nurse sounds clueless anyway.

Ali