switching from mixed insulin to basal/bolus

[linda321]

After 10 months on mixed insulin (Novomix70) I have an appointment with my diabetic nurse to switch to basal/bolus. Over the last 10 months my control has not been brilliant, my last hB1Ac was 8.1. My blood sugar seems to be between 8 and 12 most of the time. I do eat a low carb diet and completely avoid the big starchy things, rice, potatoes, bread, cereals etc. I do have milk and dairy and eat plenty of vegetables. As to fruit I only eat strawberries and blueberries. To be honest I am quite disappointed with myself that I haven't done better! When I try to increase my insulin dose I get hypos! I do quite a bit of exercise, 3 x per week at the gym and plenty of walking, gardening etc. The amount of exercise seems to affect my blood sugar more than anything. I saw my consultant at the end of April and he agreed that I should switch insulin - but have only just got an appointment with the diabetic nurse! The only thing he said was that I am taking a very small dose of mixed (10-11 in the morning and 12-14 in the evening)

My question to you is - is there anything I should bear in mind for my appointment? Is there something I must ask? Should I start eating carbs again? Can you eat carbs only sometimes and take extra bolus?

 

[Atalay]

I would prefer mix 30 instead of R type ( all insulin, no mix ) for you, at this point. I am T1 for 14 years. I tried a few different mixes, and I found my balance. My balance is not the right one for you, ofcourse, I wont mention about it.

R type insulin acts the fastest in your veins, so I wonder what he will tell you if youd ask about mix 30...

Good luck finding your right way.

 

[dancer]

Do you carb count? The best results from basal/bolus will be found from carb counting and using insulin:carb ratios which could be the same or different at different times of the day.

If you don't know this method, ask to go on a course e.g. DAFNE.

Eating carbs is up to you, once you are stabilised. The only time I reduce my carbs is when I'm trying to lose weight.

Good luck with basal/bolus it should give you much better results.

 

[June_C]

Hi Linda, best of luck with the possible change over. I'm considering switching from mixed, so will be interested to see how you get on.

 

[Robcz]

Hi Linda321, I was on 4 injections a day...Actrapid 3 times a day and Semitard before bed....And the doctor wanted to give me more!!
I now take Mixtard 30 insulin 2 times a day (Mixtard 30) Prescribed by a student Thai doctor in Thailand..... 20 in the morning, and 12 at night. And this gets me through the day between 4 and 6 BS results (With the right diet)). I had to give up my favourite food ......like you say Potatoes etc....
I also asked the doctor for a fast acting insulin for those days I want a special meal.....So far the best idea I have ever had
And I don't get many of those

I can't be bothered with counting carbs, life is too short.....I think we all know what we can eat....and if not....we learn!
I think that's what diabetes is about....learning about yourself, and what you can do......I have had the worst advise from doctors in my life....and it seems to be the same advise....more insulin :-( And it does not have to be like this....

Read, learn, and in the end you will find your mo jo...I hope! Wishing you all the best....

 

[Daibell]

Hi. Yes, going Basal/Bolus is a good move. Do ask about carb-counting at your appointment. It took my DN 10 minutes to explain it and you don't need to go on a training course; it's dead easy, but we all have to guess a bit. With Basa/Bolus you get the Basal balanced (ask the DN or come back here if needed) and find a Bolus ratio that suits you. Most people are started at 1 Bolus shot for every 10 gm of carbs. Experience with the meter will enable you to tweak this.

 

[linda321]

Thanks for your replies. I had a phone call this morning cancelling my appointment as my surgery nurse is off sick! GRRR! I had pysched myself up for this for ages! Now I have to wait a bit longer