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What to expect going on MDI?

V

victry77

Well-Known Member
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Hi there, I've been T1 for nearly 2 and half years and have been on 2xday Novomix. This has been fine for me as I've had quite a nice honeymoon period and while I've needed to be fairly rigid with my eating patterns I found that it didn't impact too negatively on my life.

However, the past couple of weeks, my levels have been quite erratic and not as predictable as normal so I'm wondering if I'm slowing exiting the honeymoon period. I'm not getting huge spikes but I'm above target quite a lot and I'm also having far too many hypos. I don't feel the 2xday is controlling me that well anymore. I have an appt. to see my endo in Aug and was thinking it would be about time to switch to MDI.

If anyone has the time, could you break down what it is I can expect from going on MDI? I sort of understand the basal/bolus regimen. I just wondered how this all gets started? How do dosages get worked out. I remember my endo once saying that because I'm only very slim, I would tend to be more sensitive to insulin, so would this be a factor? Are there any particular brands of insulin I will likey to be put on to start me off? My clininc isn't registered with DAFNE so I can't do one of their course.

I'm also a bit worried because on the 2xday you tend to be safe from hypos during your sleep but will this likey change on MDI? Also, I quite like the extra calories I have on Novomix (due to needing to have a supper and various snacks) because I really can stand to gain some weight. Is it a bit iffy to snack on MDI? I know I will be shooting when I eat but I'd be a bit concerned about having too much insulin floating around and causing myself hypos. What kind of things to I need to be aware of/cautious about?

So, if any could help me, that would be great. I have done a lot fo reading in the past but it can be a bit hard to process all the info.

Thank you :wink:
 
Hi,

When i was first diagnosed i was also put onto novomi 30 two injections a day..

after about two months i realised it really wasn't working for me and asked to be put of four injections a day.

This is mainly due to flexibility, it takes some work to get your basal (background) insulin right, an after you do there is no higher possibility of night tim hypo's

With the rapid acting insulin you can be more flexible with your meals as you can adjust your insulin according to what you eat so instead of having a fixed dose in the morning and having to eat at a certain time later and eating a certain amount to how it peaks later on... you eat how much carbs you like and simpl over it with insulin. or if you have no carbs and your BG's are at a suitabe level no insulin will be needed.

There definately are alot of perks to be on the four a day regime, but it's up to you to decide wether its for you or not.

I think after doing the DAFNE course a few months ago i will recommend it to anybody :lol:

It's unfortunate that your area doesn;t do DAFNE. maybe you could enquire if you an travel to a different area to do it as if you were to swap regimes then the information and knowledge you would get from it in my eyes is invaluable!

The doses are worked out similar to how they are with the two a day, you'll b started on a recommended dose by your diabetes team and increase or decrease according to the levels you are getting with certain doses, usually starting with one meal in the day until you are at a good level and gradally getting better as estimating how much insulin you need to cover a set amount of carbohydrates.

It can be complicated at first but with hard work, testing and learning to recognise which does of isulin has affected your BG, it might certainly be a step foward for you.

i hope i haven't mumbled on too much or confused you! :)

I hope whaever desicion you make it works really well fr you!
 
Definitely ask if you can go on a dafne course in a different area. My PCT doesn't offer dafne but I hassled them until they referred me to another borough. It's the most useful thing I've ever done. :-)
 
badmedisin said:
Definitely ask if you can go on a dafne course in a different area. My PCT doesn't offer dafne but I hassled them until they referred me to another borough. It's the most useful thing I've ever done. :-)
Click to expand...

As badmedisin says, ask your dsn about a DAFNE course in your area, all these questions and more will be answered by the DAFNE nurses.

Nigel
 
Thanks for taking the time to reply, ebony. I appreciate the info you gave me :D

badmedisin and noblehead - hi, the problem, though, is if DAFNE isn't run in my area, isn't it? Had a look at the DAFNE website and there's nothing even remotely close by. I got told that if I decided to switch to MDI then I just make an appt with my DSN and she will teach me how it all works.

Pity cos I keep hearing great things about these courses. I guess I'll have to ask at my next appt.
 
Victry,

It may well be possible that your dsn has been DAFNE trained, I have 4 dsn working in my local hospital and all have been trained on the DAFNE approach. When you see your dsn express a interest in the course, and perhaps if other type 1's in your PCT did likewise, they may consider running a course. As ever, it all comes down to funding, but most people do have a positive outcome from attending the course, and I believe that all type 1's should be given the opportunity to enroll, more-so newly diagnosed patients.

Nigel
 
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