Novomix 7030 for the first time....

[alexg]

I just got my insulin pen for the Novomix 7030 yesterday. I have attempted it twice and still have some concerns. First time, I think I got nervous and counted to fast to 5 like they told me with 6 on the dial of Novomix 7030. I might have not gotten it right the first time. Well anyways, second time this morning, I did count to 5 and actually heard the thing click. Hurray!

Anyways, let me run over this to see if I have it right.

1. Shake the mix first rolling it with your hands making sure its cloudy and not being clear or have any lumps in there.

2. Put the niddle, set dial to 2, squeeze, let air bubble out.

4. Set dial to dosage (6 for mine), then in a stab 45 degree motion, insert the needle to the gutt (thats what I use), count to 5 regularly squeezing the top part of the insulin pen and it should click down while it transfers the insulin.

5. Cap needle, remove it, the throw it away. Put cap back on insulin pen to avoid light.

Is this all right. The nurse went over it pretty quickly, so I just got all that.

By the way, are those lumps that they say may appear really big and noticeable?

Is it normal for the the insulin to have a bubble in there after using and removing needle?

What happens if a bubble enters my system?

Please anyone help to clarify this for me. I appreciate it.

Alexg

[Mich]

Hi Alex, three things I noticed about your routine:

1. If your box of needles say "short needle" (you should be injecting straignt in, not at a slant. Most people with pens use short needles these days--about 3/8 of an inch, 30 or 31 gauge.

2. I think the click you will hear is when you pull the pen back on its spring. It is the lock that lets you know the spring is set. The second click is the spring letting go. The squeeze is to put the insulin into you. Be sure to count to five AFTER you squeeze so the insulin dosen't run back out the little hole you just made. The five seconds gives it time to "soak in."


3. Keep an eye on how your sugar runs with the 70/30. The 70, and you know is NPH which has a peak after about 8 hours. You may find yourself eating to feed the NPH's peak, which is a pretty inconvenient way to live. The 30 is fast acting insulin, which will work starting in 15 minutes and be pretty much finished in 2-3 hours. You will have to eat to feed it too. Depending on your tolerance for injections (and with a pen, they're pretty simple and painless) you may want to ask your doctor about a regimen of twice a day Lantus for your basal insulin and a quick stick of Novolog, Humalog, or some other fast acting insulin right at the times you eat. Much better control and predictability, but at a minimum of 5 shots a day. This is what everyone here calls Multiple Daily Injections or MDI,

No, the lumps don't appear quickly and you can avoid them altogether by rotating your injection sites to different places.

Hope this helps, Mich

[alexg]

****** I guess I am doing this all wrong. Does everyone get this right the first time cause I didn't and feel so stupid.

Your saying to start counting to FIVE after I click the button and hear it go back to zero?

The lump thing I was talking about are the ones that may develop inside the insulin that you may no longer use after that.

Alexg

[caswellhb]

I recently started on Novomix30 and love it.
I usually count 10 seconds down after releasing the insulin into myself but other than that you seem to be doing the same as me.
Don't worry. You will know if you have done it wrong from the resultant numbers.
Good luck and I hope you love it as much as I do!

Heather.

[alexg]

Thanks for the replies, I guess I might have done it wrong the first two times, but now I got it. I will stick myself, click the button (it will return to 0 from my 6 Dosage), then count to FIVE.

Alexg

[alexg]

Hmmm... Just found the instructions for inserting the Novomix. It says this:

Deliver the dose by pressing the push-button
all the way in. Be careful only to push
the push-button when injecting.

Does this mean press the blue button only not the whole dial thing down? Or do they mean not to move the dial while pressing? Will pressing the blue button on top produce the clicking sound to where the Flexpen goes back to 0 or not?

I guess I was pressing the whole thing and not just the button. I will try it again this afternoon. Did I do any harm to myself by doing this procedure wrong first two times?

Alexg

[Mich]

Relax, the whole thing will be pretty clear soon. You may want to try the old practice method of injecting into something other than you a few times. That would help you get the mechanics down. Since you would throw the needle away afterward, it wouldn't matter if you dulled or otherwise ruined it. Try just holding it over a wad of paper towels and see what happens when you inject.

The only harm you could do to yourself is run high blood sugar because you got too little insulin in the injection. Test often until you know what is going on. Before you eat, an hour and two hours after, when you go to bed, when you get up and when in doubt. Make sure your doc writes your test strip prescription for enough strips.

Another idea is to attend a group discussion of new diabetics, or ask your doc to set you up with a Certified Diabetes Educator to go over things again. The nurse must have been rushed, she should have maybe tried you out with a few practice runs on the paper towel pile.

We all felt this way when we started a new regimen. You should have seen me mess up my first few set changes for my pump! Hang in there Alex, you weren't born knowing this stuff and are doing just fine. Mich

[alexg]

Thanks for the info. Testing my Blood Glucose twice already during my two attempted tries at the Novomix injections, I have noticed no change in my glucose levels. They are the same as when I had without the Novomix.

Alexg

[alexg]

Can someone explain the difference between insulin being uniformly cloudy vs frosty in the Novomix Flexpen. My flexpen is now, I am guessing, mostly pertinently like cloudy milky color. Knowing this, how would I know when it looks frosty and not use it anymore?

Sorry for being so ignorant but I don't know anything about this and just want to study up on it.

Alexg

[ladytaz]

Hi Alex, I was using the Novolin 70/30, but have gone MDI now, and I did/do it the "old fasioned way" [syringes] and have never used a pen so I'm of NO help there, sorry! But wanted to say congrats on the insulin! You should be feelin better about it all in no time!! :wink: Also had a question, does your doc still have you taking the Glimepiride?? If so, WHY??? This can cause you to have even MORE chances of going low, taking it along with the insulin!

[alexg]

Yes he has me taking the pills too. I don't know why but they weren't really working. I am at a low dosage right now of insulin so I don't really know what will happen.

I have attempted twice already with the insulin pen and don't even know if I am doing it right. Anyways, I will try it again tonight and see what happens. Hope I am not making a full of myself by not getting this right the first time, I am a former cancer patient and needles make me nervous so maybe thats why I am awful at this.

Alexg

[ladytaz]

Personally, I think he should have taken you off it straight away, since, it causes your pancreas to make and secrete insulin (if you have any to spare! LOL) BUT, it is in NO kind of regulated form. You never know how much or when your pancreas will spew the stuff out!! Doc too me off it the day I started on insulin! And for me too, it wasnt working. Tho I was on a different brand of sulfonylurea [Glipizide (Glucotrol)]

When ya "get it right" play CLOSE attention to your BG's!! [altho I think you should be off it NOW] and let your doc know of the lows if you have any.

NEVER feel like a fool!! It's NEW!! You've never done it before, so how are you supposed to know how it all goes??? You're doing the exact right thing by coming her asking questions of those in the know!!! :wink: Don't worry, you'll "get it" soon enough!!

I'm sorry to hear about your fear of the needle though! Although, I think that it won't be a matter of time that you'll be saying to yourself, "what was all THAT about anyways??? This ain't nuttin!!! Sheeeeeeesh" :wink: YaY on being a Cancer survivor too!!!! :)

[alexg]

Thanks for your replies and making me feel much better. I truly appreciate that I am not alone here.

About the medication, he had gave me glipizide back then and last week before the insulin, he change me to this new one. He said they are basically the same thing though. But yes he still told the head nurse to tell me to keep taking them. Maybe cause of the low dose of Novomix intake I am taking right now. Who knows what this doctors are thinking.

Being that this insulin can cause low glucose levels, if I eat breakfast at 8 - 9 AM, lunch at 12 PM, and dinner at 6 - 7 PM, taking the insulin shots + meds before breakfast and dinner, should I still use that rule of eating a snack every 2 - 3 hours between meals to keep things rolling? I know that with insulin, I have to consume a bit more than with just meds, but not clear about it though.

Alexg

[pjams]

Alex:
Have you tried calling the Novo company? They are pretty helpful and may send you some information or video. The number should be on the pen. I also had many questions when I started using their pens and they answered all my questions.
JayP

[ladytaz]

Who knows!!! LOL

I'd worry about it [snacks] most between your lunch and dinner, and then after dinner. Just like in the beginning, it comes down to trial and error again. Keep a close watch on the BG. If you're say around 70-80, go ahead and have a snack if it's gonna be a while till your meal. If you're 80 or above, I wouldn't really worry about it, unless you're dropping fast, which happens sometimes. ALSO ... what time are you taking your PM shot? between 5:30 and 6:30 (30 min before your meal)? You should be ok at that time, but say you have a later meal, say 9 pm (I often eat this late, but then, I awake much later in the day than you :wink:) be sure to wake yourself up about 1/2 way thru your sleep time and check your BG to make sure you aren't going low. You said he's got you on a low dose, so this may not be a problem at all for you at this time.

[alexg]

PM shot is around 6 yes. I mostly eat maybe a snack around 9 or 10, go to sleep around 12 - 1 AM. I have never had my glucose go low and wouldn't be able to recognize the symptoms as of yet. Any advice of what I would feel first? I will most definitely now check my glucose more often if I feel bad during the day or night though, bad meaning anything, though I would be going in blind in know what to expect.

Alexg

[ladytaz]

The most common symptoms of a hypo is, shaking, that feels like it's coming from the core/pit of your body, sweating, feeling flushed with heat all of a sudden, and sometimes that turns into cold sweats feeling cold (that's how it goes for me) lack of being able to concentrate, can't seem to form thoughts properly or get your thoughts straight and blurred vision and insatiable hunger, you feel like you just want to eat yourself out of house and home. Tho do NOT do that! LOL Things differ for everyone, but those seem to be the most common ones. If you go low (60 or below) treat it!! If you don't have any go and get you some glucose tablets. You can get them at any pharmacy. At the very least, get you some of those sunny delight bottles of OJ drink, the one that comes in the 6 pack, the smallest ones. I think they might be 8oz sized ones. Treat with about 15 or so carbs, and wait about 15 to 20 minutes and test again to see that your BG is on the rise. If it isn't, then do the same again ... just remember 15 and 15 ... 15 carbs and 15 minutes :wink: One of those little sunny delight drinks is about 26 carbs, so I drink about 1/2 of one (save the rest for a snack later!), unless I,m down around 40, then I'll just drink the whole thing right away. REAL jam or jelly is also good when in a pinch! About a tablespoonful, if you can tolerate eating it that way!

[Mich]

Hi again Alex. Did your doc give you any info on a target blood sugar reading? I would think 100-110 would be a good starter target if he didn't. If you are in that general area, you probably don't need to eat a snack.

If you go below 100 or so, and it is another three hours until dinner, test every hour and see if you are dropping. You needn't worry until you are maybe 75 or so, then evaluate when you will eat again and take into account any exercise you may be planning. Exercise will make your sugar drop faster, the stress of trying to figure this stuff out is probably causing it to rise a bit.

The four things you need to know are your sugar level, insulin injection amount and time, meal times and expected exercise. Those four things will determine when you need to eat a snack to stay at the right level until your next meal. You will learn to balance all of them sooner than you think.

Insulin comparison chart here http://www.musc.edu/pharmacyservices/medusepol/InsulinComparisonChart.pdf

Drugstores carry GLUCOSE TABLETS, with four grams of carb each. They come in an easily carried plastic tube. Fast acting for treating lows or as a substitute for a snack.

Believe it or not, some day sticking yourself will feel like less of a big deal than brushing your teeth. :D

Mich

[alexg]

Thanks!

I have always been in the 160 - 200 area before meals. Thats why my AIC is around 10 in last visit. Started insulin because of that. Now since I haven't gotten a good shot of insulin in. Today in the morning before breakfast, I was at 155. Before lunch I was at 185. This clearly shows that I have not had a good insulin shot or maybe the low dose they started me at is having no effect. After lunch today, 3 hours or later, I was at 255. I am not getting good readings yet. So I will attempt to give my insulin shot again right now and post later.

Alex

[ladytaz]

As I'm unsure how insulin pens work, you said you set it to 6. Does this mean you are taking 6u of the mix? If so, with the numbers you just stated you've been having BEFORE the insulin, I'd say that's probably not enough! My numbers were right about the same when I was put on insulin, my doc put me on 20u of the mix 2x daily, which worked amazingly perfect for me. But, as everything else, each of us is different. So based on MY experience, if you are actually getting the insulin into your system, then it may not be (probably isn't) enough, BUT on the other hand, if you aren't getting it into your system, well that needs to be done first to determine if you are taking enough or not. Please do let us keep us updated, and let us know how tonights dose went Alex!

[alexg]

Well took the next shot at around 7:45 PM then got some dinner (mainly some grilled chicken and veggies) then at around 12:15 AM, got home after seeing a movie and my glucose level is 160. So there you go, maybe not enough insulin intake. I think I did do it right this time, click the thing, waited 6 seconds or so, removed and release. I felt the liquid in there this time, felt different than the other times. Did feel a bit odd at times also while at the movies at around 10 PM.

Alexg

[ladytaz]

Give it another day or so Alex. You were already high, so that most definitley wasn't enough to bring you down to normal levels. But it DID bring you down! :wink: The odd feeling may be because, altho you didn't drop low, you may have been dropping quickly. Let us know how tomorrow goes!

[kgm0612]

Alex.........when I was on 70/30, I did not refrigerate my pen once I took it out and used it for the first time. I used the pen for about 12 days before discarding. I also found it helpful to date the pen with a magic marker.

Karen

[alexg]

Its around 9ish and I ate breakfast. My reading before breakfast was 144 coming from 160 last night. Took my insulin before breakfast as well. Lets see if this thing is working at lunch time. I do notice now that the syringe is actually wasting insulin, so it must be going into me. Finally I think I am getting it right. HOPEFULLY!

Hey kgm0612, they say it lasts around 30 days, so around what day is good to discard, do you do it on that day, or a bit before? Is it really obvious when its frosty coated instead of a cloudy milky color to know its bad? Mine stays cloudy, I mix it like it says in the instructions every time though. I don't have 20'20 vision so how do you tell its bad? What would happen if its bad and I accidentally use it?

Alexg

[ladytaz]

144 is still an improvement!! :D By George .... I think you've got it!!! :wink: Like I said, if after a couple days you don't see that you're down to normal ranges, then it'd be pretty clear that the dose isn't quite enough for ya, and I'd bump the dose up a notch or two ... try again for a couple days, etc. Until you do come down to normal ranges.

As to the refridgeration question, I myself couldn't tell ya, since my vials of mix were gone in about 3 weeks time. Now Novolin R I can tell ya about, since I'm workin on 4-1/2 months with the same vial (my first initial one at that!) But your doc hasn't put you on that just yet. :wink:

Hope your numbers continue to come down today, and that you have a superiffic day Alex!

[alexg]

Well about 3 hours later after breakfast, my glucose level is 173. Now that ain't good at all since the normal after two hours of eating is around 140, but it is an improvement for me because I used to be in the 250's - 300's 2 - 3 hours after eating.

Alexg

[ladytaz]

a real good improvement I'd say!! :) Keep a watch on it! :wink:

[alexg]

Do any of you know whats the best way to transport the Novomix 70 30 (or any other insulin) when going an a trip that require it being in the car for the driving distance. I mean it can't be in the heat and has to be in the 33 - 80 F range. Do you put it in an ice chest or what do you use?

Alexg

[ladytaz]

an icechest would work fine, just make sure it doens't get frozen. also, you can buy some of those icepacks, and slip it into a zippered type of case to keep it cool. There are places on the net you can buy special cases for carrying insulin pens, cartridges and vials too.

Here's the place I bought my case at Alex:
Diabetic Supplies-The Insulin Case Shop-Diabetes Supplies for the Diabetic at Great Prices . (http://www.insulincase.com/default.aspx)

[Mich]

Yay Alex!

It sounds like you are definitely getting the hang of it. When I travel, I use a Frio bag which cools by evaporation. You can google the name and check them out.

Before I new about Frios, I would take a small soft-sided cooler with me and a frozen milk carton of water wrapped in a small towel. In a pinch, if traveling and it was hotter than I expected, I would stop at the market for a bag of frozen peas!

Keep up the good work! Mich

[alexg]

Thanks for the help all of you.... just right now before dinner and before my next insulin dose right now, I am at 120. Hope I can keep it around this level and make it a bit lower for now on.

Alexg

[ladytaz]

YaY!!! Awesome!!! :five: Do know that when you eat, it will rise, but hopefully it'll stay under 140! Actually, THIS is were "R" insulin comes in!! When I was on the mixed, IF I was over 160 I'd take me some R then it'd come right on down :wink: So, if you find that you continually rise above 160 after meals, let the doc know that you'd like to use some R to bring down those higher after meal numbers.

[alexg]

Another day and before breakfast and my next insulin shot, I am at 112. I am off to vacations with my family. Will see how I do for the weekend.

Alexg

[ladytaz]

YaY Alex!!!!!!! :five: Now ya gotta do the *happy dance* LOL Four and a half months later (since starting insulin) and I STILL get excited by these good numbers! [I dunno, maybe I'm just easily entertained?? LOL]

Have a SUPERIFFIC time while you're away!!

[alexg]

Okay an update, at 10 units of Novomix 7030 twice daily, I was ranging from 80 - 140 different ranges different times, mostly was in the range less than 120 mg/dL. Anyways, I am afraid now that the doctor told me to increase it to 22 units twice daily. I understand he wants to lower my 100's to the 90's - mid 80's, but I am worried now about those low readings I was already getting sometimes. Does this mean I have to be munching more during the day and before bed to keep my sugar at a reasonable level?

They left the message of the dosage change with my mom and didn't even say anything about dropping the Glimepiride pills. Like others said, it might lower my glucose level even more. Its Friday, so I can't talk to them until Monday.

alexg

[HollyB]

Hi Alex,

If you're nervouse about it (and that IS a big jump), you won't do any harm by waiting through the weekend and not starting till you can talk to the doctor about it. It's not an emergency, just an adjustment.

[ladytaz]

Hi Alex,
I think that was a rather large jump!! Not to mention that your range is already pretty darn good!! If you are already having some lows, then yes, you will be more likely to have even more, and having to eat just to feed the insulin.

I would call your doc and bring up taking NPH and R seperately, taking R using the I:C (insulin to carb) ratio with meals!

If you want to go ahead and up your 70/30 maybe try upping to 15u AM & PM and see how that goes for a few days. Then decide by your numbers if you really want to jump all the way up to 22u.

[sofaraway]

it doesn't sound like a big jump to me at all, 10 units twice a day = 20 units daily,
change to 22 units daily, means 11 units twice daily.
but if you are already having lows, you will be feeding the insulin
i would also ask about taking the insulins seperatly as already suggested

[alexg]

it doesn't sound like a big jump to me at all, 10 units twice a day = 20 units daily,
change to 22 units daily, means 11 units twice daily.
but if you are already having lows, you will be feeding the insulin
i would also ask about taking the insulins seperatly as already suggested

Its 22 units twice a day not total. I mentioned that in the earlier post. I think its ridiculous. For example, yesterday before dinner, I was at 86. Now I haven't gone to the new dosage, this is still with 10 units twice a day.

By the way I used to take Glipizide then he changed me to Glimepiride, which one is actualy better?

dja2k

[xMenace]

Okay an update, at 10 units of Novomix 7030 twice daily, I was ranging from 80 - 140 different ranges different times, mostly was in the range less than 120 mg/dL. Anyways, I am afraid now that the doctor told me to increase it to 22 units twice daily. I understand he wants to lower my 100's to the 90's - mid 80's, but I am worried now about those low readings I was already getting sometimes. Does this mean I have to be munching more during the day and before bed to keep my sugar at a reasonable level?

They left the message of the dosage change with my mom and didn't even say anything about dropping the Glimepiride pills. Like others said, it might lower my glucose level even more. Its Friday, so I can't talk to them until Monday.

alexg

You are getting this information second hand from your mom? Call the doctor for clarification.

[alexg]

Hi Alex,
I think that was a rather large jump!! Not to mention that your range is already pretty darn good!! If you are already having some lows, then yes, you will be more likely to have even more, and having to eat just to feed the insulin.

I would call your doc and bring up taking NPH and R seperately, taking R using the I:C (insulin to carb) ratio with meals!

If you want to go ahead and up your 70/30 maybe try upping to 15u AM & PM and see how that goes for a few days. Then decide by your numbers if you really want to jump all the way up to 22u.

I think I should mention taking it separate, but he is really hard to convince. Is using the I:C (insulin to carb) ratio as hard as it seems? I am barely getting used to this Novomix 7030 and if I change now, I am gonna be lost again. I think just moving just a tad more on my daily dose will do the trick, but I will have to see. I will talk to my doctor on Monday and see what he says, I am still not crazy enough to take 22 units twice a day even if he says so, no way!

dja2k

[alexg]

You are getting this information second hand from your mom? Call the doctor for clarification.

My mom actually writes down exactly what they say and she also questioned the nurse about such high change and the nurse said thats what the doctor told me to tell your son. But anyways, I will still call him to verify.

Alexg

[ladytaz]

I think I should mention taking it separate, but he is really hard to convince. Is using the I:C (insulin to carb) ratio as hard as it seems? I am barely getting used to this Novomix 7030 and if I change now, I am gonna be lost again. I think just moving just a tad more on my daily dose will do the trick, but I will have to see. I will talk to my doctor on Monday and see what he says, I am still not crazy enough to take 22 units twice a day even if he says so, no way!

dja2k


No, it's not hard at all. It's just simple multiplication. :) Everyone's ratio is different, but I'll tell you what mine is and how easy it is.

My ratio is 1u insulin per 10g of carbs (1:10) So if I'm going to eat a 30 carb meal, I take 3u of R insulin, a 45g carb meal, 4.5u, a 60g carb meal (RARE! LOL) 6u. See, just simple multiplication.

I too thought it would be difficult, but I started doing it while I was still on the mix. (I was instructed to take R on a sliding scale IF my BG was over 160) So, like when we'd go out for supper and I wanted to eat something that was higher in carbs than I'd normally eat (that's usually when I'll eat a higher carb meal). I would take extra R along with my regular evening dose of mix, so that I didn't go high after my meal. I was working with the 1:15 ratio at that time, and factored in how much R was already in the mixed. So when I went to NPH and R separately, it was easy peasy for me :wink:

Most likely you would be started out at 1:15 (seems to be the most common "starting point") then work from there. So if it was 1:15 then for a 30g carb meal that would be 2u of R. A 45g meal would be 3u of R, etc.

1:15 wasn't enough for me, and I knew it in one day. The next day, based on my numbers at 1:15, I dropped it down to 1:10 and that was perfect for me. I'm also comfortable with changing my insulin doses when/if needed, on my own, without my docs approval. I do realize that some people aren't comfortable doing that, though.

As for your doc not listening, well strongly remind him that this is YOUR disease and it is up to YOU to control it, but, you'd appreciate his help and guidance along the way! If he's not willing to work WITH you, then you'd be more than happy to find a doctor who WILL!

I'm SO glad I don't have those troubles with my doc! When I was considering going NPH and R separately, I told my doc that, or his physicians assistant actually, and she was, Ok, if that's what you want to do, go ahead! You've already figured out your dosages, they sound right on to me. Go for it! She then informed my doc about what I was considering, and he too said it was fine with him.

Not that I "needed" their "approval". I would have done it no matter what they said, IF I so chose to. Which, I did chose to, and it was a very good choice for me. Having their "blessings" was just a perk.

Good Luck Alex, keep us updated!!

[alexg]

Well it turns out that the nurse and my mom have a communication problem because both were wrong. My mom asked if it was 22 and the nurse said yes, but it was 22 total. He wants me to inject 12u at morning and 10u at night. It seems my lunch reading is a bit higher due to the time between breakfast and lunch. Anyways, I asked about the split insulin and he said I can change it if this doesn't work and that I am still at a trial of Novomix 7030. He will now be slowly increasing the dosage until I get normal readings throughout the day.

I am still having the same problem of my morning before breakfast reading being slightly higher as well compared to my before dinner reading. What can I do before bed to help my glucose level during sleep?

Thanks all of you for the replies you have provided so far, I really appreciate it.

dja2k

[ladytaz]

Well, that sounds much better!! Guess it pays to go ahead and double check with the doc then, huh? :wink:

Mine higher morning numbers went away when I started on the insulin. I usually wake up with in 10 points of where I went to bed at. Now, if I have a high morning number, there's a reason for it! LOL

What are your numbers like before you go to bed? And have you awoken at 3 or 4 am to test? To make sure that you aren't going low in the middle of the night, and then, rebounding causing that higher morning number? I

[alexg]

I just got my second batch of pens today, five total. The stupid people in the pharmacy kept them a bit outside while I was paying, so they kinda got a bit hot and now the white novomix along the tube is already loose but not mixed yet. Will they still work? I already put them in the fridge.

alexg

[notme]

That amount of time out of the fridge should not effect your insulin at all. If they were left in a hot car or outside in 100 degree weather, you might have a problem. Most insulins can sit at room temps for days with no problem.

[alexg]

That amount of time out of the fridge should not effect your insulin at all. If they were left in a hot car or outside in 100 degree weather, you might have a problem. Most insulins can sit at room temps for days with no problem.

Okay I put them in the fridge that is set to COLD, second level besides the OFF and COOL. I only removed the one I will be using and took it out, that one will stay at room level. So the rest in the fridge I think should be okay, don't know how cold it is there, but its not freezing nor near. I don't understand this two temperatures the instructions talk about, they say fridge 36'F - 46'F before usage and also say store around 70"F room plus refrigerate when not used for long time.

alexg

[alexg]

Okay after a day of fridge storage, the novomix is back to normal like I was used to it. The white mix has aligned back to the glass in a straight line. This is a strange thing, I checked my glucose level before bed and it was 93, then in the morning it was 150. Can someone explain to me what is happening? This is probably why my levels are high in the morning and screwing up my other levels throughout the day.

Alexg

[ladytaz]

For the temperature thing, when the insulin has NOT been opened (used, needle stuck in) it's required to be kept between 36 & 46 degrees. Once it has been opened (used, needle stuck in) it CAN sit at "room temperature" ( no higher than 85 degrees) for up to 30 days. So they say anyway. I've never kept mine out for longer than a day, and I don't think above 75. That was just by mistake too. Though I've never had a vial of mixed or 'N' longer than 3 weeks, so I can't say that it would or wouldn't last longer than 30 days period! R (Regular) I can PROVE that it works longer than the 30 day time frame they give. I've had my vial of R since Feb 12th!! I have left it out of the fridge her and there, but again, never more than a day, and again, I don't think above 75 degrees. For the most part, it's pretty much been refridgerated. Six months now, and it's STILL working!! :wink: So who knows!?

Anyway ... the 93 and 150 BG's. That could just be the Dawn Phenomenon!? If I go to bed at 93 (which I often am around there somewhere before bed), I generally wake up no higher than 10 to 15 points above that. Have you woken up abo ut 1/2 way thru your sleep cycle and tested to see where you're at at that time? To make sure it's not a "rebound" high because you've gone low? If so, then I'd chock it up to the Dawn Phenomenon. How much Metformin are you taking right now?

[alexg]

I don't take Metformin... Anyways, the unused insulin is kept in the fridge at a cold level, maybe I should check with thermometer. Anyways, the one I am using, I keep outside at room temp usually at around 70 - 72 degrees. I throw away the used pen no later than 5 days, then take out a new one and so on.

I am going to have to check my blood in the middle of the night to see what my reading is to prove its what you say.

alexg

[ladytaz]

The pen should be good for 30 days (as long as it's kept below 85 degrees), so no need to throw it away before that time otherwise.

Get one of those cheap thermometers at Walmart to stick on the wall inside of your fridge, so you can check the temp inside of it. Though, I'm quite sure it's cold enough. Your milk doesn't spoil in less than a week does it? If so, well, then you keep your fridge too warm! LOL

Wise to wake up and check your BG in the middle of the night. A PIA to be sure, but, it's worth it, just to be sure you aren't going low in the middle of the night!

I thougth you were taking Metformin, sorry ... you MAY need to be!! If you are insulin resistant, then it's a good thing! :wink:

[alexg]

Can't take anything besides the meds I have now since my liver is not good enough to resist the other diabetes oral meds.

alexg

[alexg]

This is a good thing and also a bad thing. Both yesterday and today, I started the day okay at about around 105 then before dinner I was at 79. This is without snacks during the day, yes I know, I had to take snacks but didn't as a test.

Now if the morning is good and the evening is lower, can taking snacks during the afternoon make this an excellent glucose control, what do you think? Or am I going too low before dinner?

alexg

[ladytaz]

Oh, ok on the Metformin. Does present a problem if you are indeed insulin resistant. I also know of no other way to deal with that specifically.

I don't think 79 is too low. Now, if it was going to be a couple/few hours, and you had no access to any snacks, well, then it MIGHT be. But otherwise, no. It's pretty much perfect :wink: I've often been in the high 70's lately, before meals. Example tonight, I was 78 before my supper. Two hours later, I'm at 113 :D So yes, if you could keep your BG between those numbers, that'd be excellent control! :D If you are afraid of going low, then by all means have a small snack!! Truly, if you are under 120 before meals, and idealy if you stay under 140 after, that's GREAT! I generally range anywhere from 80 to 140 on any given day. That includes all testings in a day. Before and after meals as well as any other tests. My meter averages are usually between 102 and 104.

[alexg]

USES: Glimepiride is an anti-diabetic drug (sulfonylurea-type) used along with a proper diet and exercise program to control high blood sugar. It is used in patients with type 2 diabetes (non-insulin-dependent diabetes). It works by stimulating the release of your body's natural insulin. Effectively controlling high blood sugar helps prevent heart disease, strokes, kidney disease, blindness, and circulation problems, as well as sexual function problems (impotence).

HOW TO USE: Take this medication by mouth usually once daily, with breakfast or the first main meal of the day. The dosage is based on your medical condition and response to therapy. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day. Monitor blood glucose levels on a regular basis, and share the results with your doctor.

I just saw this information for the Glimepiride that I am taking, it says only one a day (yet I am taking twice a day). Secondly it says its for non insulin dependent diabetes Type 2, yet I am taking it. Now I wonder if this medication is better than the regular glipizide I was taking.

alexg

[ladytaz]

It's pretty much the same thing. But for some reason, my Endo said that it causes more hypos that glipizide ... tho, I don't know why that is? But I agree that those on insulin shouldn't be taking it BECAUSE of the fact that if you are indeed still producing insulin naturally, and it causes you to produce more of it, and since it cannot be regulated, and you take insulin by injeciton, there is the possibility for you to have TOO much insulin in your system, but you never know if or when this will happen, nor how much you will naturally produce. Of course, yes, this could happen even while not taking the med, but there is less of a chance of it. Also, though it says once a day, I think they're finding it better to take most of these kinds of meds twice a day, 12 hours apart, to keep a constant amount in the system at all times. If taken only once a day ... the amount in the system would seemingly rise, then begin to fall as the 24 hour window comes near, causing BG's to rise.

[alexg]

Oh okay, thanks. I do take it twice a day and I am keeping a watch on my levels.

Today I woke up at 105 and before dinner I was at 86. Before Lunch was at about 114. Need to work on those two hour after meals thing, as I have been getting in the mid 150's - low 160's areas. A little more and I think I got it.

I still can't seem to believe that a month ago, at 6 units, I was getting okay readings, then they got high again, then having to up the dose to 12 units now, and it gradually got a bit better. Guess my body is either getting used to the insulin and wants more of it.

alexg

[alexg]

Today I woke up at 86 was at 105 at lunch time and back to 99 at dinner time. Right now before bed I am at 85, too low for me, so I took a small snack. I don't know if that was a good idea or not but I guess I will have to eat a bit more at dinner time or go back to 10 U of Novomix instead of 12 U.

alexg

[alexg]

Today I woke up at 95 then before lunch I was at 76 then 2 1/2 hours later, I am at 113.

alexg

[ladytaz]

Sounds like it's going GREAT Alex!!! :D If I'm below 85, before I head for bed, I too eat a small snack. I've only woken up once so far in the middle of the night with a low, that was a couple weeks ago, and well, it weren't pretty! It was one of the nastiest feeling low's I've ever had! I thought my legs were going to collapse on me, and I was just about to holler for hubby! Scared me big time!! I've had lows, and probably just as low of a number (didn't test straight away .... survival was more important ;) ... tested a few later and was at 42 I think it was, I was beginning to feel better. Anyway.... anytime you know it's going to be more than an hour til you eat next, it's best to take in a small snack ;)

[alexg]

Have you heard anything about using Green Tea to help Diabetes? I think it also helps out in something of the metabolism to help loose weight.

alexg

[ladytaz]

yea, though I don't know much about it, but I've also heard it tastes yukky! LOL I'm doing very well on the insulin, so I've no worries about any of that now anyway. MAYBE before, but I'm not prone to eat or drink things I don't like the taste of! If I have to force myself thru something for an extended amount of time, I'm not gonna do it! I can deal with shots much easier! *nods* IF it hurts, it's only momentary, and I don't have to TASTE it! LOL

[alexg]

Yesterday night, I was at 86 before dinner. I went out to a friend's house and thought I would go low so I was drinking some Gatorade throughout the night, about four cups from like 8 PM - 2 AM sipping them slowly. I got home and checked before bed, I was at a 213, WOW that Gatorade must have raised it up. Anyways, in the morning, I couldn't believe it, I was down to 69. Is this even possible or just weird?

alexg

[alexg]

I think my doctor is crazy. His assistant called this morning to tell me that the doctor wants me to raise it up to 14 U twice a day. I said "no way" I am already going low even at 11 U and he said, "well the doctor saw some high readings". Yeah those high readings were at 12 U and only twice, rest of them were under 100. He called back again and the doctor said to stay at 11 U. Now thats what I call "putting the doctor back in his place"

alexg

[ladytaz]

Yesterday night, I was at 86 before dinner. I went out to a friend's house and thought I would go low so I was drinking some Gatorade throughout the night, about four cups from like 8 PM - 2 AM sipping them slowly. I got home and checked before bed, I was at a 213, WOW that Gatorade must have raised it up. Anyways, in the morning, I couldn't believe it, I was down to 69. Is this even possible or just weird?

alexg

Yes, possible ..... AND weird too!! LOL REALLY gotta watch that gatorade, FULL of carbs that stuff is!! When I was first dx'ed, I'd be really sick, and so when I got home from the hospital, hubby bought me some gatorade .... In fact, I think someone at the hospital suggested it. To make sure I stay hydrated and get some nutrients and stuff, since I hadn't been eating or drinking much the previous couple weeks. For whatever reason, I know I was supposed to drink like a bottle of it a day. The BIG bottle now, not the small one serving bottoles. Ok. So I do that. Then when I went to get up on the net and do some research about D and I learned that it was carbs that raise the BG, I went to check out how many were in the gatorade. I think it was like 15g per 8oz serving. *faints* Told hubby, NO WAY am I drinking that stuff anymore!! That's totally counter productive! So if all you're gonna do is have one glass. Fine. But to sip on for hours on end. Uh. No. Not good! Just went to look up the nutrition facts. It's 14g for the regular Gatorades. Their Energy drink .... prepare yourself .... for a 12oz serving 78g!!!!!!! O.M.G.

I think my doctor is crazy. His assistant called this morning to tell me that the doctor wants me to raise it up to 14 U twice a day. I said "no way" I am already going low even at 11 U and he said, "well the doctor saw some high readings". Yeah those high readings were at 12 U and only twice, rest of them were under 100. He called back again and the doctor said to stay at 11 U. Now thats what I call "putting the doctor back in his place"

alexg


You GO boy!!! *giggles* That's right!! If he want's you to have better and tighter control, then he needs to have you go to MDI (NPH and R separately), which actually, you could do on your own if you so desired. You don't need a prescription for the Novolin insulins. Though if you want to used your insurance to pay for it, yes, you do. But if you decided you want to go that route without his "blessings", then just go to Walmart and get the ReliOn Brand, it's only $19.96 per vial.

I don't see his rationalization on all of it. I mean, you are going low WAY more than you are going high. This is like a LOUD alarming bell going off, that he's not listening to! He's only concerned about any high numbers you're getting, and then, he's not paying attention to WHEN that happened! I mean, DUH!

I didn't mind the mixed at all, it was just the fact that I was having some lows, mostly in the early afternoon, and I didn't like that. It was also due to my eating habits -- not being a morning eater, not hungry = don't even think about eating = ending up going low a few hours after getting up in the morning. I'm home all by myself all day and well into the night. That scares me with lows. So I wanted to avoid them as much as possible. That's the ONLY reason I switched to MDI.

The first month or so I only had a few, but it was after that, when I started having more lows. I didn't like it. So I considered MDI, thought about it for quite a while first too. Asked my P.A. and doc ... they said fine with them, if that's what I wanted to do. (not that their opinion really mattered, it's MY body, MY disease and MY life ;) but it was nice to have their "blessings")

So are you taking 11u AM and PM now? Or did you cut the PM dose down a bit? If you are still experiencing lows in the night, then I would cut the PM dose back down a unit, check that for a couple/few days, see how it goes, then if you're still having them, cut back by another unit and see how that goes. If you end up having good before bed numbers, but too high morning numbers, I really would suggest you go to MDI.

[alexg]

My numbers are excellent at 11u day and night. I have not gotten any higher than 107 all this past week before meals and 2 hours after meals I am back to normal. I have seen some lows like in the upper 60's but I control them. Before sleeping numbers are good, 85 - 115 or so. Mornings are between 77 - 105.

alexg

[ladytaz]

EXCELLENT Alex!!! YaY! :five: I think you've got it nailed now!! :biggrin:

[alexg]

I got it nailed down so good that today I was at 89 at breakfast 104 at lunch and right now before dinner 62. Hehehe that is a bit low for me... forgot to snack in between lunch and dinner. Ooops!

alexg

[ladytaz]

Well, that happens from time to time!! ;)
I'm so proud of you, Alex! You've done a GREAT job, hangin in there, to get it nailed!! :biggrin:

[alexg]

Well you and the rest of the people here deserve a great Thanks! Especially a bigger thanks in responding to all my postings no matter how idiotic they were.

dja2k

[ladytaz]

You're so very welcome!! :)

[alexg]

Well just got back from seeing my doctor and WOW! excellent news. I had an A1C of 9.9 back in July and now its at 6.6. My liver is much better now with then new Cholesterol medication and everything else is great.

alexg

[ladytaz]

Well just got back from seeing my doctor and WOW! excellent news. I had an A1C of 9.9 back in July and now its at 6.6. My liver is much better now with then new Cholesterol medication and everything else is great.

alexg

Wonderful news Alex!!! :D YaY! :five: Your A1c will probably be lower next time, since by then you'll have a good amount of time with much improved BG's! :D

I went to the doc today too!! ;) Fixin to post about it ;)

[alexg]

Tell me if this is normal or just stupidness from my H.E.B. Pharmacy. Yesterday I went for my Novolog Mix 70 30 (5 Pen Box) and it so happens they were keeping it outside since they had labeled it and ready for me to pick up. It was completely hot when I got it. Aren't they suppose to follow the same instructions we do to keep then insulin in the fridge until use or until I pick it up?

alexg

[ladytaz]

No, I don't believe that's normal? I don't use pens, but when I get my vials (just got one today, too), they always take them out of the fridge. My opinion is they should be kept refrigerated, until you pick it up!! As long as the insulin stayed under 86 degrees, it should be fine though. In the future, if it's not cold, demand that they get you some from out of the fridge.

[alexg]

Thanks! I kinda figured that too of what you said, but they are kinda stupid there at my HEB. I think they have a bunch of rookies. I was going to return that same day but I had other things to do. It seems the insulin is still working fine though, I am still getting my normal readings. Next time I will tell them what happened and for them not to give me any warm insulin.

alexg

[alexg]

Well for reference LINK (http://www.diabetesforums.com/forum/dieting/23306-i-need-some-suggestions-2.html)

Anyways, been going to the gym and keep a good intensive diet. Now I've been averaging glucose levels of 70 or so most of the day at 11U day and night. That is pretty low and I've had a low 56 last Saturday which was about 2 hours after dinner. I don't want to be eating all day to feed these low levels so what do you think, go down to about 9U would be safe?

alexg

[ladytaz]

Hi Alex! :0)

Yea, I think that would be fine for you. Keep close watch for a few days to make sure you aren't going too high.

Honestly, this is where having the NPH and the Regular seperately helps a LOT!! I was having issues with going low in the early afternoon, which is really my breakfast, since I don't usually eat in the mornings when I wake up. I'm not hungry, until about 3 or 4 hours or so after I awake. Most mornings anyway. So I decided to stop taking the mix and go seperate. Has worked wonders for me! I hardly ever have to take my R, unless I'm eating a high carb meal, and that's usually only a supper meal! The NPH pretty well keeps my BG below 140 on it's own for my Breakfast and lunch. Unless, as I said, I eat something high in carbs. I ususally only eat about 25g to 30g carbs for those two meals.

IF you choose to do that though, then you'll have to figure out what your insulin:carb [I:C] ratio is. Again, another thing "Diabetes" that is individual! ;)

So yea, go ahead and try the 9u. If you find it keeps you a little bit too high, then bump it up to 10u.

Good Luck!!

[alexg]

Thanks for the reply. I will go to 10 U first and see how that works. Then go gradually down until I find the sweet spot. :)

alexg

[ladytaz]

That sounds like a good plan to me! ;)

[alexg]

Well in the morning after waking up and before breakfast I was at 85 and 2 1/2 hours later back at 85. Good or not, hmm?

alexg

[ladytaz]

If you feel comfortable with that, then its good! :) If you prefer to be a little bit higher, then reduce by another unit and see how that goes. ;)

[alexg]

Well still at 10 U, this morning I was at 87 then at lunch I was at 92 and right now a bit before dinner I am at low 62. I kinda forgot to take a mid afternoon snack. I think I will try 9 U tonight and tomorrow to see what numbers I get. Do you think that controlling my glucose level by dieting is better than controlling it by higher insulin intakes?

alexg

[ladytaz]

I think that's a personal decision, Alex. You shouldn't have to eat to "feed" the insuin. But in reality, with insulin, you should be able to eat as you wish. Though I don't agree with pigging out and "covering" it with insulin at all times. For an occasional treat, fine. But on a daily basis? No. I think that can bring on a whole different set of issues. But, that's not the case here with you, anyway.

You were taking 6u previously, before the jump up to 12u, right? And now you are changing your carb intake, lowering it more than it was at that time? Correct? If so, just keep droping a unit at a time until you find that "sweet spot" as you said yesterday! ;)

Consider speaking with your doctor about going MDI [NPH and R seperately]. You may benifit greatly, as I have, from it. The NPH keeps me pretty steady all day long. Between 80 and 110 most of the time, and under 140 at the 2 hour mark. I don't have to take R that often. Only when I eat a large carb meal, or I am running higher already for some reason.

Usually though, as long as I'm under 110, and a meal is under 30g carbs or so, I don't even have to bother with the R. Of course, you may still need to use the R with every meal. But, since you don't really need to take any R for your lunch meal, and you maintain good BG levels, it seems that you may very well respond as I have.

[xMenace]

You lost me at the counting part. I've never ever counted for my some 30,000 injections:stupido3:

[alexg]

Thanks for the help and replies ladytaz.

alexg

[ladytaz]

You're very welcome, Alex! Let me know how it goes!!

[alexg]

Well I am down to 8 U as with the rest still getting low 60's. Tonight was my first 8 U and 3 hours later after dinner, I was at 104. Now lets see in the morning before breakfast what my level is.

alexg

[alexg]

In the morning I was at 81 then before dinner I was at 111. Today I woke up at 89. I think I found the sweet spot at 8 U. Now I will continue my extreme dieting and exercising routine and see if I can get some results there. :)

alexg

[ladytaz]

Good deal, Alex!! Good Luck!! :) Keep me posted! ;)

[alexg]

Yesterday being Thanksgiving gave me a reason to break my diet. I may have over did it a little eating turkey, some ground beef stuffing, some corn with butter, mash potatoes with boiled eggs, some white bread, and some pecan pie. This was in the afternoon. I went with my traditional 8 U at night. In the morning I thought I was going to be higher than normal, yet to my surprise I was at 85.

alexg

[alexg]

Tonight I tested out my numbers without Novomix night dosage. I felt hungry at around 6:45 PM and checked my blood before dinner at 7:15. My glucose level was at 65, no wonder I was hungry. I ate salmon, some dirty rice, and a dinner roll. I just tested out my glucose again right now, 1 hour later, and I am at 115. Wow I didn't even use insulin, hmmm :confused: ?

alexg

[alexg]

This morning I am at 92. Now I am getting curious to whats going on. I didn't get insulin last night and I am still normal.

alexg

[alexg]

Didn't take my morning insulin shot either and right now about 1 1/2 h after lunch I am at 129. Still have the afternoon to go, before dinner reading should be lower than 129 and in range.

alexg

[alexg]

Before dinner continuing the previous post for Saturday, I was at 69 before dinner, then 101 two hours later. Today Sunday I woke up having 94 in the morning before breakfast and 81 before dinner. Still no insulin! What do you think, am I doing good without insulin?

alexg

[noroardanto]

Hi I'm Noro, this is my first time, I'm not sure how to post new topic.. I hope it is ok to just reply to a thread.

Diagnose with type 1 three weeks ago. My doctor put me in 2100 kcal diet as I'm also in medication for lung tuberculosis. Using novomix 30 I started at 20 unit. Now I have to inject 38 unit just before breakfast (7 a.m) and another 38 at diner (6 p.m.) otherwise, my glucose level will shoot up to 300 2 hours after meal. Did anyone ever need this much of novomix? Thks.

[alexg]

Wow that sure is a lot of insulin and I haven't seen anyone around here take that much. Keep up with your shots, you don't want to be that high for a long period of time.

alexg

[noroardanto]

My md told me that infection can also increase insulin needs (in my case, lung infection). I'm moving to lantus tomorrow, starting with 30 unit, hopefully I won't have to increase it to my current novo dose. At least I hope that I will need much less dose when my lungs are fully recover (in about 5 months). Thanks Alex, please keep posting your progress, I do really hope you won't need insulin injection anymore.

noro

[xMenace]

Hi I'm Noro, this is my first time, I'm not sure how to post new topic.. I hope it is ok to just reply to a thread.

Diagnose with type 1 three weeks ago. My doctor put me in 2100 kcal diet as I'm also in medication for lung tuberculosis. Using novomix 30 I started at 20 unit. Now I have to inject 38 unit just before breakfast (7 a.m) and another 38 at diner (6 p.m.) otherwise, my glucose level will shoot up to 300 2 hours after meal. Did anyone ever need this much of novomix? Thks.


Welcome noro.

Some here take hundreds of units of insulin a day and some take less than 10. Disregard them. Take what works for you!

So you are switching to Lantus. Good! Are you also taking a fast acting insulin for meals? I sure hope so. Of course you count your carbs now too, right?

[noroardanto]

Hi John,
Thanks for the soothing advice. Yes, I count my carbs intake very carefully right now. I haven't advised to take the fast acting for meals yet. However, I'm still in the experimental stage, finding what's works best for me.

[dazzy34]

I am also new to all this, also taking novomix 30.
my morning dose started 4 months ago on 16 units, eve was 8 units, now i am on 30 units in the morning and 24 units before dinner and i am still getting highs before breakfast.
It actually drives me insane trying to get my numbers right!

[noroardanto]

Hi Dazzy,
Usually I stay on a dose for about 3 days no matter what my BG meter says, before adjusting the dose 2-4 units. Watching your daily carbs intake will aslo be very helpful when you are still experimenting to find the best dose.
Just relax.. I saw diabetes as a blessing in disguise, as I am "forced" to live a healthier life. Now I never skip meals, always have breakfast, watching my fat intake, stop smoking, exercise daily etc.

[dazzy34]

Stopping Smoking is something i know i must do, in fact its my top priority for 2008!
Before i became Diabetic i drank like a fish, smoked like a trouper and hardly ate anything. Now, i eat great, stopped drinking totally but still smoke like a trouper.
My morning numbers are still around the 9-12 mark, guess i will have to increase it yet again.