From Novomix30 to Lantus

[noroardanto]

It's been a week since my doctor put me on Lantus. Previously I'm in good bg control (109 fasting and 160 2hr after meals)using novomix 30, 38u before breakfast and 38u before diner. The only drawback was that I had frequent hypo.
I like lantus very much as I only need one 34u shot a day at 7.30 am. My bg now 95 fasting and 190 2hr after meals then usually drop to 145 at 3hr.
But there's strange thing happening, sometimes I feel like I'm going into hypo, but when I check, my bg is quite normal. Last night (3hr after diner) I have my usual first sign of hypo: the excessive hunger. Checking my bg, it's 172. Do nothing, the symtom gone in about 2 hours. Today, I am not taking my usual "3hr after breakfast" snack, and I began shaking lightly just before lunch. Checking my bg, it's 85. 1 hour later, I'm still hungry and shaking lightly, checking my bg, it's 188. Did anyone have any ideas of what's happening here? Thanks!

[ant hill]

I too have good BG's as I take Lanus overnight, After dinner.
And I also take Novomix 30 as well as I use that during the day at breakfast at a rather large dose of 70U.
Can I ask how much do you take of Novomix?

[noroardanto]

I forgot to tell you that I don't take Novomix 30 anymore, just lantus once a day. When I'm on Novomix 30 (only Novo, no other medications) I need 38 unit before breakfast and another 38 before diner. Now I only inject 38 unit Lantus once a day.

[NoraWI]

Now that you have your basal (Lantus) set, you need to ask that your doctor prescribe a bolus insulin such as Humalog, Novolog (Novorapid) or Apidra. Your after-meal BGs are too high. You could also improve your numbers by cutting down on the carbohydrates you eat. Being in Indonesia, I am sure that rice is a big part of your diet and rice is one of the starches that make BGs zoom up. You might try cutting down the amounts you eat or cutting rice out entirely. Also root vegetables are usually very carby. Experiment by omitting certain starches from your diet and definitely ask your doctor about prescribing a bolus insulin to use for meals.

The problem with using mixed insulins is that they are mixtures of NPH (as basal) and Novolog (as bolus). NPH is a very peaky insulin and hard to use effectively. When using a mix of basal insulin and a bolus insulin, there is no way to adjust each one to your particular needs. That's why you used to get hypos. Now that you have set your Lantus dose, it's time to add a bolus insulin for better meal control. Good luck!

[noroardanto]

My doctor put me on 2100 kcal diet. Using food exchange table, I mixed my daily starches intake between rice, whole wheat bread and potatoe. I bet my doctor will precribe me with bolus insulin when he sees my bg chart (I have appointment next week). Do you think it is possible to avoid bolus at all by only adjusting our carb intake and excercise. I like the idea to have only one shot a day :)