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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Type 1 Diabetic, Slight Variation In Diet Increases Levels, On Novomix, Actrapid. Suggest Shifting To Lentus. Is It Ok ?

hi ,may daughter is dm type 1 she is 7 years old now and diabetic for 1 year now she is on novomix 14 units morning ,7units actrapid before lunch and 7 u novomix at night befor dinner ,problem is that now she is badly controlled if she took any extra food or a piece of acake it becomes high like 400 mg/dl also high fasting for almost two weaks now even with diet ,her health profissional advice to shift to lentus +novorapid shots how can i start the dose she is 34 kg 130 cm hight , i am concerned about what is written about the cancer relation to lentus and hypoglycemia when she goes out or to school, (usually postprandial blood sugar with the night dose is high then at 3am it becomes around 135 mg/dl then high fasting blood sugar i read about the dawn phenomenon and reduce the dose of insulin but what shall i do about the high postpradial) please advice me

thanks
posted on Sun, 4 Aug 2013
Twitter Sun, 4 Aug 2013 Answered on
Twitter Fri, 23 Aug 2013 Last reviewed on
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General & Family Physician,  's  Response
Hello,
Your doctor is right in advising for the use of combination of long acting lantus  and short acting novorapid.
Many doctors are now switching their treatment from 2 - shot split regime to basal- bolus method because split regime is generally insufficient to meet intensive glycemic control and it also may result in wild fluctuations of blood sugar levels.
With development of once daily long acting insulins,it has become easy to have a better control of sugar levels,if basal - bolus regime is adopted.
You can use a dose of 1 unit per kg.
For your daughter of 34 kg weight,34 units of insulin is required and out of it 30to 50% can be given as injection lantus and 50to70% units ( NOVOPRID ) can be given as bolus dose divided in three equal doses before each meal.
Let your doctor decide the dosing schedule.
As far as apprehension of cancer with use of injection lantus is concerned,there is no concrete evidence and many more studies and trials are required before a conclusion is reached.
Thanks
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Type 1 Diabetic, Slight Variation In Diet Increases Levels, On Novomix, Actrapid. Suggest Shifting To Lentus. Is It Ok ?

Hello, Your doctor is right in advising for the use of combination of long acting lantus  and short acting novorapid. Many doctors are now switching their treatment from 2 - shot split regime to basal- bolus method because split regime is generally insufficient to meet intensive glycemic control and it also may result in wild fluctuations of blood sugar levels. With development of once daily long acting insulins,it has become easy to have a better control of sugar levels,if basal - bolus regime is adopted. You can use a dose of 1 unit per kg. For your daughter of 34 kg weight,34 units of insulin is required and out of it 30to 50% can be given as injection lantus and 50to70% units ( NOVOPRID ) can be given as bolus dose divided in three equal doses before each meal. Let your doctor decide the dosing schedule. As far as apprehension of cancer with use of injection lantus is concerned,there is no concrete evidence and many more studies and trials are required before a conclusion is reached. Thanks