Debbi -- I think you're absolutely right. Other than my endo, I only trust myself! Also, everyone's body reacts differently, so every T1 is different.
Doctors need to learn about many diseases in med school, so I would never expect them to understand the details of T1. But, what annoys me is when someone pretends to know more than they do or lectures me as if they know more than I do b/c that can be very dangerous!! In my own job, I find telling a patient "I'm not sure about that but I'll find out" makes them trust me more b/c it means I'll only give them an answer if I know it's correct, know what I mean?
It sounds like you're doing a great job for your son!! Kudos!!!
I cannot imagine not testing everytime he eats, which if it is like my 21 month old, he is on a strict every three hours meal plan (4x a day). Then we check him at bed, and at midnight. When we were first diagnosed we also did 3 a.m. . When I call the hospital with numbers, they expect those reports from tests. I cannot imagine the doctor said that to you. It is so hard when they are little, you don't know unless you test.
We were specifically told NOT to mix Levemir and Novolog. We also had a dedicated butt cheek for Levemir shots - and then rotated all the rest of my sons Novolog shots in his arms, thighs and the right butt cheek. We were told that even injecting the Novolog into the Levemir area could mess up the absorption of either or both - leading to unexpected highs or lows. Not saying you shouldn't, just what we were told.
We were specifically told NOT to mix Levemir and Novolog. We also had a dedicated butt cheek for Levemir shots - and then rotated all the rest of my sons Novolog shots in his arms, thighs and the right butt cheek. We were told that even injecting the Novolog into the Levemir area could mess up the absorption of either or both - leading to unexpected highs or lows. Not saying you shouldn't, just what we were told.
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Interesting about keeping the sites separated too! I also knew I can't mix my Lantus/Novolog, but hadn't thought about injection sites...
My daughter currently takes a mix of NR and NPH in the morning. Nothing at lunch, but dinner is 2 shots, 1 of NR and 1 of Levemir (this is a change - we use to just take NR at dinner and then a shot of NPH at 10pm). This switch is to avoid a late night shot.
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If Levemir is long-lasting, why does she need NPH too? Could she take Levemir once or twice a day and forget the NPH? I'm sure your endo has a reason, I was just curious why you;d need more than more long-acting insulin with different peaks, etc.
My son is also on the NR and NPH during the day and NR at dinner time but we take Levemir at bed time around 7:30 p.m. they too him off the NPH at night time because he was getting a lot of 3:00 a.m. lows. I was never told about the not mixing them or about having a designated spot for the Levemir....I often wonder why we are not on Levemir during the day too. keeping track of 3 different kinds of insulin can get tricky! keep us posted as to what you find out!
Thanks for the replies! And very good questions!! All I know is that our diabetes clinic was running a test trial on levemir (taking the shot at dinner time, with NR, but 2 separate injections). Once the test trial was finished we were given the opportunity to change our 10pm NPH shot to the levemir at dinner. We jumped on the opportunity! Much better for my daughter - we hated waking her up at night to take her shot :-( (we can easily test bg - she sleeps through that!).
I have plenty of questions for our endo next visit. Sadly this isn't until April. I too would like to get off the NPH completely and switch to Levemir exclusively. Especially since some of what I've read says it can last 24 hours!
Thanks for the replies! And very good questions!! All I know is that our diabetes clinic was running a test trial on levemir (taking the shot at dinner time, with NR, but 2 separate injections). Once the test trial was finished we were given the opportunity to change our 10pm NPH shot to the levemir at dinner. We jumped on the opportunity! Much better for my daughter - we hated waking her up at night to take her shot :-( (we can easily test bg - she sleeps through that!).
I have plenty of questions for our endo next visit. Sadly this isn't until April. I too would like to get off the NPH completely and switch to Levemir exclusively. Especially since some of what I've read says it can last 24 hours!
I will definitely keep you posted :-)
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I was really happy to get off NPH as well when I switched to Lantus (like Levemir, is advertised as a 24hour long-acting insulin) because my control got so much better within a week of switching! One thing to keep in mind, although both are advertised as 24hours, it doesn't mean it will actually work for 24hours for everyone. A number of people using the "24 hour" long-acting insulin's, such as myself, still have to do a split. I was started on one shot of lantus and later changed to an AM and PM shot because it was peaking earlier than 24hours.
anyways, glad that levemir is making things easier for you guys :)
Jill - you could always call your endo's office - she should be able to give you a call back about any drug questions you have - don't wait until your next visit!
You could also talk to your pharmacist. They are often much more knowledgeable about the different drug interactions and mixing. (Just make sure you trust your pharmacist!)
While Levemir (and Lantus) are marketed as 24 hour 'basal' insulins, meaning they are supposed to be released in a relatively constant amount over the course of the day. This mimics the tiny bits of insulin a normal pancreas makes (or the basal amount of a pump). However, we found in our son that Levemir did seem to have a slight peak and probably lasted around 20 hours for him. But this was manageable becuase he tested at the same time everyday and got a snack in the morning when he tended to go low and had a higher I:C ratio at lunchtime to counteract the levemir wearing off in the afternoon. Our endo said we could have tried splitting his dose but since at that time he was only getting 1.5 units of Levemir a day, he did not think that was worth it. (We switched to the pump soon after.)