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1 unit of insulin is the same, regardless of the type, right?

Discussion in 'Parents of Children with Type 1' started by Charlotte'sMom, Nov 30, 2016.

  1. Charlotte'sMom

    Charlotte'sMom Approved members

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    I haven't been here in forever! This month it's been 8 years since T1 happened and Charlotte decided to have donuts to mark the occasion.

    My question today is actually about my dad, but parents on this forum are the real experts so I am asking here. I'm a little frustrated with the decision his endo made today.

    My 74yo father is a T2 diabetic and can not/will not do anything to change his diet. Two to four months ago his BG got out of control and he was taking 80 units of Levemir plus 20 units Novolog at each meal (plus metformin) and he was consistently in the 300s. (it was because he was eating junk food, but he won't admit that) We finally made an appt with an endocrinologist 6 weeks ago and they put him on Tradjenta and took him off Novolog. With Tradjenta, metformin and 80 units of Levemir we were seeing numbers in the 100s for the first time in forever, but they've crept back up to low 200s. A1c today was 8.8.

    The endocrinologist today decided to take him OFF Tradjenta (which appeared to have been helping) and switch him to 80 units (40 units 2xday) of 70/30. :confused::confused::confused:

    Two months ago 140 combined units of Levemir and Novolog didn't work but 80 units of 70/30 will? :confused: I told the nurse I thought one unit of insulin brought your blood sugar down the same amount, regardless of what kind it was and she said this would "provide him with more coverage." What does that even mean?

    Am I missing something here? My dad seems to think this 70/30 must be really potent insulin, but I didn't think it worked like that....
     
  2. Lakeman

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    Tradjenta is not an insulin. Most insulin is the same except that it can come in different strengths. Different strengths of insulin have different "U" values. So what we usually use is U-100 insulin. It also comes in U-40 and U-500 and I suppose other strengths too. The 70/30 is a combination of intermediate acting and fast acting insulin which refers to how fast it works rather than its strength. I think that any U-100 insulin will lower BG the same amount as any other u-100 insulin.

    I am glad there are some things that work for him and hope he can follow some regimin which will give him success. Best wishes.
     
  3. Charlotte'sMom

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    I am aware that Tradjenta is not an insulin. It was a pill that he was taking for about 6 weeks, but despite seeing improvement, the endo is taking him off of it. My concern is that the endo is going backwards... before the Tradjenta trial my dad had been taking a combined 140 units of Levemir and Novolog daily and that wasn't keeping his numbers below 300. But the endo thinks that 80 units of a mixed 70/30 is going to "provide more coverage" and is taking him off the Tradjenta.

    I don't want to assume I know more than the endocrinologist, but this just doesn't make sense to me. He has been to this doctor's office twice. Today's visit he didn't even see the doctor. The FNP consulted with my dad and then spent 5 minutes chatting with the doctor before coming back to tell us what he had decided.
     
  4. wilf

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    Your concerns are valid. This makes no sense to me either. But you need to be chatting with someone who knows their way around Type 2.
     
  5. dpr

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    Endo's are just doctors wno are just people and are just as screwy as the rest of the general public. If the endo can't come up with a logical explanation then I'd seriously question it. Over the last 5 years between my mother, father and diabetic daughter I've had a TREMENDOUS ammount of dealing with medical "professionals" and some are definately more "professional" than others. Some are outright dangerous.

    Just recently my 81yo mother broke her hip. She has adverse reactions to morphine which I told the hospital and is in her records. Not anaphylaxis but still pretty severe. So I get a call from the hospitalist saying shes in some pain a couple days after the surgery and he sees the note but says he needs to give her morphine. I tell him no DON'T do it and explain why. He still wants to give it to her. We go round and round until I just flat out tell him don't do EVER do it. So he didn't give any but the night doctor who failed to call me did. She all sorts of unexplained problems no one can figure out until one of the nurses went over everything she had been given. Management and I had a VERY unpleasant disscusion. This is just one of a few medical mistakes I've had to deal with over the last few years. My point being, be a strong advocate for yourself, family and friends! If using common sense it doesn't seem right, question it and don't be afraid to ask for a detailed explanation, ever!
     
    Last edited: Dec 1, 2016
  6. NeurosurgeryNP

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    By switching to 70/30 they may be trying to change the action of the insulin he is using to cover meal times. Maybe they also feel it is a compliance issue as well and feel this may help with decreasing to 2 injections a day? That is the only reason I can think of.
     
  7. rgcainmd

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    I think NeurosurgeryNP's speculation may be spot on. I rarely see 70/30 in use anymore (I think the last time I saw someone on it was over 15 years ago?), and it seems to be used almost exclusively these days with people with compliance issues.

    If you don't understand why your father's endo wants him on 70/30, you should go ahead and ask him about the reasoning behind his decision.

    I hope things work out better for your father.
     

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