Dear Dr. Ashraf, Many thanks for the advise and the information, now it's time to go to my daughter's doctor with these new facts which I didn't know before. Many thanks again, I wish I am in Egypt to visit your clinic, by the way do you know a good doctor in Jordan, who I can discuss this criteria with?
With Best Regards, Mohd. --- On Sat, 4/17/10, Ashraf El Sheikh <[email protected]> wrote: From: Ashraf El Sheikh <[email protected]> Subject: RE: < DYCA > استفسار[to Dear Dr. Ashraf] To: [email protected] Cc: [email protected] Date: Saturday, April 17, 2010, 7:33 PM Dear Sir,, Yes your daughter is in danger from Mixtard because this insulin is not meeting with the body needs of insulin,, why? Only 30% of the Mixtard dose is for food (Bolus) ! and 70% for organ needs (Basal) !! which means if she takes 20 u before breakfast only 6 u will act on food and the rest 14 u for organ needs 6 u for food is enough if she eats small quantities of carbohydrates ( almost 3 carbo units) but if she eats more,, she will develop hyperglycemic excursions !! that is why Mixtard is not a flexible insulin she takes 20 + 20 + 16 = 56/day -30% (Bolus= 16.8) for food and the rest 39.2(Basal) for her organ needs,, this might cause Hypoglycemia especially during sleep when she eats a small dinner and will cause a rise in the early morning glucose !! these fluctuations are very harmful for the small blood vessels of the eyes and kidneys and nerves and causes complications, ,,, so even if her fasting and 2h after meal blood glucose tests are OK,, and even if her HbA1c is below 7% SHE MUST CHANGE FROM MIXTARD TO BASAL / BOLUS REGIMEN ,,,,,, To detect the blood glucose fluctuations she must do a CGMS or frequent home glucose measurements (SMBG) ,, GOOD LUCK Dr.Ashraf A.El-Sheikh MSc.CPT.PhD. MACP � Consultant Diabetologist & Endocrinologist Chairman Abou Seifein Diabetes Center Expert Insulin Pump Therapy & CGMS Tel (+202)33388411 - (+202)37614264 Mobile (+20127611522) - (+20122105037) Fax (+202) 33365505 - Cairo - Egypt www.adc-eg.com To: dyca...@yahoogroups .com From: mdhalallawy@ yahoo.com Date: Sat, 17 Apr 2010 07:35:11 -0700 Subject: RE: < DYCA > ุงุณุชู�ุณุงุฑ[to Dear Dr. Ashraf] Dear Dr. Ashraf, Please could you give more details about your statement "Is there someone, whom still using Mixtard?", my daughter is using Mixtard30 by Novopen (from Novonordisk) for 3 times a day (20U at 7AM, 20U at 2PM and 16U at 7PM). This is for nearly 7 years ago. Is this dangerous? I am really confused. I am really worried about this. What is the possible alternative for Mixtard30 then???? Your kind clarification is highly valuable to us Dr. Ashraf. With Best Regards, Mohd. --- On Fri, 4/16/10, Ashraf El Sheikh <adc_elsheikh@ hotmail.com> wrote: From: Ashraf El Sheikh <adc_elsheikh@ hotmail.com> Subject: RE: < DYCA > ุงุณุชู�ุณุงุฑ To: dyca...@yahoogroups .com Cc: adc_elsheikh@ hotmail.com Date: Friday, April 16, 2010, 8:23 PM
