Novorapid not so rapid?

Dillinger

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@Dillinger I tend to take my basal at 10pm and at the moment I am on 20u, It has been recommended by my nurse to take 10u at night and another 10u in the morning. I do not know what your experience with this is? Personally I am less keen to move to this as I already inject so many times a day that any way that I can keep this down saves some of the swellings in my legs which I sometimes get due to hitting veins..
I definitely find that I am more sensitive to insulin the morning and sometimes through until lunch, in the evenings is where I experience my most dramatic spikes. Is there any reason for this or is it just something which happens?

Splitting basal is a good way to go; but many find that Lantus is harder to split than Levemir. Get your nurse to change you to Levemir. I use the 4mm needles and think they make things more predictable. Lantus has a reputation for being tricky.

Your Lantus could well be running out in late afternoon/early evening (they all like to claim it but Lantus and Levemir are certainly not 24 hour insulins) so perhaps you are over compensating for that with your bolus in the evening?

Another tweak you could do is not inject more than 7 units of any insulin at once; so change sites midway through an injection. The reason being is that that will help you get consistent absorption rates. I know you are worried about lots of injections but I think you'll get used to it and the control is the key thing not the number of jabs.

But as has been said; fix your basal then your bolus then drop your carbs.

It's really not complex; you will be able to pick it up by just doing some reading. It is a scandal that all insulin using diabetics do not have this drummed into them as soon as they go on insulin. It's like giving people cars and telling them that there are no driving lessons available for the next 3 years.

Best

Dillinger
 
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donnellysdogs

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Totally agree with Dillinger and also request 1/2 unit pens.. Make sure the pens are different colours for basal and bolus.

I speak only from coming off a pump last year after 5 years of use.
I found Lantus awful but a split dose of levemir and I have just as good control with my bg's as on the pump and a lot less hassle!!!
 
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holly.king03

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Although I'm not on Novorapid (Humalog), I also experience this. Personally I think mine is down to low motabilism because as soon as I do 10-20 mins of fast paced walking to or from work my sugar levels drop, otherwise they're sluggish - so I'm going for a thyroid test to see if my hyperthyroidism is kicking in yet (anotherj oy of being diabetic!)
I went on a bloomin KAT1E course (newest one) and they said we can inject just before or up to 15 mins after eating but that seems a load of bull - never considered injecting that far ahead so will have to try it out...

I also purchased the libre and it's awesome - but get some optimum neo test strips because the libre is roughly 4 mins out (meaning it's sending a reading 4 mins behind what it actually is) so if your bsl is dropping/rising rapidly, it won't be accurate. Therefore take a blood test with the libre and it'll show you. (Sometimes I know I'm having a hypo when the libre doesn't say I am, and then when I know I've come out of it the libre will say I've just dipped)

I would say that a KAT1E or DAFNE course is fantastic at giving you information that even your GPs and diabetic nurses won't know, so definitely push to be on one. I was always told it was a major waiting list but I got on one 3 months later so you've just got to be as flexible as you can.

But ultimately, you can do everything right and diabetes will still kick you in the behind so you've always got to count for an element of surprise!
 
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james122

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I have the same problem, I once saw someone say that rapid acting insulin is really rapid acting and should be called " more rapid acting than regular insulin". The spikes are very annoying and like you I worry about my future everytime I have high bg. I have started injecting 30 minutes before and that really helps me. My nurse told me I shouldn't worry about post meal spikes but un like a lot of people in my clinic I actually care about high blood sugars and not getting ill in the future. I would suggest injecting up to half an hour before your meal and see where that takes you.

You can private message me to if that helps.
 

Ellie_Wilko

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Has anyone come up with any long term fixes for this? I've been trying to tell me dsn's and dieticians for weeks that novo rapid just doesn't work as per the instructions on the box for me. Every person I see tells me to do something different and am just stuck in a rut of having reading's of 8ish (not to bad I know) after meals slowly coming down to a normal result until 4 hours after eating when I have a hypo. This is happening every time!!

One DSN said try injecting slightly earlier (30 mins before meals as opposed to 20 mins) and then was told on Friday to inject as I sit down to eat as the insulin is missing my food!

I'm 10 weeks pregnant also and they keep telling me how dangerous all these hypos are for my baby but can't come up with a solution.

Frustrating!!


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noblehead

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One DSN said try injecting slightly earlier (30 mins before meals as opposed to 20 mins) and then was told on Friday to inject as I sit down to eat as the insulin is missing my food!

Injecting when you sit down to eat would surely make the postprandial bg levels higher, I think the first DSN is spot-on.

R
 

Ellie_Wilko

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Injecting when you sit down to eat would surely make the postprandial bg levels higher, I think the first DSN is spot-on.

R

I am still doing this yet hasn't changed the hypos atall! I've reduced my levemir by half and my ratio from 1:5 to 1:10 and yet again, a reading of 2.5 4 hours after lunch.

They keep blaming it on early pregnancy but this was happening before I was pregnant so who knows :/


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noblehead

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I am still doing this yet hasn't changed the hypos atall! I've reduced my levemir by half and my ratio from 1:5 to 1:10 and yet again, a reading of 2.5 4 hours after lunch.

They keep blaming it on early pregnancy but this was happening before I was pregnant so who knows :/


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Are you sure it's the bolus dose causing the hypo, have you tried doing a basal check to see if your bg dips without food and your bolus dose?

I'll tag @azure & @Mrsass as they have may help you with regards to your pregnancy.
 

azure

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I am still doing this yet hasn't changed the hypos atall! I've reduced my levemir by half and my ratio from 1:5 to 1:10 and yet again, a reading of 2.5 4 hours after lunch.

They keep blaming it on early pregnancy but this was happening before I was pregnant so who knows :/


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Assuming there's no obvious problem like a wrong basal amount (you may need to reduce it slightly in early pregnancy - do ask), what I did was bolus enough in advance to reduce any spike and then 'top up' my food with a small snack later. This was quite common for me in early pregnancy and I know at least one other lady did the same. So if you know you'll drop, test in good time and eat a small snack. It worked for me and it kept my BS in range, which is extra-important in pregnancy.

If you decide to do this, I recommend eating similar meals until you perfect what amount of carb snack works for you. I often ate a small snack, waited, and then tested and ate a little more if necessary.
 

Ellie_Wilko

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Are you sure it's the bolus dose causing the hypo, have you tried doing a basal check to see if your bg dips without food and your bolus dose?

I'll tag @azure & @Mrsass as they have may help you with regards to your pregnancy.

I'm not sure really! I've reduced my basal from 75 units as hit the hypo stage of pregnancy to 40 units and then again to 30 today and still had a hypo.

I have been going low in the night which I guess would indicate my basal being to much but all the DSN said was to eat a couple of crackers before bed :/


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Ellie_Wilko

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Assuming there's no obvious problem like a wrong basal amount (you may need to reduce it slightly in early pregnancy - do ask), what I did was bolus enough in advance to reduce any spike and then 'top up' my food with a small snack later. This was quite common for me in early pregnancy and I know at least one other lady did the same. So if you know you'll drop, test in good time and eat a small snack. It worked for me and it kept my BS in range, which is extra-important in pregnancy.

If you decide to do this, I recommend eating similar meals until you perfect what amount of carb snack works for you. I often ate a small snack, waited, and then tested and ate a little more if necessary.

I have found that I'm snacking quite a bit without having any real spike in my readings so perhaps I just need to do more. I feel like I'm always eating and have already put on a good stone since Christmas from being so tight with my readings

There keeping in real close contact about my readings so hopefully they'll get it sorted quickly as I'm exhausted from all the hypos!


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azure

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@Ellie_Wilko I hope you do get it sorted soon, just remember that pregnancy hypos almost don't make sense. Your body can react totally differently, and it's reaction to food ca be very different. Before I was pregnant, I would often be high first thing at work (sitting down job) and would then bolus mid morning for a 10 or 15g snack, but when I was pregnant I spent all morning eating sweets and could eat a 20g or more snack without a bolus. Very different!

I found the trick was to test lots and spot the hypos before you go too low. Lucozade works fastest if you go really low. Some mornings I'd test every 20 or 30 mins when my body was having a hormone surge and I was having a prolonged low. This meant I could eat along with the low and keep my blood sugar in range.

I set an alarm every night for 2am and tested and ate if necessary. Again, I ate more than for a non-pregnant hypo.

Tiring as they are, I saw it as a sign my pregnancy was 'doing what it should', and tried to enjoy the opportunities to eat sweet treats. It was like a series of mini breaks from diabetes in a way.

And don't worry about weight gain (unless you're obviously over-eating to excess, of course). I put on lots of weight, especially early on, but it dropped off with no effort after my son was born. See it as a cushion of stored fat for baby :)
 

Smithsky

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I am really concerned about all the mixed messages, as far as I know novo rapid doesn't start working for about 10 minutes and peaks after an hour gradually reducing for the next 3. We are trying to replicate the body's insulin reaction for non diabetic and it will never be that smooth - we work on a wonky graph. The key has to be getting the right ratio for you and trusting it the right amount of insulin shouldn't give you a hypo but correcting within the 4 hours will give you 2 lots of insulin working at different rates and you have lost all control. Test before you eat and adjust your dose accordingly for the next round