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Dose timing advice

A

ATB123

Well-Known Member
Messages
139
Type of diabetes
LADA
Treatment type
Insulin
Wonder if anyone can advise. 2 or 3 times now I've injected my novorapid just before dinner and found that it seems to work more quickly than my food is absorbed so consequently I go straight down into hypo territory before my food gets absorbed or whatever. Doesn't seem to do it at other mealtimes, I inject as I eat, have a quick spike then settle back down. Obvs I tend to panic and eat sweets and stuff to push my glucose back up but then it climbs and climbs. I ate my dinner early tonight, around 5.30, its now 10 and I'm sitting with a BG of 13, probably due to the hypo correction. Would I be better off injecting my dinner time insulin AFTER I've eaten rather than before, does this happen to anyone else? And why would there be such a difference between different times of day, its always dinner time this happens? Sorry if I'm being dumb, I've only been on basal bolus a couple of months and feel like I'm still feeling my way! TIA for any advice
 
Insulin sensitivity varies with time of day - how much varies between different people :(
What you eat and the mix of carbs/protein/fats also affects how quickly food starts to get processed ... fats tend to slow things down.
It's going to require some experimenting ... you could try splitting the bolus dose so you see how much an effect it has compared with how much you were expecting - then adjust the second insulin injection. You can also adjust the timing. Might be better to run a little higher and correct rather than having a hypo and having to correct for that ... your support team should be able to help ...
 
jonathan183 said:
Insulin sensitivity varies with time of day - how much varies between different people :(
What you eat and the mix of carbs/protein/fats also affects how quickly food starts to get processed ... fats tend to slow things down.
It's going to require some experimenting ... you could try splitting the bolus dose so you see how much an effect it has compared with how much you were expecting - then adjust the second insulin injection. You can also adjust the timing. Might be better to run a little higher and correct rather than having a hypo and having to correct for that ... your support team should be able to help ...
Click to expand...
Thank you, splitting the dose sounds sensible will give that a try and hadn't thought of that. Afraid I haven't had a lot of support other than being told to inject when I start eating, really just been left to get on with it and find my way, which isn't great. I know I can ring either the diabetes GP or nurse but it's such a faff getting through to the surgery.
 
Insulin sensitivity also varies depending upon your current BG.
This seems to be more pronounced with the ultra fast insulins like Fiasp but some people experience it with NovoRapid.
It works faster when your BG is lower.
If you have the same meal at the same time of day but experience different reaction times, this may be the reason.
I now time my bolus according to my BG. And if my BG is in the 4s, I bolus after eating.
 
In Response said:
Insulin sensitivity also varies depending upon your current BG.
This seems to be more pronounced with the ultra fast insulins like Fiasp but some people experience it with NovoRapid.
It works faster when your BG is lower.
If you have the same meal at the same time of day but experience different reaction times, this may be the reason.
I now time my bolus according to my BG. And if my BG is in the 4s, I bolus after eating.
Click to expand...
Thank you that's interesting and I hadn't even thought of that, my BG before dinner is usually around 5 so that may well be the reason!
 
@ATB123 it is all indeed a very big learning curve. I think the biggest one is accepting that it is due to each individual to learn about their own bodies and react accordingly. Medical professionals can advise, but they are advising 100s of people and we are individuals. My brother is also a Type 1 and his needs and way of managing are totally different to mine, but it suits him.
Different times of the day definitely have a huge impact on insulin sensitivity. What you require in the morning as regards dosage and timings will likely be different as the day progresses. Injecting sometime before, after, or during a meal and even splitting doses - a big favourite of mine - are for you to experiment with. It is for you to experiment and find your own way.
 
becca59 said:
@ATB123 it is all indeed a very big learning curve. I think the biggest one is accepting that it is due to each individual to learn about their own bodies and react accordingly. Medical professionals can advise, but they are advising 100s of people and we are individuals. My brother is also a Type 1 and his needs and way of managing are totally different to mine, but it suits him.
Different times of the day definitely have a huge impact on insulin sensitivity. What you require in the morning as regards dosage and timings will likely be different as the day progresses. Injecting sometime before, after, or during a meal and even splitting doses - a big favourite of mine - are for you to experiment with. It is for you to experiment and find your own way.
Click to expand...
Thank you Becca it certainly isn't straightforward at all! There are so many variables but this forum is a godsend, like you say medical professionals advice can be very 'textbook' which is why I'm a big fan of this forum, so much helpful advice to try from real people living with the condition. I'm going to try delaying my evening bolus first see how that goes, and then try splitting the dose to find which works best. I will get there it will just take time.
 
Diabetes can also sometimes 'have a mind of it's own', and what normally works, or works 80-90% of the time suddenly doesn't work, as a one off or became your basal/bolus rates or carb ratios have changed.
Weather affects how much insulin some of us need, and I have 2 different basal profiles on my pump for summer and winter.
Over time you'll find what mostly works for you though.
 
As many have previously said there a various things that make blood sugars change and not conform to what we expect . Unfortunately there is no one type fits all. We are never going to have perfect levels all the time! Personally I try to have a range I try to keep my blood sugars in . I think a lot of stress can be caused by trying to keep diabetes within too tight a range . Diabetes is all about finding what works for you and it takes time and a lot of experimenting, and we shouldn’t be afraid to experiment ! It is us who have to live with it.
 
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