Novorapid frustration

[Tony337]

Hi Tony,

Thanks for your reply. I hate it when it becomes a rollercoaster and for no definable reason. My levels were much better this morning, right back down to 7.4mmol/L, but that was after having to correct and then eat something at 5am this morning because I had a hypo. I'm just so worried at the moment about whether I've taken enough insulin for what I'm eating. I'm on a new vial of NovoRapid today, so I'll see if that makes a difference.

Best wishes

Rob

Hi Rob
Do you have a CGM?
I have a libre which has alarms set below 3.2 (libre is always lower than a finger prick) and 9.0 (to see off a high)
and i have to confess to being obsessive in keeping my levels good.
My watch talks to my phone too so i know where i'm going with a quick glance.

I obviously see off a low by eating and a high by going for a walk or taking extra insulin.
My libre makes it easy for me and i rarely go above 10 and i've never flaked out either and can operate fine above 3.

I do have issues from time to time but 50 years a type 1 has taught me not to beat myself up when things do go west.

Again i have only given you what i do as that is all i'm qualified (lol lol) to do.

Insulin resistance is a curse to all diabetics.

Tony

 

[CheeseSeaker]

Hi @Rob110577,

Have had similar fun. Was using Novorapid for 20+ years (might be longer) and developed resistance. Had over-injected the same sites which caused the fat to go lumpy and cause resistance.

Swap sites to uninjected bits - worked great again. Switching insulins to a different type probably wont help, Novorapid (in my experience) is quite stable most of the time.

The Ultrafasts (Lyumjev and Fiasp) can give different issues - I use Fiasp now for speed in my pump-loop and it needs a bit more understanding and experimentation than Novorapid, Lyumjev didn't like me at all.

I recommend trying different injection sites and go from there.

Cheers,

Rob.

 

[Rob110577]

Hi Rob
Do you have a CGM?
I have a libre which has alarms set below 3.2 (libre is always lower than a finger prick) and 9.0 (to see off a high)
and i have to confess to being obsessive in keeping my levels good.
My watch talks to my phone too so i know where i'm going with a quick glance.

I obviously see off a low by eating and a high by going for a walk or taking extra insulin.
My libre makes it easy for me and i rarely go above 10 and i've never flaked out either and can operate fine above 3.

I do have issues from time to time but 50 years a type 1 has taught me not to beat myself up when things do go west.

Again i have only given you what i do as that is all i'm qualified (lol lol) to do.

Insulin resistance is a curse to all diabetics.

Tony

Hi again Tony,

Sorry for taking a while to reply back again. I don't have a CGM, I have been offered a senor, but I wasn't overly keen on the idea of having something attached to me constantly. I'm autistic, so I do find change extremely difficult and have very set ideas about things and what can unsettle me. Things are relatively back to normal for me now, well my normal at least, no high levels since last Thursday and not seemingly having to take any extra insulin anymore, so all good again.

Rob

 

[Rob110577]

Hi @Rob110577,

Have had similar fun. Was using Novorapid for 20+ years (might be longer) and developed resistance. Had over-injected the same sites which caused the fat to go lumpy and cause resistance.

Swap sites to uninjected bits - worked great again. Switching insulins to a different type probably wont help, Novorapid (in my experience) is quite stable most of the time.

The Ultrafasts (Lyumjev and Fiasp) can give different issues - I use Fiasp now for speed in my pump-loop and it needs a bit more understanding and experimentation than Novorapid, Lyumjev didn't like me at all.

I recommend trying different injection sites and go from there.

Cheers,

Rob.

Hi Rob,

Thanks for your reply. I've been using NovoRapid since I was diagnosed back in 2001, so for it to suddenly stop working or not be as affective was worrying. Thankfully everything has settled back down again now (new vial might have been the fix). I have a good visual map for injection sites on my body and thankfully I've never developed any hard spots or lumps - I know the risks of over using the same place, but also know it's very easy to get comfortable with somewhere you feel happy to inject.

I'm very grateful that for the majority of the time my levels are good and I don't have to worry, but it's difficult when things unexpectedly catch you off guard and you can't explain it.

Rob

 

[becca59]

Hi Rob. Whenever I have ridiculous unexplained results I change the insulin vial. Just had to do the same with my Tresiba. After two days of banging my head against the wall I realised it was losing its efficacy. A couple of days into the new vial normal service resumed.

 

[Tony337]

Hi again Tony,

Sorry for taking a while to reply back again. I don't have a CGM, I have been offered a senor, but I wasn't overly keen on the idea of having something attached to me constantly. I'm autistic, so I do find change extremely difficult and have very set ideas about things and what can unsettle me. Things are relatively back to normal for me now, well my normal at least, no high levels since last Thursday and not seemingly having to take any extra insulin anymore, so all good again.

Rob

Hi Rob
With regards the CGM i'm a bit stuck in my ways having been a type 1 for 50 years but the Libre has improved my life as well as control in such a way i wouldn't be without it now.
Its the alarms...being able to go to bed knowing it will wake me up if i'm low to me is a marvel.
Its connected to my watch too so a quick glance at my watch tells me all i need to know (v useful when driving) and i'm 4.8 as i type.
I'm being made to change insulins after easter as they are discontinuing making levemir and its my libre that will make the change achievable as i do not see a specialist or DSN.

This is just my take on it and do understand your point of view and to quote my favourite Time Lord...
"never be certain of anything as its a sign of limited intellect"

I wish you well
Tony

 

[Rob110577]

Hi Rob. Whenever I have ridiculous unexplained results I change the insulin vial. Just had to do the same with my Tresiba. After two days of banging my head against the wall I realised it was losing its efficacy. A couple of days into the new vial normal service resumed.

Hi Becca,

I've never been given the advice before to change my vial and it never even occurred to me that might have been the cause. My NovoRapid is definitely working again now as it should be as I'm now back to trying to stop myself from going too low. It's such a fine balance and just the slightest thing can throw everything off. Knowing yourself and all the experiences you have with this condition is invaluable, but it's so good to be able share this with other people who understand and get what you're going through.

Rob

 

[Rob110577]

Hi Rob
With regards the CGM i'm a bit stuck in my ways having been a type 1 for 50 years but the Libre has improved my life as well as control in such a way i wouldn't be without it now.
Its the alarms...being able to go to bed knowing it will wake me up if i'm low to me is a marvel.
Its connected to my watch too so a quick glance at my watch tells me all i need to know (v useful when driving) and i'm 4.8 as i type.
I'm being made to change insulins after easter as they are discontinuing making levemir and its my libre that will make the change achievable as i do not see a specialist or DSN.

This is just my take on it and do understand your point of view and to quote my favourite Time Lord...
"never be certain of anything as its a sign of limited intellect"

I wish you well
Tony

Hi Tony,

It's all those little ways that really help to manage things and finding what works best for you. My body does wake me up if I go too low when I'm sleeping, but I can see the benefit and peace of mind of having an alarm to let you know.

I've got to change Levemir sometime this year too. I've still got quite a few vials left and I can still order more at the moment - one vial usually lasts me about five weeks. I don't know what the replacement insulin will be yet, but hopefully it won't be too different. I haven't seen my diabetic consultant for quite sometime as when I do it's usually a five minute conversation with her and then I'm off again. I do see a diabetic nurse more often, so hopefully they can help with the transition when I need it.

Thanks for the quote too - I missed that era, Mr Davidson was my Doctor growing up and Mr Tennant is my favourite from the modern era, before the show seemingly lost it's way.

Wishing you well too.

Rob

 

[becca59]

Rob it is interesting when you say your Levemir lasts five weeks. My Tresiba would last at least that long and it does say on the packet it will be good for six weeks. However, as time went on I realised, yes it keeps working, but a lot less efficiently. I was injecting lots of Fiasp to correct continuing higher numbers. I decided to start changing vials at three weeks, the difference in my management was marked. Just occasionally like this week I forget. Yes I felt awful disposing of a half vial of expensive insulin, but in reality I was using a lot less Fiasp. So swings and roundabouts and I am happier with a better TIR showing on my Libre.

 

[JJ2026]

I'm having great difficulties with Novorapid. It's not the pen, as a new one has been the same. I used to be able to take 1 unit of NR and my blood sugar would drop between 2.5 - 3 units per unit of NR and that was how I would gauge how much to take before a meal, based off BS readings, Now, 2 units drop me 1.5 units tops, combined.

My diabetic nurse told me to eat anyhow but that's dangerous talk. I was at 12.9 and with the food I was due to eat, I would have gone Hyper. Now, I have to use exercise to bring the levels down enough to eat and then exercise again half an hour later, so there isn't such a spike. I don't know what is happening, in this regard. It's frustrating.

I'm currently at 15.1 and have taken 2 units of NR and an hour later, the reading is exactly the same. I have drunk 1.5 litres of still water today. I have exercised.

 

[Rob110577]

I'm having great difficulties with Novorapid. It's not the pen, as a new one has been the same. I used to be able to take 1 unit of NR and my blood sugar would drop between 2.5 - 3 units per unit of NR and that was how I would gauge how much to take before a meal, based off BS readings, Now, 2 units drop me 1.5 units tops, combined.

My diabetic nurse told me to eat anyhow but that's dangerous talk. I was at 12.9 and with the food I was due to eat, I would have gone Hyper. Now, I have to use exercise to bring the levels down enough to eat and then exercise again half an hour later, so there isn't such a spike. I don't know what is happening, in this regard. It's frustrating.

I'm currently at 15.1 and have taken 2 units of NR and an hour later, the reading is exactly the same. I have drunk 1.5 litres of still water today. I have exercised.

Hi JJ,

That all sounds very frustrating. I really hate it when things go haywire without explanation and then you're struggling to find your way back to your normal range. I get unexplained hypers sometimes when I've eaten the same food and taken my normal amount of Novorapid and then when I test four hours later my blood sugar levels are sky high, when I've eaten the same thing and taken the same amount of insulin from the previous day and my levels had been fine.

I do find my body is very sensitive to change and more often than not I can track something I might have done differently from the day before and I can figure out the reason for why I might be higher than I normally would be. Exercise is really a good way to keep my sugar levels balanced too and just being generally active throughout the day.

I don't think what your diabetic nurse said is necessarily the best advice. I do wonder whether you've had a virus and not realised. Being ill always affects my insulin regimen and I usually have to double the amount of Novorapid I take when I'm poorly.

Hope everything settles down for you.

Rob

 

[JJ2026]

I don't think what your diabetic nurse said is necessarily the best advice. I do wonder whether you've had a virus and not realised. Being ill always affects my insulin regimen and I usually have to double the amount of Novorapid I take when I'm poorly.

What I have noticed is that having an org**m always affects my levels for days after. The problem is, the process is automatic and there is nothing I can do about it. Nocturnal stuff. Yes, messes with my blood sugars no end and I'm not sure why.

Hope everything settles down for you.

Thank you.

 

[Antje77]

I'm having great difficulties with Novorapid. It's not the pen, as a new one has been the same. I used to be able to take 1 unit of NR and my blood sugar would drop between 2.5 - 3 units per unit of NR and that was how I would gauge how much to take before a meal, based off BS readings, Now, 2 units drop me 1.5 units tops, combined.

My diabetic nurse told me to eat anyhow but that's dangerous talk. I was at 12.9 and with the food I was due to eat, I would have gone Hyper. Now, I have to use exercise to bring the levels down enough to eat and then exercise again half an hour later, so there isn't such a spike. I don't know what is happening, in this regard. It's frustrating.

Insulin needs aren't static, they change over time and even more so in newly diagnosed like yourself.
In time, you'll learn to adjust your doses for food and corrections.
I'd also see if you can be signed up for a DAFNE course.
This is typically aimed at T1's, but because both T1 and T3C mean a lack of insulin, treatment and dose adjustments work largely the same.

Home - DAFNE

DAFNE stands for Dose Adjustment For Normal Eating. It aims to help adults with type 1 diabetes lead as normal a life as possible.

dafne.nhs.uk