Changing food requirements

[Nomi]

Hi all,

I'm hoping you might be able to help me out.

I've been T1D for 10 years, and on the pump the last two years. I switched to the pump due to rubbish absorption at injection sites.
In the last 18 months or so I have really started to struggle with how fast my insulin acts with respect to food. In the past (on MDI and initially on the pump) my insulin was done and dusted within a couple of hours and my BG was back to where it had been before eating. Now it seems to take ages to get it back down postprandial...a good 4-5 hours. If i test after say 3 hours and am high and then take more insulin to correct I end up hypo.

Is this something other people have experienced?

I don't think it is my basal rates, because when i don't eat my BG is pretty stable. I don't understand why I seem to react differently now when eating the same things I have always eaten?

For ages I could eat pasta ok, not excessive amounts but a small portion was fine. Now, even with the split bolus I feel exhausted as soon as I have eaten it...in fact i feel exhausted after anything that is vaguely 'high carb'. I have never had an issue with curry n rice etc... but recently if i eat it my BG is all over and i just feel zombified.
These are extreme examples as I don't eat these foods often, but just things like bread or tea cakes seem to cause me trouble in a similar way.
I try and limit the amount of carbs I eat...if i have carbs at all i try and keep it under 40/50 g in one sitting, and generally don't eat more than 150g (absolute max) in a day.

Any advice would be great, I'm getting a bit fed up with things and don't really know where to go from here to get it sorted.

Thanks

Nomi

 

[noblehead]

TBH I've not experienced the same, but if your bg levels are taking 4-5 hours to return to normal then it looks like your experiencing absorption issues @Nomi

Edit to add, maybe try bolusing more in advance to see if it help matters.

 

[Nomi]

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TBH I've not experienced the same, but if your bg levels are taking 4-5 hours to return to normal then it looks like your experiencing absorption issues @Nomi

Edit to add, maybe try bolusing more in advance to see if it help matters.

Thanks for reply @noblehead. I did think about that, and I have switched my cannula from my stomach to my thigh this time, but i still seem to be having the same problem...
I have spoken to the DSN and manufacturer about getting different cannulas but they wont change out my pump for another two years and no alternative cannulas are available for this model at the moment :S

 

[noblehead]

@Nomi , since moving to a pump the only site where I get a poor absorption rate is my legs, arms, stomach & sides seem fine but haven't yet used my bum.

I've expereinced lipohypertrophy problems before on MDI, it's characterised by a delay in insulin absorption, maybe get your pump DSN to check your sites over. Best wishes.

 

[1abRat]

I'd second what @noblehead said, try bolusing more in advance. You could also look into changing to Fiasp.

When I was on Novorapid I had to bolus 20-30 mins before most meals. On Fiasp today I bolused 5 minutes before eating a Subway and Snickers ice cream and "spiked" to 7.9 mmol/L before returning to pre-prandial 5.2 mmol/L within 90 minutes.

 

[Nomi]

I'd second what @noblehead said, try bolusing more in advance. You could also look into changing to Fiasp.

When I was on Novorapid I had to bolus 20-30 mins before most meals. On Fiasp today I bolused 5 minutes before eating a Subway and Snickers ice cream and "spiked" to 7.9 mmol/L before returning to pre-prandial 5.2 mmol/L within 90 minutes.

Wow that sounds like great stuff! I will try the advance blousing and see what happens. Thanks

 

[Deleted Account]

A few thoughts
- I don't understand why you split your dose. Not enough insulin when you need it will result in higher BG until your body has absorbed all the insulin.
- you don't mention your insulin to carb ratio. I was advised there may be absorption issues if you try to pump more than 10units in one go. Is this part of your problem or is it with all meals?
- I was going to mention changing your sites or taking your insulin earlier but this has already been suggested