Correction doses

[Lva1989]

Hi there I have recently been diagnosed type 1 (3 weeks ago) originally thought as type 2 but doctors were quick to link all my autoimmune stuff and carry out extensive bloods which showed type 1.

For 3 weeks I’ve been taking Levimir morning and night but the dietician just said to start on novarapid now I have done my Bertie training. And having high readings after carbs.

Just a question about correction doses, she’s started me on 1 unit - 5mmol as a starter and see how I go she said better to start lower then build up.
At what point should I I see my blood sugars lower after a correction dose? Like how long do I have to wait?

Novarapid really scares me and I am starting on days when I am at home so i can check sugars regularly.

Many thanks
Leanne

 

[In Response]

One thing you will see again and again is that we are all different.
But to get an idea of the length of time insulin takes to work, it is useful to look at the profile graphs (Google "NovoRapid profile graph"). This shows how long NovoRapid starts to work, when it is at its most potent and how long it is still active. On average!
So, usually, it starts acting in about 20 minutes and lasts 5 to 6 hours wit a peak in the middle.

This profile is very useful to understand to avoid "stacking" - adding extra fast acting insulin to bring your blood sugars down when you already have some active in your body. This is often referred to as Insulin on Board or IOB.

The other thing to bear in mind is the multitude of things that can affect our blood sugars. Another thing to Goggle is "42 factors that affect Blood Glucose" to see If we take a correction dose just as we start a stressful meeting, the correction may not have as much effect.

Sorry, that was a long winded way of saying, it varies but you should see some impact within 30 minutes

 

[Lva1989]

One thing you will see again and again is that we are all different.
But to get an idea of the length of time insulin takes to work, it is useful to look at the profile graphs (Google "NovoRapid profile graph"). This shows how long NovoRapid starts to work, when it is at its most potent and how long it is still active. On average!
So, usually, it starts acting in about 20 minutes and lasts 5 to 6 hours wit a peak in the middle.

This profile is very useful to understand to avoid "stacking" - adding extra fast acting insulin to bring your blood sugars down when you already have some active in your body. This is often referred to as Insulin on Board or IOB.

The other thing to bear in mind is the multitude of things that can affect our blood sugars. Another thing to Goggle is "42 factors that affect Blood Glucose" to see If we take a correction dose just as we start a stressful meeting, the correction may not have as much effect.

Sorry, that was a long winded way of saying, it varies but you should see some impact within 30 minutes

No that was super helpful thank you, I know it’s all gonna be pretty trial and error as as everybody is different! Just abit panicky as never experienced a hypo before

 

[In Response]

No that was super helpful thank you, I know it’s all gonna be pretty trial and error as as everybody is different! Just abit panicky as never experienced a hypo before

Hypos can be scary.
One piece of advice I was given when I was first diagnosed (but not from a HCP) was to force a hypo in a safe environment. So, with someone next to me who I trusted, with a pot of dextrose within easy reach, I took an extra unit of NovoRapid. Knowing what I could experience in the future took away some of the fear. I am not saying it was pleasant ... or that any hypos are pleasant ... but some of the fear is the fear of the unknown.
I am sure there are HCP who would go white at the thought of doing this but it helped me.

 

[TashT1]

I was tempted to try that, it’s the fear of the unknown but instead I did a hypo course online & there was so much info I felt less concerned.

If you google hypo awareness course it should come up, it’s free & it’s reasonably quick to complete

 

[urbanracer]

Hi there I have recently been diagnosed type 1 (3 weeks ago) originally thought as type 2 but doctors were quick to link all my autoimmune stuff and carry out extensive bloods which showed type 1.

For 3 weeks I’ve been taking Levimir morning and night but the dietician just said to start on novarapid now I have done my Bertie training. And having high readings after carbs.

Just a question about correction doses, she’s started me on 1 unit - 5mmol as a starter and see how I go she said better to start lower then build up.
At what point should I I see my blood sugars lower after a correction dose? Like how long do I have to wait?

Novarapid really scares me and I am starting on days when I am at home so i can check sugars regularly.

Many thanks
Leanne

What are your glucose levels like?

I ask because if they've been high for a while then it's quite normal to experience something called a 'false hypo' as you bring your levels down.

You won't be clinically hypoglycemic (below 4mmol) but you may well experience some the symptoms and learn to know what it feels like.

 

[searley]

To be fair if you’ve been a bit high for a while then you’ll probably feel a hypo quite early and you should be able to feel it quite well just have some dextrose tabs or something handy

For me I see a drop within 20 mins of taking with a peak at about 70 minutes and finishes working after about 4 hours

For me 1 unit will drop me by about 3mmol

You don’t really want to correct unless you are massively high after 2-3 hours and not aim to get a too lower number certainly until you have more knowledge of how thing will affect you

Good luck

 

[Jaylee]

Hi there I have recently been diagnosed type 1 (3 weeks ago) originally thought as type 2 but doctors were quick to link all my autoimmune stuff and carry out extensive bloods which showed type 1.

For 3 weeks I’ve been taking Levimir morning and night but the dietician just said to start on novarapid now I have done my Bertie training. And having high readings after carbs.

Just a question about correction doses, she’s started me on 1 unit - 5mmol as a starter and see how I go she said better to start lower then build up.
At what point should I I see my blood sugars lower after a correction dose? Like how long do I have to wait?

Novarapid really scares me and I am starting on days when I am at home so i can check sugars regularly.

Many thanks
Leanne

Hi Leanne,

I normally see a stop before a turn around with a correction dose on wayward bloods around an hour later?
I agree with the guys above regarding "false hypos." Pending on what & how long the high BGs you have been acustomed to.
You may get symptoms in the normal range? Hypo symptoms can vary. My lower field of vision shimmers or has LED style flashing lights. Cognitively I can still function, however the brain has a feeling it's in a room looking for something & forgotten what & why..

Alway back up anything you feel with your meter.
Though your high readings after eating, could be your dosage timing regarding the novorapid's working profile not quite complimenting your BGs with the meal?

Home experiments forcing a low with someone you trust..? I would be wary of that one. Untill you know what you are capable of when low that person you know based on mutual trust could see something "dark."

I'm pretty dopey & passive, but others have given acounts of agression, conforontational & or denying they need something to eat, throwing the help back at a loved one..

I myself was assaulted by a hypoglycieminc customer 20 odd years ago. I had to wrestle the guy across the counter when he lunged at my throat?
He did come back an hour later sheepish & apologised.. We shook hands. Lucky for him I understood the deal.

 

[searley]

At one point the used to force hypos in hospital prior to discharge

I believe this is no longer done due to risk of brain damage????


Either way I wouldn’t personally risk it as mentioned above you may not be co-operative

Also you could be on dodgy ground legally if you have a driving license as any daytime(awake) hypo requiring the help of another person should be notified to the dvla and could risk your driving license

Also if you have a driving license have you notified the dvla you are on insulin as you are required to?

And it’s wise to notify your insurance too

 

[StewM]

I’d highly recommend trying to get a Libre if you haven’t got one already, as these can be valuable in 1) preventing Lows before they happen/get serious and 2) helping you become aware of how different Blood Sugar levels feel.

 

[Lva1989]

Thank you all for your advice it’s been really helpful, My blood sugars have been between normal and 18 since I’ve started measuring them! I’m not sure if forcing a hypo is somthing I want to do, as I have seen patients experiencing them at work, think that’s probably why I’m so nervous! But it’s interesting about the false hypos.

The diabetes nurse said I have to wait 6 months before they consider giving me a libre, however I should be able to get one on nhs as I work in A&E (paediatric) and could prove due to a busy job I don’t have time to finger prick non stop!

I have notified the DVLA just waiting for them to send my nee liscence, I don’t drive long distances really, work is 10 mins away.

So far today my first time using novarapid checked and was around 6 which was great! I’m just going to spend a few days monitoring very closely!

I’m aware I’m probably honeymooning and my doses will change a lot, just gonna take some time to adjust to it all .... very overwhelmed right now!