Bolus Insulin not working properly

Has anyone had the same problem?

  • Yes

    Votes: 3 100.0%
  • No

    Votes: 0 0.0%
  • Unsure

    Votes: 0 0.0%

  • Total voters
    3

SamFlood

Newbie
Messages
1
The past week or more there have been episodes where my bolus insulin just won't work properly. I'm on Novorapid, been diagnosed for almost 3 years. Recently I have been getting high blood sugars, some up in the 20s after meals. Then ill take a correction dose, 1 hour later will hardly come down, another hour same thing, another hour same thing until the morning when the insulin finally works. It feels like I'm taking long-acting insulin for meals when I'm using rapid-acting. Then it starts working fine before happening again. The episodes are only lasting longer and longer and happening more often. My ketones are fine, the highest I believe they have been was 0.3. I'm pretty sure I'm going into another now after a day of it working. This is crazy and I hate it.

I have tried changing insulin vials, even getting a new one from the pharmacy; rotating injection sites, but they haven't worked. This seems like it's a problem with my body and not the insulin!

What's going on? I need help this is getting worse!
 

In Response

Well-Known Member
Messages
3,373
Type of diabetes
Type 1
Treatment type
Pump
@SamFlood a few thoughts
- when our levels are high, we become insulin resistant so we need a lot more insulin to bring our levels down. For me, over 15 mmol/l, I need twice as much correction.
- have you done a basal test recently? You may be coming to the end of your honeymoon period and need a higher basal dose. My honeymoon period lasted 8 years but was probably longer than most, so after 3 years your pancreas may be producing even less insulin than it was a few months ago.
- you say you start the day ok and then your levels start to rise. Are you taking enough bolus for breakfast? Often we are more insulin resistant first thing in the morning due to dawn phenomenon so need a different insulin to carb ratio than at other times of the day. If you get this wrong, you will be out for the rest of the day.

I strongly recommend talking to your diabetes team - they should be there to help you.
 
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Seacrow

Well-Known Member
Messages
496
Type of diabetes
LADA
Repeatedly taking correction doses is called 'stacking' your insulin, and you need to be really careful when doing it. What you are doing is adding one insulin profile on top of another. Normally the 'tail end' of the insulin is tiny, when all of them add up it can cause a late and extremely sharp drop in blood glucose.

A couple of things may be happening. When your blood glucose is high you need more insulin to bring your blood glucose down by the same amount. You may be underestimating your correction dose. The other is insulin resistance. I don't know what kind of shape you're in, but being type one doesn't mean you can't have insulin resistance, and this will vary depending on exercise, health etc.

I don't know that it helps a great deal, but you are not the only one with this. Try discussing it with your diabetes medical team, they might be able to help.
 

Fairygodmother

Well-Known Member
Messages
4,045
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Bigotry, reliance on unsupported 'facts', unkindness, unfairness.
Hi @SamFlood, it might be a good idea to get in touch with your DSN and ask for a guide to basal testing. It’s a method to show whether or not your doses are right. It involves splitting the 24 hours of the day into four six hour periods during which you don’t eat anything and just watch what your blood sugars get up to. There are quite a few other factors involved such as the timing of the last bolus, the blood sugar level before you start, so it would be best to get it from your DSN.
I did try to google for a guide before I wrote this but was only able to find basal tests for pump users. Grrrrr! There are still a great number of us without pumps.
You may well need to change the bolus to carb ratio for eating too.
While you’ve got their attention, it might also be a good idea to discuss the insulin you’re using, and the ways correction doses are calculated.
If you keep a record of your blood sugars that also notes times of eating and doses of insulin taken, plus doses of basal, it would give your DSN information to work with.
You’ll probably find some of this in Bertie online.
Good luck.
 

Hertfordshiremum

Well-Known Member
Messages
385
Type of diabetes
LADA
Treatment type
Insulin
The past week or more there have been episodes where my bolus insulin just won't work properly. I'm on Novorapid, been diagnosed for almost 3 years. Recently I have been getting high blood sugars, some up in the 20s after meals. Then ill take a correction dose, 1 hour later will hardly come down, another hour same thing, another hour same thing until the morning when the insulin finally works. It feels like I'm taking long-acting insulin for meals when I'm using rapid-acting. Then it starts working fine before happening again. The episodes are only lasting longer and longer and happening more often. My ketones are fine, the highest I believe they have been was 0.3. I'm pretty sure I'm going into another now after a day of it working. This is crazy and I hate it.

I have tried changing insulin vials, even getting a new one from the pharmacy; rotating injection sites, but they haven't worked. This seems like it's a problem with my body and not the insulin!

What's going on? I need help this is getting worse!
Yes I have recently had the same problem lasting about 3 weeks. It’s been very frustrating and I haven’t been able to drive very much as I get bad blurry vision. However the last 2 days I have improved hoping this continues. I am seeing my nurse in a few weeks. In the meantime I have slightly increased my basal (as per quick email exchange with my nurse) and I have cut out various foods and discovered I am spiking very badly after 100g plain yogurt only 3.5G of carbs but this is sending me up to 13 about an hour later It’s taken a while and process of elimination to work this out. I am still in honeymoon period so could also be that, I also have bad bruising after injections but I agree with ‘In response’ it’s really hard to get your BG down from over 15 compared to 10. I am on Fiasp which should be quicker than Novorapid but think it’s been the yogurt and maybe just getting worse after 3.5 years now. I would get in touch with your nurse as could be a few reasons could you email her? I find if I put ‘getting ketones’ in the subject she been quick to reply.