Novorapid Very Slow

[static192]

hi iv been use novorapid and its taking literally 5 hours to get back to target level so was 9mmol other day took like 5 hours after meal. to get back to 9mmol this is happening reguardless what meal i have and its really annoying. i know alot of people get back to target within 2 hours does anyone esle take 5 hours to get back to there target level?.

 

[Jenny15]

This is a T1 question so I won't be able to offer any useful advice but I'm interested to know what your target level is? It that a pre-meal target?

 

[static192]

This is a T1 question so I won't be able to offer any useful advice but I'm interested to know what your target level is? It that a pre-meal target?

hey it was 9lol took about 5half hours thow to get back to 9

 

[Jenny15]

hey it was 9lol took about 5half hours thow to get back to 9

Thanks for the info. I think the T1s will have a few questions for you before suggesting things, but it will take a few hours before many of them are online, since most forum users are in the UK/Europe.

I think they will ask what your meals include, how many carbs in the meal, and what your insulin:carb ratio is. The may also ask about your basal insulin. Is your novorapid OK, like has it been stored correctly, not past its expiry date and is it working correctly, ie delivering the right number of units. The T1s can suggest ways to check this.

If your meal time insulin doses aren't enough for the grams of carb you eat at a meal, then I assume they wouldn't be enough to bring your BG down to 9 within 2 hours. if all these things are OK, then there may be other issues which I certainly don't know anything about, being a T2.

I'm sure you will be able to get the issue sorted out fairly quickly once you have more info and if needed a call with your diabetes nurse. The T1s on this forum are very knowledgeable.

 

[EllieM]

hi iv been use novorapid and its taking literally 5 hours to get back to target level so was 9mmol other day took like 5 hours after meal. to get back to 9mmol this is happening reguardless what meal i have and its really annoying. i know alot of people get back to target within 2 hours does anyone esle take 5 hours to get back to there target level?.

5 hours is quite a long time, but there are so many many factors that could affect this., as @Jenny15 said.

1) I assume you're on basal/bolus? What's your basal and how confident are you that it's correct?
2) Insulin sites : if you've overused a site it may be delaying the uptake of insulin.
3) Are you insulin resistant at all?
4) What's your daily total for basal and bolus?
5) What sort of carb regime are you on? (50g / 100g/300g per day???)

 

[SueJB]

hi iv been use novorapid and its taking literally 5 hours to get back to target level so was 9mmol other day took like 5 hours after meal. to get back to 9mmol this is happening reguardless what meal i have and its really annoying. i know alot of people get back to target within 2 hours does anyone esle take 5 hours to get back to there target level?.

Similar issue. I've not actually timed it but my Novorapid seems to work incredibly slowly too.....................so slowly in fact I checked the date on the current pen, the pack in the fridge both OK but started a new one anyway. Then I got really weird and bought a fridge thermometer. I eat low carb 30g-40g and don't have to use the stuff much except this morning when I woke with 12.8 and had to correct

5 hours is quite a long time, but there are so many many factors that could affect this., as @Jenny15 said.

1) I assume you're on basal/bolus? What's your basal and how confident are you that it's correct?
2) Insulin sites : if you've overused a site it may be delaying the uptake of insulin.
3) Are you insulin resistant at all?
4) What's your daily total for basal and bolus?
5) What sort of carb regime are you on? (50g / 100g/300g per day???)

@EllieM can I ask about Q3&4. How would you know if you're insulin resistant and what's the relevance of Q4?

 

[mountaintom]

Yeah mine sometimes takes 4 hours. Depends what type of food I’ve eaten.

 

[EllieM]

@EllieM can I ask about Q3&4. How would you know if you're insulin resistant and what's the relevance of Q4?

I think you'd be reckoning on being a bit insulin resistant if you've got a high ration of insulin to carbs (eg I reckon I'm a bit insulin resistant and I need 3 units for 10g, whereas the "starter" amount is 1 unit for 10g. ) Also my waistline is more than half my height so I reckon I'd be at risk of T2 if I weren't T1, I've got family history of T2 (and T1 , my kids are diabetically genetically doomed), and twenty years ago I needed significantly less insulin than I do now. But having said that, when I suggested to my diabetic specialist that I might be a bit insulin resistant she didn't seem to think so.

Q4 is maybe not that relevant, but it might give an indication of something being off and/or of insulin resistance. "Most" people apparently are on roughly equal amounts of total basal and bolus, though I suspect that isn't true of the very low carb crowd.

 

[tim2000s]

Hi @static192 - lots of detail and information needed in response to your query, and it's not a straightforward thing to answer.

First up, go and have a look at this page that talks about how long insulin lasts. It's quite important in understanding what happens: http://bit.ly/InsulinDuration

Secondly, Novorapid is often known as NovoSlow or Slovorapid. None of the rapid insulins are particularly fast, as most don't have peak action until 75 minutes after injection, meaning that it takes around 4-5 hours for them to bring you back in line if your ratios are correct and you bolus with eating.

When people get back in line after two hours, generally, they are doing something additional. The most common factor is to "prebolus" where you take the insulin 20-45 minutes before the food you are eating to give the insulin absorption profile a chance to match the food absorption profile of what you're eating. Why a period of time? Because different foods absorb differently, e.g. Meringues absorb very quickly, whereas a roast dinner is somewhat slower. As a result, prebolusing generally needs to be earlier for the meringues.

Then you also have other aspects about "dialling in" your basal dose, Carb Ratio, etc, that @EllieM mentioned, all of which need to be just about on point in order to best manage those food spikes.

 

[SueJB]

I think you'd be reckoning on being a bit insulin resistant if you've got a high ration of insulin to carbs (eg I reckon I'm a bit insulin resistant and I need 3 units for 10g, whereas the "starter" amount is 1 unit for 10g. ) Also my waistline is more than half my height so I reckon I'd be at risk of T2 if I weren't T1, I've got family history of T2 (and T1 , my kids are diabetically genetically doomed), and twenty years ago I needed significantly less insulin than I do now. But having said that, when I suggested to my diabetic specialist that I might be a bit insulin resistant she didn't seem to think so.

Q4 is maybe not that relevant, but it might give an indication of something being off and/or of insulin resistance. "Most" people apparently are on roughly equal amounts of total basal and bolus, though I suspect that isn't true of the very low carb crowd.

Thanks @EllieM I understand Q3 and almost had to laugh when you said about being at risk of T2. Q4 not quite sure I understand but heyho, I'm sure in the fullness of time all will become clear

 

[SueJB]

Hi @static192 - lots of detail and information needed in response to your query, and it's not a straightforward thing to answer.

First up, go and have a look at this page that talks about how long insulin lasts. It's quite important in understanding what happens: http://bit.ly/InsulinDuration

Secondly, Novorapid is often known as NovoSlow or Slovorapid. None of the rapid insulins are particularly fast, as most don't have peak action until 75 minutes after injection, meaning that it takes around 4-5 hours for them to bring you back in line if your ratios are correct and you bolus with eating.

When people get back in line after two hours, generally, they are doing something additional. The most common factor is to "prebolus" where you take the insulin 20-45 minutes before the food you are eating to give the insulin absorption profile a chance to match the food absorption profile of what you're eating. Why a period of time? Because different foods absorb differently, e.g. Meringues absorb very quickly, whereas a roast dinner is somewhat slower. As a result, prebolusing generally needs to be earlier for the meringues.

Then you also have other aspects about "dialling in" your basal dose, Carb Ratio, etc, that @EllieM mentioned, all of which need to be just about on point in order to best manage those food spikes.

Thanks @tim2000s very useful stuff and clear.

 

[Bluey1]

Depending on what I have eaten it can take me 4 - 5 hrs.

 

[porl69]

Hi @static192 is this happening with every meal?
Are you rotating your injection sites? I used to have this problem, many years ago, with Novo Sluggish but I rarely changed sites as it was comfy injecting in the same place!

 

[static192]

Hi @static192 is this happening with every meal?
Are you rotating your injection sites? I used to have this problem, many years ago, with Novo Sluggish but I rarely changed sites as it was comfy injecting in the same place!

hey yeah i do rotate sites and yeah with every meal its slow lol

 

[pearlzo]

hi iv been use novorapid and its taking literally 5 hours to get back to target level so was 9mmol other day took like 5 hours after meal. to get back to 9mmol this is happening reguardless what meal i have and its really annoying. i know alot of people get back to target within 2 hours does anyone esle take 5 hours to get back to there target level?.

Believe you mean...It takes me approx 4 hours...kinda strange...

 

[pearlzo]

Hi @static192 - lots of detail and information needed in response to your query, and it's not a straightforward thing to answer.

First up, go and have a look at this page that talks about how long insulin lasts. It's quite important in understanding what happens: http://bit.ly/InsulinDuration

Secondly, Novorapid is often known as NovoSlow or Slovorapid. None of the rapid insulins are particularly fast, as most don't have peak action until 75 minutes after injection, meaning that it takes around 4-5 hours for them to bring you back in line if your ratios are correct and you bolus with eating.

When people get back in line after two hours, generally, they are doing something additional. The most common factor is to "prebolus" where you take the insulin 20-45 minutes before the food you are eating to give the insulin absorption profile a chance to match the food absorption profile of what you're eating. Why a period of time? Because different foods absorb differently, e.g. Meringues absorb very quickly, whereas a roast dinner is somewhat slower. As a result, prebolusing generally needs to be earlier for the meringues.

Then you also have other aspects about "dialling in" your basal dose, Carb Ratio, etc, that @EllieM mentioned, all of which need to be just about on point in order to best manage those food spikes.

very informative...thankyou

 

[Mungobean]

Novorapid seems to take hours to bring my levels down; I’m thinking from the responses here, that should rotate my site as I inject blood thinners and another drug, and rely on the numb part of my leg

 

[Circuspony]

Mine has about a 6 hour window - I can bolus 45 min ahead of a meal if I'm organised. Nothing "rapid" about it

 

[becca59]

@static192 rule of thumb is if you are back in range 5 hours after initial reading then it is working. May not be what you want but is the expectation. I think in these days of Libre and TIR we all want faster outcomes. What I would say is your numbers at start were quite high, which would have an effect on speed. I personally would not be wanting to inject and eat on a 9. I feel it slows down the insulin. It seems to have to work harder.

 

[jackois]

I was told that your insulin dose was correct if it got your numbers back to within 2mmol of your starting number after 2 hours and it would tail down steadily after that.

Pre-bolusing works well if your meal times are planned but I woulldn't pre-bolus if out for a meal when you can't gaurentee how long your meal will take to arrive.