Blood glucose peaks with Novorapid - Apidra/Humalog better?

[etmsreec]

Hiya,

I know that the NIHCE guidelines state that my blood glucose should be something like 8 two hours after eating a meal, but mine are typically at least twice that. Leave measuring for three or four hours and they'll be in line with the recommendations.

So, that indicates to me that Novorapid really isn't as rapid as it claims to be. Would Apidra or Humalog be any quicker?

Current regimen is 1u Novorapid for 10g carbs. 6u Levemir 9am/11u Levemir 9pm
Novorapid is injected just before the meal. Most meals are around 80 to 100g carbs (yes, I'm a greedy ******!)

Thanks in advance

Steve

 

[noblehead]

Re: Blood glucose peaks with Novorapid - Apidra/Humalog bett

I believe Apidra is faster than Novo but has a shorter profile, have you tried injecting 10-20mins before to give the insulin a change to work before your food starts to digest ? Choosing foods that have a lower glycemic index can be helpful in preventing postprandial spikes along with reducing the carb value of your meals.

If you do inject in advance remember to test regularly and keep fast-acting glucose to hand.

 

[jopar]

Re: Blood glucose peaks with Novorapid - Apidra/Humalog bett

Yes Apridra reaches

Here's the onset, peak and duration times for each of them,

• Insulin Onset Peak Duration
  Novo 10-15min 3hours 4-5hours
  Humalog 10=15m 2hours 3.5-4 hours
  Apridra 10-15m 1.5 hours 2.5-3.5 hour

Roughly 80% of the insulin dose is used by the end of its peak period, and the remaining will burn out the system rest of the duration time..

But these are the clinic stats, for the individual, peak and duration can be slightly different, either faster or slower to burn out the system

As Nigel says, if you'll spiking perhaps giving a longer period between the injection and eating, might sort out the spike..

If not look at the type of carbs you'll eating, slight changes to these might resolve the problem

 

[iHs]

Re: Blood glucose peaks with Novorapid - Apidra/Humalog bett

Hi

Another option to consider is to change the ratio you are using so that your bg levels are lower 2-2.5hrs after the meal bolus. This will probably work but may need you to eat a very small snack about 3hrs after the meal bolus so that your bg levels still remain ok before you eat your next main meal.

I dont like the idea myself of bolusing in advance as I can never be sure if I am actually going to eat the carb that I've bolused for. I use Novorapid myself in a pump but am able to manipulate the basal rate a bit to suit the action of the Novo but the more carb that I eat, the more Novo I need and then the more unstable its action starts to be................. so I just have to keep testing.... testing... :roll:

 

[smidge]

Re: Blood glucose peaks with Novorapid - Apidra/Humalog bett

Hi Steve!

I use Apidra and I find it really good. Taken just before most meals it brings my BG back to pre-meal level by the two hour mark. However, there are exceptions:

1. With some food it works too quickly and I have to take it just after the meal. Otherwise I get a hypo at the 1 hour mark. Particularly true with meals that have little carb content but have a good amount of protein e.g. Chicken salad.

2. With some food I have to split the dose and take some before the meal and some an hour to two hours later to avoid my BG rising at three hours when the Apidra has worn off. This is particularly true of high fat meals. I think for me, the Apidra action is pretty much finished at two hours.

3. Some food is just flipping difficult! Cereal shoots me really high at 1 hour but the Apidra has it under control by two hours. I'm experimenting with taking the Apidra 15 minutes before cereal, but it's not working for me at the moment - still 12+ at 1 hour.

Just for your information and to put what I'vesaid in context, I generally low-carb, keeping my carb intake to less than 50g per day made up of 15g breakfast, 5g lunch and 20 - 25g tea.

Smidge

 

[CarbsRok]

Re: Blood glucose peaks with Novorapid - Apidra/Humalog bett

Hiya,

I know that the NIHCE guidelines state that my blood glucose should be something like 8 two hours after eating a meal, but mine are typically at least twice that. Leave measuring for three or four hours and they'll be in line with the recommendations.

So, that indicates to me that Novorapid really isn't as rapid as it claims to be. Would Apidra or Humalog be any quicker?

Current regimen is 1u Novorapid for 10g carbs. 6u Levemir 9am/11u Levemir 9pm
Novorapid is injected just before the meal. Most meals are around 80 to 100g carbs (yes, I'm a greedy ******!)

Thanks in advance

Steve

Like others have said, it all boils down to the time of injecting to meet your insulin and food peak. I was reading on another forum that research shows the analogues work best when injected at least 15 mins before eating. The fact you are back to normal at 4 hours would to me point in the direction of the time insulin given.

 

[ChrisMaleType1]

Re: Blood glucose peaks with Novorapid - Apidra/Humalog bett

I find it doesn't make a whole lot of difference whether you bolus 10 minutes or so before you eat - novorapid, after all, lasts for 3-5 hours. What does make a difference, and could probably explain why your sugars are back to normal after 4 hours is the type of carbs you eat. Do you eat potato, bread, rice etc? I know it's been mentioned a couple of times but, just to emphasise (in my opinion), a low (or perhaps medium) GI diet is crucial, or should be crucial, for most diabetics.

 

[noblehead]

Re: Blood glucose peaks with Novorapid - Apidra/Humalog bett

I find it doesn't make a whole lot of difference whether you bolus 10 minutes or so before you eat - novorapid, after all, lasts for 3-5 hours.

It does last 3-5 hours but takes around 15mins to start working, I find bolusing 10-15 mins before helpful in reducing postprandial spikes, as you say the gi of the food is important along with the portion size.

 

[ChrisMaleType1]

Re: Blood glucose peaks with Novorapid - Apidra/Humalog bett

I find it doesn't make a whole lot of difference whether you bolus 10 minutes or so before you eat - novorapid, after all, lasts for 3-5 hours.

It does last 3-5 hours but takes around 15mins to start working, I find bolusing 10-15 mins before helpful in reducing postprandial spikes, as you say the gi of the food is important along with the portion size.

I agree with that but how much of a spike can you get in 10-15 minutes? Depending on what a person's eating I might hazard an estimate at say 2 mmol maximum (I think). I think that Steve has peaks of about 16 mmol and there's no way that timing will sort that out. As I say, I think it can only be down to the gi of the foods. You can usually compensate for bigger portions by carbohydrate counting (which he's doing) and possibly splitting the dose into two but, in Steve's case, I still think it's more likely the type of foods he's eating. I'm not saying don't eat certain foods, though there are a few I wouldn't have now, but that it's really important to emphasize the importance of gi.