Can novorapid act differently for each person

[johnmtp]

Hi all,

I was diagnosed with type 1 in march of this year, and have been put on Lantus and Novorapid.
I was told Novorapid is active for 4 hours, but not sure this is the case with myself.
I take 5 units Lantus at 8am, the Novorapid with each meal (1:35 ratio with breakfast / 1:20 at lunch / 1:12 at evening).
I have my lunch at 12.30pm (bg is in range), and usually have a bg test about 4.30pm for driving home at 5pm, and my bg is still highish (8 to 12mmol),
but by the time I have my evening meal (between 6pm and 7pm) it will be ok (5 to 7mmol) and sometimes drops low (3 to 4mmol).
So, is the Novorapid active longer for me, or do you think I could be taking too much Lantus, and not enough Novorapid?
I will speak to my diabetes nurse about this, but I don't see her for another 3 weeks.

Thanks,

John

 

[toby64]

Hi John,
There are many things that can change you BSLs eg. stress, pain, illness, headaches,and different foods have a short or long digestive time all these will make a difference, a thought may be to Graph your BSL readings as well as using your control books, by graphing it can show pattens that may be happening, and you can adjust your insulin to suit the highs or lows, also put it to a time line so you can see for yourself what is happening and when the insulin's seem to be ending this may mean you will need to take more monitoring, but may show up problem areas for you.
Another thought, is that if you picture a set of scales in your mind, then put your food on one side, and now imagine that you are putting you insulin on the other side, they need to make the scale balance, this is what you are doing with insulin, try not to become worried about little hick ups along the way they will always happen as long as you manage to keep a good average balance, [HBA1C} you will be doing well.
I have been a diabetic for over 50 years, and believe that stress is the one you need to watch for.
Also keep in mind that nova rapid is still overlapping your lantus and that the long acting may be part of your issues but as stated look at graphing to help show this up.

Kind regards
Toby64

 

[johnmtp]

Thanks for the reply,
At lunch I normally have a sandwich, banana, crisps and a yoghurt, most of which I believe are slow release carbs. I suppose this could account for the highish bg levels at 4.30pm and then the rapid drop just before my evening meal.
Would increasing my Novorapid ratio at lunch affect the slow release carbs? or would it stop being active before the release of the sugars into my system?

 

[iHs]

The sandwich, banana and crisps are not really slow release carbs so will be the cause of needing more insulin to deal with the spike . Better off just eating the sandwich

Sent from the Diabetes Forum App

 

[johnmtp]

The sandwich, banana and crisps are not really slow release carbs so will be the cause of needing more insulin to deal with the spike . Better off just eating the sandwich

Sent from the Diabetes Forum App

If I had just the sandwich I would be starving by 3pm ! - maybe need to find something else to eat that's not carbs to keep me going

 

[iHs]

What you can do is bolus for the sandwich but eat a very small carb snack mid afternoon. This will stop the novo from causing the low bg as it stsrts to end its action, will give you better bg control and will curb yr appetite

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[johnmtp]

I could give that a try .. have my sandwich and then mid afternoon maybe the banana.

 

[bonus]

I had a book once (i think it came in a news paper) with foods pictured with the levels of sugar that is in them. (equivalent to something, cant remember) GI maybe.

A banana was in the highest at 7 tea spoons of sugar.

 

[Pilgrim22]

When you get home, are you doing any exercise in any shape or form, as it can lower BGL.


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[iHs]

Although banana doesn't cause my bg to change very much, that's not so for many, so best eat something far lower in carb than banana. How much carb is down to trial and error and bg testing. Ideally, dont bolus for the snack, just eat something to curb the bg lowering effect of the bolus.

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[SamJB]

Could be Lantus. The way to check whether it's right or not is by not eating or injecting fast acting a few hours before bed. If your before bed and before breakfast readings differ by more than 1.6 mmol/l, then your Lantus is out by at least 10%

 

[dtennant9]

I know this is not the same for everybody but Ifind massive differences in how long NovoRapid hangs around for based on my injection site.
I've always been told that the abdomen is the fastest and outer thigh is slower, but if I inject in my thigh I find it is so much slower. Unless I'm out for a walk when the reverse happens.

 

[Heathenlass]

Could be Lantus. The way to check whether it's right or not is by not eating or injecting fast acting a few hours before bed. If your before bed and before breakfast readings differ by more than 1.6 mmol/l, then your Lantus is out by at least 10%

Sorry if I'm hijacking the thread, but I'm seriously confused about checking the levels of Lantus I suspect mine may be wrong, and all the info I've found so far seems to be based on once daily injections, and I split mine, so I'm not sure how to test. I'm waiting for a referral to the clinic, but that will probably be some time away yet.

Any advice, or a link to a previous thread on this would be so welcome

Thanks!

Signy

 

[noblehead]

Sorry if I'm hijacking the thread, but I'm seriously confused about checking the levels of Lantus I suspect mine may be wrong, and all the info I've found so far seems to be based on once daily injections, and I split mine, so I'm not sure how to test. I'm waiting for a referral to the clinic, but that will probably be some time away yet.

Basically you eat a low-fat meal and then test your bg 4 hours after your meal and QA injection, you then skip the next meal (and injection) then continue to test your bg up until the next meal-time, if your basal insulin is correct your bg shouldn't fluctuate much more than -/+ 1.5mmol.

Whilst carrying out basal tests you should not eat anything even if it contains zero carbs, also you should stick with plain water if you can.

 

[SamJB]

Sorry if I'm hijacking the thread, but I'm seriously confused about checking the levels of Lantus I suspect mine may be wrong, and all the info I've found so far seems to be based on once daily injections, and I split mine, so I'm not sure how to test. I'm waiting for a referral to the clinic, but that will probably be some time away yet.

Any advice, or a link to a previous thread on this would be so welcome

Thanks!

Signy

I got my technique from Gary Scheiner's Think Like a Pancreas book. You can do what Noblehead said and skip meals, but I don't fancy that so just follow what I posted above. I also inject my Lantus in the morning, so that I know that if it changes (and it does frequently) I can act on that change immediately, instead of waiting all day to inject the new dose in the evening.

 

[PaulinaB]

Plus, actual acting time for novorapid is anywhere between 3 and 5 hours.

 

[Pattidevans]

Heathenlass

To test your basal use the technique as per the instructions half way down this page http://www.diabetes-support.org.uk/info/?page_id=120 It doesn't matter whether you are injecting once or twice a day, the same instructions and methods work.

 

[Heathenlass]

Thank you all
Patti - thanks, I tried that from your link, but got myself in a mess of confusion as I wasn't sure if the Lantus splitting had any effect on the results, and I'm not at all sure that my conclusions from that were correct - maths is definitely NOT my strong point

Now, following this unscheduled interval... back to normal service and the thread relating to the OP

Signy

 

[spaceman]

Hi all,

I was diagnosed with type 1 in march of this year, and have been put on Lantus and Novorapid.
I was told Novorapid is active for 4 hours, but not sure this is the case with myself.
I take 5 units Lantus at 8am, the Novorapid with each meal (1:35 ratio with breakfast / 1:20 at lunch / 1:12 at evening).
I have my lunch at 12.30pm (bg is in range), and usually have a bg test about 4.30pm for driving home at 5pm, and my bg is still highish (8 to 12mmol),
but by the time I have my evening meal (between 6pm and 7pm) it will be ok (5 to 7mmol) and sometimes drops low (3 to 4mmol).
So, is the Novorapid active longer for me, or do you think I could be taking too much Lantus, and not enough Novorapid?
I will speak to my diabetes nurse about this, but I don't see her for another 3 weeks.

Thanks,

if youve been a type 1 since march youll be still in the( honeymoon period ) your diabetic nurse will be controlling your doses of novorapid and Lantus IM ON NOVORAPID & LANTUS myself been a type 1 for 2 years now

 

[spaceman]

[/ regarding you driving has your diabetic nurse mensioned informing DVLA swansea regarding you driving and a new insulin taker ? ok the dvla medical group get involved , there check with your GP at random, there take your licence off you for about 2/3 months then re issue with a new one short term licence that lasts 3 years'