Changing bolus for humulin R - avoiding hypoglycemia and hyperglycemia after every meal

[bhk]

View attachment 21708

Hi all,

I have big struggles since a few weeks/months. My bolus insulin being humalog (since maybe 15 years), each time that I eat, I noticed that I tend to have a rapid increase in my blood glucose and it raises for about an hour, then starts to drop. So to solve the issue I take the insulin and wait for 15-30 mins before eating (depending on what I eat). The problem is lately, the drop (between hours 1 and 2) is MASSIVE. Even with very low quantities of insulin, I often get in hypo very quickly and intensively, then at hours 3 and 4 I get a huge rise in the blood sugar. I tried to vary my diet and make some observations, and to analyze the situation better I eat few lipids and proteins during meals to be sure these aren't an underlying cause of the problem.

I think that the problem is actually that I absorb carbohydrates at a steady rate, for a long time (3-4 hours) and the peak of humalog is clearly not appropriate. You can have a look at the graphs on the picture. This is happening almost at every meal, and I really want to solve the issue as it is a constant stress all day, day after day. My best approach so far would be to try an insulin that is still rapid but with a less pronounced peak and longer time of action, which seems to correspond to humulin R. Has anyone switched from a very rapid analog (novolog, humalog, etc.) to humulin R or a similar insulin (pork insulin for instance)?

Thanks a lot!

 

[bhk]

 

[tim2000s]

Hi @bhk, given your suspicions, have you ever done a carb absorption test to see just how quickly you really absorb carbohydrate?

It's very straightforward. When you have a level glucose level for an hour, eat around 15g of fast carbs on one occasion and slower carbs on another, and test every ten minutes until your glucose levels have stopped rising and are flat. This will tell you how long carbs are taking to absorb.

 

[diamondnostril]

Hi @bhk . . .

A few years ago I had similar problems to what you describe . . . I was generally eating low-carb and injecting Humalog, and in the 2 hours after eating I would drop too low. It made a huge change to me when my Doctor asked me to try Humulin S for my meals - the fit was much better.

Since then, I've never had any problems with getting prescribed 2 Bolus Insulins from any Doctor - I've moved around a fair bit and no Doctor has ever been against it. I use the Humulin S for my normal (Ketogenic) meals, and I use the Humalog for any corrections and for my scheduled binge days.

If you are able to identify a Bolus Insulin which fits better to your regular meals, you don't necessarily have to switch from the Humalog; you can probably get both and use them as needed.

Best Wishes,
Antony

 

[bhk]

Thanks a lot guys, your advices are really helpful and appreciated in these struggling times...