Confused about speed insulin and carbs speed

corbanwolf

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Hey
Recently I found myself spiking quite often, even after probolusing A LOT. The food I eat causes me to spike a lot and very quickly. I eat on breakfast, for example one crumpet 16g carbs, 250g yoghurt 12g carbs, and one medium apple 20g carbs, so in total it is 50g carbs so it is 5units of my Humalog insulin. But I add extra 1unit cuz I know I will spike. And I injected 2h ago and the insulin is still not working. My carbs are being digested very quickly and cause spikes, I sometimes pre bolus even 1h, just to see, that sometimes, the insulin I inject, it is not delayed, it simply doesn't work at all, or, will work after like 5h in the middle of the night. I know this is to be not advised, but I gave up, and I simply inject into the muscle. I cannot wait 2h and gamble if insulin will work or not, or plan 6h ahead. I eat now and I need my insulin to work now, or even 30min is still acceptable to me.

I found different spots on my belly react at different speed. I will attach a picture. Please let me know if you experience same thing and what parts of belly do you inject too. I feel a bit lost. Sometimes insulin seems like doesn't work, but actually it works, but is delayed 5h-6h.
In general, the further from the belly button, the slower the insulin works, and, sometimes, doesn't work at all.
 

In Response

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Due to Dawn Phenomenon and/or Foot on The Floor, breakfast boluses are not a great indicator of the speed insulin starts working because it is likely to be injected at the same time as your blood sugars are rising anyway.

However, if your insulin is working slowly at other times of the day, it could be useful to try one of the faster acting insulins such as Fiasp.

It may also be useful to do a basal test as the problem may be that you do not have enough background insulin.
 

Juicyj

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Hello @corbanwolf

Unfortunately there aren't exact set parameters for insulin speed/efficacy vs carbs eaten. Factors which influence insulin speed can be time of day, heat, type of carbs eaten/amount of fat, and even if you eat the same thing/inject the same amount of insulin every day, you will always get different results, then if you exercise this can speed things up too. Some areas may pool insulin too, so will peak later. I will very often take my bolus 20 mins early to try and balance this against my rise, but again this isn't precise or works every time.

Personally I will avoid carbs at certain times of the day because I cannot manage the rise, but how you respond to insulin is unique to yourself, it takes trial and error and it's good to keep a diary to record info to help you manage this more easily also as evidence to support your case if you need to get your insulin changed.
 
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KK123

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I personally think it's just guesswork and follows NO rules that you could actually logically apply. Wherever you inject it seems to take a different pathway every time to wherever it is supposed to go, sometimes it decides to do a bit of sightseeing along the way and takes the scenic route, and at other times I swear it sprints directly to the spot and gets to work. I've given up trying to establish the 'best' time to give it or place to inject, the outcome is ALWAYS different. x
 

ert

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I have a Freestyle Libre so can see when my blood sugars start dropping after taking fast-acting and before eating. Dr Berntein (Diabetes Solution) recommends waiting until they have dropped 0.3 mmol/l. The time for this to happens varies enormously every day.
 

StewM

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Yeah I’d personally say this is the biggest issue holding me back from “perfect” control. Even after collecting data and making predictions based on that data, I find it highly unpredictable when the Insulin will do what it’s supposed to.
 

KK123

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Yeah I’d personally say this is the biggest issue holding me back from “perfect” control. Even after collecting data and making predictions based on that data, I find it highly unpredictable when the Insulin will do what it’s supposed to.

I agree. I think sometimes people are given the impression that injected insulin will act exactly like insulin produced by the body. It doesn't. The body releases insulin in conjunction with other hormones, all working together intricately to ensure a smooth transition, released at the exact time it should be, stopped at the right moment and getting to where it should go at the right time and in the right quantity regardless of whether we are eating or not. Here WE are injecting a calculated (aka guessed) amount in a place nowhere near the pancreas, trying to measure the exact carbs in a food group, hoping that ALL of it gets to where it should go and works immediately (not all of it does according to my Consultant). Insulin is great of course and a life saver BUT it simply cannot do a 'perfect' job and when we try to make it we end up disappointed. They really should educate people that it is NOT a failure to 'manage' when levels go high or low, if we are able to keep it roughly within the targets then we're doing good (and if we're not, then it's not because we are doing bad). x
 

karen8967

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my stomach just does not work for me,i use thighs and bottom,also i changed to fiasp which i find a lot quicker to kick in.my levels do rise quite a lot of a morning and i cant tolerate many carbs were the rest of the day im fine ,if i ate crumpets and apples i wouls be sky high, the rest of the day i can eat what i want without too many issues(for breakfast i have 4 ryvita with cheese)hope you get it sorted x
 
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Juicyj

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They really should educate people that it is NOT a failure to 'manage' when levels go high or low, if we are able to keep it roughly within the targets then we're doing good (and if we're not, then it's not because we are doing bad).

Perfectly said - so many insulin users experience mental health issues because of trying so hard and still not getting it right, it's setting realistic expectations at the word go that's vital. I never forget the nurse saying to me when I was diagnosed type 1 that I needed to stay within 5-9 mmol/l and the reality was only getting within this range 40% of the time and beating myself up mentally when I didn't, it was only when my next DSN set me more realistic targets and worked with me to fine tune things that I felt better about this, teaching resilience is vital with diabetes care.
 
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sl0042

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I can sympathise with this problem; at present I am on Apidra & it takes about 3 hours to kick n. I started on Apidra & complained about the kick-in time; I was then put on FIASP a very fast acting insulin; on the literature it said it had to be administered 0 - 1 minute before eating; of course it still took about 3 hours.
Obviously these problems dont help to keep sugar levels low.
I am about to try another insulin to see if it works any quicker & if it does I will report back.
 
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