Delayed NovoRapid - Diagnosed 1 month Ago

[BekC]

Hi there!

25 year old from Australia here. I was diagnosed with type 1 a little over a month ago and have been feeling pretty good with everything and for the most part, I have felt on top of it. When I was admitted to hospital with what I thought was food poisoning, I had a blood glucose of 24 and Hba1c of 8.7. Within the last month since I started insulin, according to my contour next app, I have been averaging 7.5BG - and have managed to have a couple of night outs with some drinking, yummy food and been on a 2 week holiday overseas (with 24 hour long flights there and back) and managed ok- just testing lots and lots!!! I love my life, travel, going out with friends and with my supportive husband, I don't plan on giving that up.

I have been on Toujeo 10 units daily and Novo Rapid 1 unit for roughly every 13-15g carbs.

I have always been a bit OCD with my eating and plans, as I had an eating disorder a decade ago and a few little quirks like recording my food in a food diary have stuck with me which has actually helped immensely with this. I eat a reasonably low carb diet most of the time, average 80-100g daily and exercise daily. This was my diet and routine pre diagnosis so haven't changed too much.

On Tuesday I met with my endocrinologist and was given a Novopen Echo so I can do 1/2 units. Previous to this I was using the disposable Novopen Rapid. With the disposable pen, I found my BG was as expected after eating. I was generally around 7 mid morning and stayed within 6-8 throughout the day. I eat 25g carbs at my mid morning break and another 25g carbs around lunch time and was having 2 units with each of these meals resulting in a steady BG between 6 and 8 and could see the Novorapid taking effect within around 1hour as I was relatively steady when testing between 1-2 hours later.

As of Wednesday, I began using the Echo with Novorapid (I assume the refills are the exact same insulin as in the disposable version?) but it seems it has a super delayed effect now.

The pattern the past few days since using Novorapid in the echo pen has been as follows:

WEDNESDAY
10:30am 8BG > 2 UNITS > 25G CARBS
12pm 12 BG > 1 UNIT
1pm 12BG > 2 UNITS > 25G CARBS
2:30PM 11.4 BG > 2 UNITS
4PM 7BG
5PM 4.3BG

THURSDAY
11am 8.3BG > 2 UNITS > 25G CARBS
1pm 8.9BG > 2 UNITS > 25G CARBS
2:30pm 11.4BG > 1 UNIT
4pm 5.4BG

FRIDAY (Today)
8am 7.4BG
9:45am 9.9BG > 1 UNIT
11:45am 9BG > 2.5 UNITS >25G CARBS
1:20pm 9.5BG
2:20pm 8.4BG
3:45pm 6.7BG (NOW)

I seem to be higher in general in the morning so am going to raise my Toujeo dose to either 11 or 12 tonight which will hopefully bring me down a little, but I don't understand why Novorapid has suddenly gone from keeping me steady and working within an hour or so to now seemingly letting me rise for 5 hours later before hitting me all at once and going low? Previous to this week, if I was to take 1 unit on its own it would bring me down 4-5 in less than one hour.

Do you think the Echo pen has something to do with it? This began literally the day I started using it. I keep doing test squirts and it seems to be coming out, I have used a variety of different areas on my stomach. I just don't get it.

I have honestly felt really positive since my diagnosis however this sudden lack of control has really brought me down.

Any advice would be appreciated. I have actually spent hours on this forum in the past month and it has helped me immensely with getting the hang of things however, this is my first post.

Thank you in advance <3

 

[EllieM]

but it seems it has a super delayed effect now.

Have you looked at the use by date on the cartridges? Changed the cartridges? Could they have been left out in high temperatures? If insulin doesn't work properly then one of the first things to try is changing the cartridge....

Edited to add, welcome to the forums. You sound to be doing very well with coping with this illness.

Remember that if you are still in the honeymoon period, producing some insulin, you may get random fluctuations just because your pancreas is having a good, or bad, day.

 

[kaylz91]

As EllieM has suggested but its also possible that your basal needs or bolus ratios are changing so if a change of cartridge doesn't work first place to look at is basal, your bolus and corrections wont work if your basal is off so its really important to get that as precise as possible, then once you have that sorted if your still having problems then look at your bolus ratios xx

 

[Juicyj]

Hey @BekC Welcome to the forum

I also think you're doing incredibly well too - don't let blips destroy your positivity, we all get them, some we can work our why and other's we simply have to say 'next' and move on, it's all a learning curve though so please take this as a positive in regards to learning more about your condition.

I agree with Ellie, sometimes insulin out of the fridge can lose it's efficacy so best change it.

A good book to help with your knowledge and development is 'think like a pancreas', early on in my diagnosis I decided to learn and read as much as I could to empower myself and this book was one of the most useful reads I came across, written by a type 1.

Also hat off for taking the holiday and coping so well, don't let your type 1 hold you back from anything, we have to make adjustments at times but it shouldn't stop you fulfilling your dreams

 

[BekC]

Thank you @EllieM @Juicyj and @kaylz91 for the tips and the kind words of encouragement

The issue hasn't been as noticeable the past few days. After your comments, I upped my basal to 12 from 10 and I seem to be hovering in a better range now, I think. Maybe it was just a weird few days and the basal was a little off. I think it best if I try not to overthink it... Which is a bit of a struggle for me as I really want to get it right!

Thanks again everyone

 

[mentat]

Hi BekC! I'm from Sydney, diagnosed at 22 which was 9 years ago.

Do you think the Echo pen has something to do with it? This began literally the day I started using it.

Not likely. Stuff just changes, especially in the honeymoon period, and this was probably a co-incidence.

I have honestly felt really positive since my diagnosis however this sudden lack of control has really brought me down.

I know how it feels. One of the things you need to develop is "emotional hygiene." You have to develop a mindset where your BG results don't matter to you. They're going to be terrible sometimes, for no reason, and the natural human response is to get frustrated or feel you're to blame. But you have to just relax and say "Ommmm..."

You will need to learn to relax your expectations when diabetes is playing up, or when you need a little break.

Unfortunately diabetes is not "if-this-then-that". It's not 1+1=2. It's just a guessing game with rules of thumb that are usually OK.

Of course if you go in with that expectation and it turns out to be better, then no harm done