I use Toujeo and Novorapid. Switching from Toujeo to Tresiba this week. I do not have a half unit pen, but it would be really convenient if there even is a half unit pen with novorapid? I do use a CGM, the Dexcom G5, so I know what`s going on. I just can`t correct it, because every time I do 1 unit drops me 15 points. Double the points if I actually go out walking or shopping for one day. I do feel like **** all the time, but it is so normal to me now that when I don`t it`s not normal. I don`t care how I feel anymore physically, just care about the risks.
My advice is to go back to basics. That is, start from the beginning and don't assume that anything is right. Obviously, get help from your DSN and do tjings gradually as it's sensible to be cautious and to change one thing at a time.
I'd also suggest considering whether a change of insulin might be something that would help.
And do ask for a half unit pen. They're incredible useful, and available for most insulins. Your DSN should have some or you can just get your GP to prescribe the correct one(s).
Don't despair. There's an answer out there for youYou just need to find it - with the help of your team and hopefully the many Type 1s here, some of whom will have had similar problems.
If you don't already have it, get the book Think Like A Pancreas. It's fantastic for Type 1.
Tagging some helpful Type 1s for you : ) @noblehead @himtoo @catapillar @GrantGam @EllsKBells @tim2000s and there are many more : )
My doctor has always told me to inject right before I eat. I do see with my readings I could benefit from having the insulin on board 1 hour before I eat, but that is physically not possible as it would cause me to have massive hypos before the food kicks in. Once I did 1 unit bolus, my bg was 7 and turns out I did`nt need that 1 unit, cuz 20 minutes later my bg was 5 and kept going dow. I will ask for half increment pens, but are those profiled pens? I have always used profiled pens that I just throw away when I`ve used them up. I am switching my long acting insulin to Tresiba. The only thing I am wondering is if I would benefit from switching from novorapid to homolog. However I am not nearly confident enough to change EVERYTHING right now
Then I suggest two things only to prioritise - firstly, half unit pens; secondly, having your bolus at the appropriate time, which may allow you to reduce the amount of insulin you have and so avoid that drop after two hours.
You don't need to bolus an hour in advance. You should proceed with caution and gradually move your bolus forward eg try it 5 mins in advance for a few days and then increase to 10 mins. Very fast acting insulin isn't as fast acting as was originally thought, and most Type 1s need to bolus around 15-20 mins in advance of eating.
It sounds like you're having quite a few issues with your blood sugar. Can you also call your DSN for help?
P.S - I'm notbsure if they make half unit disposable pens but you don't need disposable pens. Re-useable pens are better, in my opinion - more robust, better mechanism, more environmentally friendly - and less bulky when travelling : )
P.P.S - you could try Humalog if you want. Not every insulin suits every person and it's worth a try.
Excuse the quick reply for now @Elise Broenlund
You'll probably find you can bolus at different times in advance depending on the meal (ie breakfast, lunch, etc) On pens I bolused with Humalog 30mins in advance of breakfast, 10 mins in advance of lunch usually, but could often get away with bolusing just 5 mins before my evening meal.
You've mentioned dropping before the food puts you up - have you asked about your digestion to make sure there are no issues with that that are affecting your control? What kind of things do you eat?
What you've said about the affect of walking (staying flat for 2 hrs then dropping) suggests your basal may be a bit high.
The re-usable pens are easy to,use : ) You just drop in a cartridge (like an ink pen) and screw a needle on. Each cartridge has 300 units so can last days. When it runs out you simply put a new one in. It takes seconds (literally).
Do you think switching from Novorapid to Fiasp would help solve my problems?
It is an even faster acting insulin that would be out of my body 3 hours after eating, might minimise my drops.
It is considered to be twice as fast as Novorapid, so I may need less of it and a lower basal, but what do you think?
If I'm honest @Elise Broenlund I think your basal probably needs to be modified first up as what you're describing doesn't sound like it's set right. Then you never answered whether you were carb counting, and if you're thinking of Fiasp, that's even more important than Novorapid or Humalog, as it acts that much faster, having the dose wrong has a much quicker impact.
Personally, before looking at Fiasp, I'd try and sort out Basal and Insulin Carb ratio, and count carbs properly.
I also would consider waiting for FIAsp until you are back from the US as it isn't available in the states.
Just my twopenneth.
If I'm honest @Elise Broenlund I think your basal probably needs to be modified first up as what you're describing doesn't sound like it's set right. Then you never answered whether you were carb counting, and if you're thinking of Fiasp, that's even more important than Novorapid or Humalog, as it acts that much faster, having the dose wrong has a much quicker impact.
Personally, before looking at Fiasp, I'd try and sort out Basal and Insulin Carb ratio, and count carbs properly.
I also would consider waiting for FIAsp until you are back from the US as it isn't available in the states.
Just my twopenneth.
I know this might sound quite blunt, but unfortunately, you get out what you put in. Given the description of your symptoms, I'm really surprised a pump didn't work for you as it sounds like the ideal solution to your issues given the much smaller doses that can be taken.
Your description of "I could easily do the same dose for 2 tacos as 2 potatoes" just adds to the impression that your basal is not set up correctly.
Whilst you say that insulin carb ratio doesn't work for everyone, you are the first person I've come across to say that. Like I said before, that's also usually a symptom of not having Basal set up correctly.
As others have said, I think you need to go right back to the start and act like you're newly diagnosed, and work everything out from there. You may be surprised at what you find!
Hi @Elise Broenlund Just wanted to quickly say that I use a NovoRapid half unit pen and it's great so would recommend trying to get one of those if you can. Basically you'll get given cartridges of NovoRapid which you insert into a re-usable insulin pen. Once the cartridge is empty you just pop in a new one
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