Help With "when" To Inject Please!

[Millie Brown]

I'm T1 but still have a wee bit insulin kicking about.
I'm only taking Rapid Acting Insulin at meal times and was told to inject before eating, just after eating or indeed, before and after if I'm not sure what I'm eating or change my mind. I get this.
Here's my problem. If I eat carbs, they take SO long to increase my bloods. The insulin makes me drop quite quickly and I end up having to eat to stop a hypo. Then, ultimately, I end up higher than I want to be.
This only seems to be an evening meal drama. Breakfast and lunch are less dramatic.
Have hospital this week so I will ask but on here, I get to ask LOTS of you!

 

[Deleted Account]

Unfortunately, the answer is "it depends".
You mention your evening meal "drama" which probably illustrates the main dependent well.
I find it depends mostly on what I am eating and how quickly it is digested. Pure sugar is digested quickly which is why it is used to treat hypos. You may have been told chocolate is not a good hypo treatment ; this is because the fat in chocolate delays the digestion. The same is true for the fat in pizzas.
There are other things which delay digestion which dictates the Glycaemic Index (Google it to find out more examples).
As a result, when we inject depends on what we eat and this depends on how it affects us individually because we are all different.
Therefore, there is no rule which says we should inject at the same amount of time before every meal.
I would keep a note of what causes your "dramas" and inject later for these foods.
Sorry, but I can't give you an absolute time: our bodies don't work that way.

 

[Millie Brown]

Unfortunately, the answer is "it depends".
You mention your evening meal "drama" which probably illustrates the main dependent well.
I find it depends mostly on what I am eating and how quickly it is digested. Pure sugar is digested quickly which is why it is used to treat hypos. You may have been told chocolate is not a good hypo treatment ; this is because the fat in chocolate delays the digestion. The same is true for the fat in pizzas.
There are other things which delay digestion which dictates the Glycaemic Index (Google it to find out more examples).
As a result, when we inject depends on what we eat and this depends on how it affects us individually because we are all different.
Therefore, there is no rule which says we should inject at the same amount of time before every meal.
I would keep a note of what causes your "dramas" and inject later for these foods.
Sorry, but I can't give you an absolute time: our bodies don't work that way.

I will Google GI info. I've not done that yet. Still very new to it so I'll take any advice going!
Thanks for your reply.

 

[Scott-C]

I think you've maybe answeted your own question @Millie Brown !

All fast acting insulins have a shape over time: for example novorapid typically takes about 20 mins to start working, an hour to three hours to peak and three to five hours to tail off.



So, the trick is to figure out how best to match that pattern to your own personal carb absorption rate, which will also be influenced by the GI of the food and what it's eaten with.

In your case, as you take a while to absorb, it's suggesting injecting after the meal is the way to go.

It might be worth asking the docs if there is anything to suggest gastroparesis might be involved. In some diabetics, a complication involves damage to a nerve which controls the emptying of the stomach into the intestine, where the glucose is absorbed. I'm not saying that's what is going on here, but maybe worth asking about if only to rule it out as a possibility.

 

[Millie Brown]

I think you've maybe answeted your own question @Millie Brown !

All fast acting insulins have a shape over time: for example novorapid typically takes about 20 mins to start working, an hour to three hours to peak and three to five hours to tail off.

View attachment 28524

So, the trick is to figure out how best to match that pattern to your own personal carb absorption rate, which will also be influenced by the GI of the food and what it's eaten with.

In your case, as you take a while to absorb, it's suggesting injecting after the meal is the way to go.

It might be worth asking the docs if there is anything to suggest gastroparesis might be involved. In some diabetics, a complication involves damage to a nerve which controls the emptying of the stomach into the intestine, where the glucose is absorbed. I'm not saying that's what is going on here, but maybe worth asking about if only to rule it out as a possibility.

Thank you. I ate a pizza last night (for research purposes only ) to see how long it took to increase my bloods. I checked my bloods every 15 mins after eating it. It was around 40 mins before i noticed a rise. At that point, I took my insulin.
I'll run it by my hospital this week. Thanks for your reply.

 

[Circuspony]

I have the opposite problem - I have to take insulin around 30 mins before eating because otherwise my BG shoots up before the novorapid kicks in.

Makes you realise that injectable insulin doesn't come anywhere near matching the sensitivity of your pancreas!!

 

[Dixon1995]

Strange one, my honeymoon period lasted 1.5 years, and I think my ratio was 0.5 units per carb or something, I used to use my calculator when I was first diagnosed I used to have 50grams carbs in a meal for example and 3 units of novo rapid instead of the 5 I have now my pancreas is gone, but I guess this doesnt help absorbtion times, they should have put you on novomix 70/30. although im cutting carbs down now anyway. Also when I get a hypo I only take between 10-15g of carbs 5-6 ***** bears then check it 15 minutes later, saves the whole spike thing but sometimes its hard not to indulge