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Just started Novorapid - hypo after eating?


Thanks so much, will take a look
 
Id echo everything that the peeps here are saying ...also .food logs with ratio of carbs , insulin and outcomes are brilliant i have a pocket noteboook and a carb counter that i always have in my bag . As for babies ......if im say 4 .5 / 5
ish and lunch is cooking but an hour away i will bite a head off it just gives me peace of mind. Not for everyone but i do it and thats diabetes .....its your diabetes and stuff will be ok for you but not everyone (the green ones are )blurgh.
Dont forget .....youll need at least 3 to get you out of hypo proper a little head or bod wont do it.
 

Hi there, just to add (since I've had my libre) it has shown that glucose levels can change at least every 15 minutes if not less. I check a LOT on the libre and in the space of an hour it can be; 4, 4.8, 5.9, 4.5, 7.1, 6, 5.2 4.7 and so on (backed up in the early days with prick tests). I think that is why they say to wait and check 2 hours after the meal when (hopefully) it will have settled on the aproximate number it's happy with for the next few hours! I'm guessing that is why we are set a target (usually between 4 & 10 dependent upon personal circumstances). Thinking back to when I was on finger prick testing it makes me realise that a more or less random prick test is practically useless as it only tells you what the reading is at that precise time. Try not to worry about fairly narrow fluctuations as you will start to think you are not doing well when in fact you are. x
 

Peanuts and cheese have little carbohydrate and won't raise your blood sugar much, if at all. If you're going low, its best to have something sugary that contains 10 - 15 g of sugar. Jelly babies are almost all sugar, so weigh out 10-15g of them. This should raise your blood sugar by 3 - 6 mM (the exact amount varies in different people). There are lots of other quick-acting sugary things you could eat instead of jelly babies. Sweet cake or biscuits, for example, or a small glass of Lucozade. If you're not doing this already, it's worth always carrying something like a pack of dextrosol glucose tablets when you are away from home.
 

Thanks, current issue (one of many) is dropping soon after eating waiting for digestion I guess. For example I ate half an hour ago, novorapid 15 mins before then, and now dropping again. If I get lower (but not hypo low) should I have a jelly baby and wait for the lunch to raise my blood glucose? Biscuits take a while to rise I’ve noticed, as does chocolate. Thanks!
 

Thanks, I’m glad I’m not the only one eating Jelly baby heads
Yes, have four for a hypo but finding that biscuits or chocolate take too long to give a rise but the odd jelly baby part has been working I think. It would be nice if I just sat at a 5 or 6 but that’s never happening, just plummets!
 

Hi there, yes, if you are having an actual hypo (under 4) then you need something fast acting (ie, pure sugar).If you are on the lowish side but over 4 and you just want something to tide you over to stop you dropping lower, then I find a biscuit is fine, BUT it's not suitable for a hypo treatment, these are two different things and as you know a hypo needs urgent treatment.. x

Just edited to add, I was the same I think as you, (and I suspect I am still in the honeymoon period), at the start it was hypos galore to the extent that I eventually lowered & lowered my insulin down to the 1s and 2s until it reached the point where the hypos became fewer. x
 
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I think youve got it ! " waiting for digestion " .i found many years ago that timing is crucial with a bolus. I bolus 25 mins before a meal this gives the food and insulin both time to work unless its fatty then i inject as i eat . Thi is where a little notebook comes in .....i have lots of foods in it with bolus timings and outcomes ( lots of scriibbles and can do betters )! Its all work in progress x
 

Hi, like you I have fairly recently been put on to the basal/bolus routine. My diabetes nurse was very helpful and encouraged me to carry on, when I was all ready to give up and go back to my previous routine. However once Covid -19 set in I’ve been carrying on unaided. I was delighted when a few weeks ago everything was settling down to constant levels throughout the day but it suddenly went haywire so I’m trying to get it all back again.
What I have found helpful is, as well as logging everything in the diabetes record books which are available at the clinics, I rigged up anA4 pro forma which gives me more space to record meals, levels, comments etc. I also religiously used the Carbs and a Cals book to calculate carbs in every meal. My nurse gave me a ratio of 1unit of Novorapid for every 8 carbs, with a 1 unit per 3 mmols ratio for correcting doses. My Lantus evening dose gradually was increased from 12 units to start with and now its 22. I think my failing is that I’m always trying not to take too much insulin so that I won’t have hypos. I have had very few on the new regime but I did wake up very hot and distressed in the early hours recently and found that although my levels had been 12 before bed, they had dropped to 3.6! I don’t have a clue why.
One thing that has puzzled me though is that the nurse said lantus is a very mild insulin, however, I find that I’m needing to keep my bedtime levels around 10 because they drop considerably by morning. I can only think that this is when the lantus kicks in. I wonder if anyone else has noticed this.?
Sorry to have posted at length but I hope my experience will help you to realise that once you get the balance right between insulin and carbs, you will find it a lot easier. Good luck!
 

I spoke to a nurse yesterday and she said it sounds like the honeymoon period for me too - she doesn’t know what to do with me, possibly take me off Novorapid completely. We agreed on reducing lunch and dinner to 1 unit and keep breakfast at 2 units as that seems to be alright. So I had one unit with dinner last night (potatoes) and had a small rise to 7 and that was that. Today forgot and injected 2 units and spent the afternoon battling lows and a hypo mid afternoon. Was going low again before dinner so jumped in a bath to raise blood sugar (noticed it used to do that) but dropped again. Had to get out, have a jelly baby and wait. No rise. Felt so down and fed up that I decided not to inject any bolus and have cauliflower rice with fish, veggies etc. I’ll have toast before bed probably, I’m just feeling so defeated. I guess I’ll try again tomorrow with the 1 unit bolus. Did you find one unit was ok for meals? Scared not to have any at all in case I end up sky high.
 

Hi there, yes, I found 1 unit was absolutely ok for some meals, zero units for other meals and so on. I actually stopped the insulin after the first 3 months (on advice of the dr because of the honeymoon period) but I found my levels rose again more than I wanted so I started insulin again but only in units of 1 or 2. It's the same now (3 yrs later), I have 6 units of lantus and 1 or 2 novarapid per meal or sometimes more if I am eating a particularly carby meal. I find that I prefer to have the insulin at hand whether I use it for all meals or not, as you go along you will find what amounts work for you at the moment. Some people even use half a unit. It's perfectly fine not to bolus for a meal and if your levels are fine afterwards then that's a win. Please don't feel defeated!!!! I doubt very much that NOT having your 1 unit would make you sky high anyway...and if it does then you can adjust. The problem seems to be that (like me) you are still producing your own insulin so that kicks in at any given moment making your injected insulin a bit tricky to manage. My strategy was to use very low units when I was at the start and hypoing all the time and on days when my meals were low carb or I was exercising, then none, (apart from my basal which were around 4 units to begin with and 6 now). x
 

Thank you so much, this is so reassuring! I was dreading another day to be honest - it’s like a full time job keeping my blood sugar up or normal. I’m grateful I have the Bubble with the Libre now so I can monitor all the time with my phone and have alerts. I’m finding even small walks can cause drops - had a rapid one suddenly yesterday and ended up hypo which turbo fuels my anxiety and the kids are always asking if my blood sugar will ‘allow’ me to play frisbee etc! Sometimes I’m scared to even walk across a room haha. I’m going to try one unit for breakfast, maybe the two units then were causing the lows after lunch - not sure how long it’s in my system. I’ll keep jotting down what’s working and feel like I’ll eat the same things forever for ease if I have to!!!Thanks so much, it’s so good to know that I’m not alone with this experience and that no units/one unit is absolutely fine for some people at certain times. I’ll no doubt need more at some point, maybe soon, but guess I’ll have to adapt to this just now x
 

Hi, thanks for your message. That’s so frustrating for you that it was all settled then went haywire again, ugh. I don’t use Lantus so I don’t know anything about it but find Tresiba is working well for me. That’s great that you’ve mastered carb counting, I was going to but I’m currently needing such tiny amounts of insulin that it wouldn’t be possible I think - only 1 unit per meal (or possibly no units - nurse isn’t sure what to do with me as yet)
Logging records sounds great, thanks, I’m going to print out some today as I’ve just been jotting stuff down on random scraps of paper all over the flat and am a bit disorganised. I understand the fear of hypos, I’ve been having them daily since I started to bolus and it’s exhausting mentally x
 

Hi,

Baths, saunas & high temp climates, oddly have a tendency for me to make me more insulin sensitive?


Hello,

Lantus, what time do you inject your dose? I do mine around 10/11pm, what I have noticed is if I am going to drop during the night, it will be around 2/3am or 5/6am? Sometimes both.?
Lantus is a long acting insulin, it's only as "mild" in respect of the dosage? (Most find it's function lasts around 20/22 hours?)
I found the hypos can creep up without any fast acting insulin on board. Get the dose wrong & "mild" it ain't. Your nurse puzzles me too..

Has she spoken with you regarding "basal testing?"
 

and if it's any consolation, I had a month off work to begin with as I was worried about falling to the floor, I went on holiday later on and never went a step without a bagful of carbs, I worried to a ridiculous extent BUT a few months later it became the norm for me and I now laugh at how afraid I was. Don't get me wrong, I still manage it well but I no longer worry about playing frisby or going for a run or anything else, YOU will calm down I promise especially when you are more experienced. x
 

Hi JMoli, I stumbled upon your post and just to reassure you that I'm going an through almost identical experience to you - hypersensitive to my fast-acting insulin and finding that even 2 units takes me into a hypo after a carby meal of 50+ grams. I'm now injecting 1 unit or sometimes none at all with meals. I exercise a lot so i think that's making me hypersensitive. My understanding is that provided i'm still injecting the long-acting (Lantus) insulin, my cells are still able to access the carbohydrates that I'm feeding my body so it's not an issue if you have zero fast-acting units with a, say, <30g carb meal
 
Thanks for your post @JMoli and everyone's replies - this has been a really interesting thread for me.

I have been on basal only for around ten months since being re-diagnosed as LADA from T2 - split dose of 10-12 units (Humulin 1) daily. Through trial and error I have developed a sort of rule of thumb that if my reading is 10+ I'll go for six units, more usually five. This has worked reasonably well, in tandem with low carb and a lot of activity, but recently things have gone more erratic - no hypos but too many highs, some days the identical meal/exercise/insulin regime works fine and then others not.....Basal is a blunt instrument, and while I must be producing some of my own insulin, I am no longer getting a good enough level of control.

I have a phone consultation with my Dr on Thursday and am going to ask to add fast-acting when and if I need it, much like @jwatty's approach. If you are wondering why I'm not already on it, well last time I asked my consultant back in September, she said my control was 'surprisingly' good, and just suggested splitting the basal dose. The three month follow-up didn't happen and I spent most of Jan long-distance walking abroad and didn't want to start risking hypos just then. Since March, everything has just been a Covid-blur, but time to get a grip!

Like you my carbiest meal is the evening one, so that looks like the prime candidate to start with and means I should be able to reduce my basal dose. I am definitely not an expert in using insulin, but have been around long enough to gain the confidence to experiment a bit. I am also encouraged by all the amazing long-time T1s who have survived, and thrived despite all the short-comings of the early forms of insulin and testing. This tells me that avoiding the extremes is key and as others have said, keeping clear records is key in this.

Good luck, you will find your own way!
 

Hi, thanks for replying - good to know I’m not alone. I’ve been experimenting a bit and found I don’t need insulin for lunch (sandwich) but need a unit for breakfast (two if I’m very inactive) and depending on dinner I either take no insulin or one unit. I’ve also noticed a difference in when I take it - the nurse said to inject novorapid 15 mins before a meal but online it advised 5-10 minutes which makes more sense for me as it’s almost too fast acting for me. I take a Jelly baby after dinner if I’m dropping before the digestion kicks in - I guess it’s all learning what works for us individually isn’t it. I’ve noticed that how much exercise and how warm the weather is has an effect too.
 

Hi, thanks for replying - how did the chat about insulin go with your dr?
I’m getting a better understanding how my body reacts now - jotting down how I react to food and snacks and deciding on how much bolus needed if I’m very active/it’s a hot day etc. I seem to need to bolus for breakfast but not for lunch, sometimes not for dinner. One unit seems fine for potatoes and pasta for the time being, no doubt that will change if I get too comfortable or confident haha
I guess we are all different and have to factor in different things like activity and personal reactions to food
 
I actually feel pretty deflated.....having gone into the phone consult with a clear view about what the next steps should probably be, I asked my key question - when would it be appropriate to add short-acting insulin into my treatment plan? Dr replied they don't recommend short-acting insulin for T2 due to weight gain. I said but I'm T1.5, he asked about my recent numbers and said I could ask for a short-acting insulin trial and to arrange an HBA1C at my GP surgery (it's a system of shared care with hospital managing medical review).

To me it was one thing for the consultant to look at my blood records and results and say what I was doing was good enough not to need short-acting insulin back in Sept, but she was very clear LADA is treated as a variant of T1 resulting from failure (gradual in my case) to produce enough insulin. My take on yesterday was that this Dr viewed LADA is a variant of T2, where (please someone correct me if I'm wrong) insulin resistance is the key - quite a big difference in how you go about treatment

This is definitely a marathon not a sprint, so I'm not panicking, just annoyed. I'll put that energy into my exercise routine and being honest and addressing a bit of lockdown carb-creep and see what difference that makes.

Glad to hear you are getting you head round things - it is amazing just how much difference things like weather can make - one of only two hypos ever so far for me was on holiday abroad last year, a surprise 3.8. The lack of hypos is definitely a plus on my current regime, but the lack of control is a clear negative. At the current rate of progress you will be a super-expert insulin user long before I get on to 'the hard stuff'!!! Best of luck x

PS as a matter of interest, is anyone else on a slow-release only insulin regime?
 
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