NovaRapid & after meal blood spikes

[Jjoshh]

Hi I've been Type 1 for 10 years and I'm in NovaRapid & Omnipod Dash.

Over the last 6 months it's as if my absorption has slowed down. When I eat a meal (carb counting 1:10), I inject NovaRapid up to 15 minutes before but still get a spike for up to 3-4 hours later (I'm talking like 15-18!), and then at about 4 hours, it comes crashing down - usually to a hypo!

Anyone else experienced this or have any tips? Or is there any quicker acting/absorbing insulin?

Thanks in advance!

 

[Antje77]

Anyone else experienced this or have any tips? Or is there any quicker acting/absorbing insulin?

Quicker acting insulins are Fiasp and Lyumjev. For some they work very well, others like the old NovoRapid better.

For what it's worth, when I was on NovoRapid, I had to prebolus for a lot longer than 15 minutes to prevent a spike.

 

[CheeseSeaker]

Hi @Jjoshh - try switching injection sites - you can build up resistance by over using the same sites (I did with Novorapid many years ago).

Easy to do - just inject into somewhere you don't normally.

Watch for the insulin kicking in as expected if you've increased amounts to compensate for resistance.

Might not fix it - but simple and worth a try.

 

[Fairygodmother]

I found the same thing happened to me when I was taking NovoRapid. It worked well for the first few years and then it seemed to lose its power.
I notice Omnipod Dash is approved to use both Fiasp and Lyumjev; both have an action time that begins 5 minutes after the bolus is given. Some find that Lyumjev stings when it first enters the body but it’s worth it.
It’d be a good idea to discuss with your pump team which insulin might work best for you.

 

[Iain Byrne]

Same thing happening to me, I have been on Novorapid and Lantus for the last 28 years (type 1 now for 66 years ) I now try and bolus at least 30 mins prior to eating but still sometimes get a spike.
My GP suggested to my DSN that my insulin should be changed but for some reason they have refused.

 

[Hopeful34]

My GP suggested to my DSN that my insulin should be changed but for some reason they have refused.

Has the DSN told you why they refused? Was this a hospital DSN or one from the surgery?

 

[Iain Byrne]

Has the DSN told you why they refused? Was this a hospital DSN or one from the surgery?

It was the hospital DNS, they say they will only consider changing the Novorapid if I am using over 70iu per day. Also I have diabetic retinopathy, blind in my right eye, extensive laser to my left. Consultant ophthalmologist says keep Hba1c as low as possible and DNS says don’t give control insulin doses until BS above 17. I ignore this as time Novorapid works BS would be well into the 20’s. I am honestly not impressed

 

[Fairygodmother]

Can you ask to see a Consultant? It seems to me that you need another voice on this.

 

[Iain Byrne]

I have, but never been referred, lived here for 13 years and never seen a consultant, just managed by DNS

 

[Hopeful34]

In your situation I'd chase that up. You're entitled to a second opinion.

Try writing to the endocrinologist asking to see them together with your DSN, as they're normally part of the same hospital diabetes team. Other avenues to try are PALS at the same hospital or the opthalmologist may be willing to contact the endo on your behalf.

Do you have a copy of the letter from the opthalmologist to your gp, saying to keep your hba1c as low as possible.

 

[Iain Byrne]

Unfortunately no letter that I know of, but he emphasises this point whenever I see him. I have just heard today I have managed to get an appointment face to face with my GP Friday afternoon so going to see what he suggest.

 

[Fairygodmother]

I hope your GP refers you to a Consultant. It may be that the system allows your GP to refer you but the DSN doesn’t have the power to.

 

[Iain Byrne]

GP has referred me twice, but you are seen by the DNS first regardless and the consultation goes no further. There is definitely politics at work here

 

[rosemaree]

Hey @Jjoshh, I have been struggling with this too, really high spikes after meals and then at about 5 hours I get terrible lows! I have tried to either give it a longer time or wait for my blood sugar to be around 4.5 mmol before eating, but then I sometimes end up low during the meal