Novorapid frustration

[MikeEMike]

Im at a bit of a loss lately. Has anyone had issues with Novorapid not working?

Im doing a 10:1 ICR, injecting 40 minutes before a 70g carb meal and getting no result over 2 hours later...

Yet with this ratio on a 30g meal I level out fine.

Confirmed with a prick.

 

[Nicola M]

Hi and welcome to the forums.

Personally, I always had issues with Novorapid. It got to a point where I was injecting 45 minutes to 1 hour before I needed to eat, and even then, sometimes it wouldn't fully work, especially for high-carb meals, which I eat a lot of. I ended up swapping to Lyumjev. It starts to work quicker and handles my high-carb meals much better. Not everyone gets on with it, though. You can also get Fiasp, which does the same thing.

 

[MikeEMike]

Took 3 more units, 3 hours after the last. Then went to bed. Woke up to this.

I'll have a look at Fisap as a few have suggested it.

 

[Introverted_And_Proud]

Hi there @MikeEMike .

Have you done a finger prick test to compare the Libre readings to your BG? The ISF readings that occur within 24 hours of activating the sensor can sometimes be inaccurate.

Regarding your meals, do they contain food that you eat often? If so, how have your blood sugars usually behaved in the past when eating them? Is it any different to what you've experienced recently?

 

[MikeEMike]

Hi there @MikeEMike .

Have you done a finger prick test to compare the Libre readings to your BG? The ISF readings that occur within 24 hours of activating the sensor can sometimes be inaccurate.

Regarding your meals, do they contain food that you eat often? If so, how have your blood sugars usually behaved in the past when eating them? Is it any different to what you've experienced recently?

Yes, have confirmed with a finger prick.

No diet change. This is something I eat regularly.
I skipped lunch yesterday, which could have triggered a Glycogen stores release causing the initial rise, but after 10 units and arriving at 15.8 something is definately not working here.

I took another 7 units this morning, waited 40 mins then had 30g carb breakfast. Hardly any change. Slight drop, then rise again when the carbs kicked in.

 

[TimLibre]

Hey! I sometimes have the same. The following helps for me:
- excersize/walk/run before eating
- dont eat/dont eat carbs in the morning
- avoid food that has both high carbs and high fat (fries, pizza, crisps). Or you have to do a proper workout before.

i sometimes tend to take too much novorapid when i have a persistant high, a sharp fall can occur after a while. So if youre really taking lots of insulin, keep some sugar close to avoid hypos.

 

[Hopeful34]

Have you done a basal test recently @MikeEMike because all these numbers are high? The amount of insulin we need can be affected by changes to weather for some people - I need more basal in winter than summer, other people find the opposite.

If I was to eat when in double figures, I'd have to take a higher correction dose due to insulin resistance, and it takes longer to return to my target blood glucose, so maybe that's happening for you. I use Fiasp and like it, so it's well worth trying. However on the odd occasion my blood sugar is mid teens upwards, it takes 2- 3 hours to return to normal levels

 

[Introverted_And_Proud]

Yes, have confirmed with a finger prick.

No diet change. This is something I eat regularly.
I skipped lunch yesterday, which could have triggered a Glycogen stores release causing the initial rise, but after 10 units and arriving at 15.8 something is definately not working here.

I took another 7 units this morning, waited 40 mins then had 30g carb breakfast. Hardly any change. Slight drop, then rise again when the carbs kicked in.View attachment 70277

I'm also a user of Novorapid and am currently experiencing similar problems.

Sometimes when my blood sugars have gone unusually high despite injecting the correct dose, I've found that the problem is related to my injection sites. I tend to bruise very easily when I inject and it frequently causes lumps on my skin, which has affected how the insulin works. In other cases, I have a knack for hitting a muscle, which has also affected how the insulin is absorbed into my body. In the case of the former, I tend to experience high levels, while in the latter case, it's a hit or miss. Sometimes it goes too high, while in others it can drop too low.

Have you checked your injection sites for any hard or lumpy skin? When you administered your injections, do you recall if you felt any pain or experienced any bleeding?

 

[MikeEMike]

Have you done a basal test recently @MikeEMike because all these numbers are high? The amount of insulin we need can be affected by changes to weather for some people - I need more basal in winter than summer, other people find the opposite.

If I was to eat when in double figures, I'd have to take a higher correction dose due to insulin resistance, and it takes longer to return to my target blood glucose, so maybe that's happening for you. I use Fiasp and like it, so it's well worth trying. However on the odd occasion my blood sugar is mid teens upwards, it takes 2- 3 hours to return to normal levels

I feel like my basal is okay. In the first photo you can see a good level for most of the day.

Now at 15.7 after morning dose and carbs.

Im starting to think this insulin has gone bad altogether.

 

[Introverted_And_Proud]

Im starting to think this insulin has gone bad altogether.

Oh, actually, that's a thought: have you checked the insulin you used to see if it's gone off or is past its expiration date?

 

[MikeEMike]

Oh, actually, that's a thought: have you checked the insulin you used to see if it's gone off or is past its expiration date?

Not expired. I checked this morning. But since I started using the sensor Ive figured that this Novorapid, when it does work, doesn't start bringing down my BGL until at least 40 mins after injection. Sometimes it peaks at 1hr 20min, sometimes at 2 hrs. Its very erratic.

BGL now at 17. FML.

 

[EllieM]

If I was to eat when in double figures, I'd have to take a higher correction dose due to insulin resistance

This applies to me, once I go into double units bg my insulin ratio changes and I need a larger correction ratio than I would need if my bg was say 7...

And once I am too high my basal dose doesn't act as well either so I have to get back into normal levels before my system gets back into sync. (This is using humalog and lantus, and now a pump wth humalog, so I don't think ithas to be an insulin issue.)

 

[Introverted_And_Proud]

Not expired. I checked this morning. But since I started using the sensor Ive figured that this Novorapid, when it does work, doesn't start bringing down my BGL until at least 40 mins after injection. Sometimes it peaks at 1hr 20min, sometimes at 2 hrs. Its very erratic.

BGL now at 17. FML.

Oh dear. >< I hope your levels drop soon.

My Novorapid doses are quite erratic as well with certain meals. The majority of the time, according to the sensor, my Novorapid takes around 30 minutes to start working from injection, then when it reaches an hour, my levels start to rise. It’s not until around the two hour mark that it’ll suddenly start to dip and drop into normal range, sometimes going too low. Other times, my levels rise steadily but will fluctuate between dropping and rising until hitting the two hour mark, then it’ll just drop.

I will say that in my case, however, the problem doesn’t just lie with the Novorapid. Sometimes, I’ve had other things happen which have made my levels worse, like issues with my basal insulin, or my injection sites as previously mentioned, or illness and stress.

Have you been feeling ill or overly stressed at all recently? Could be causing you a little bit of insulin resistance.

 

[MikeEMike]

15 units later...

God this is so frustrating sometimes.

 

[CheeseSeaker]

Hi @MikeEMike,

Assuming you're a long-term Novorapid user and its stopped working recently?

Couple of suggestions.

1. Try switching sites to somewhere you don't normally inject - it's possible to get huge resistance if you keep using the same bits over and over (I had this problem some years ago). (Moderator edit to remove dosing advice)
2. Fiasp is Novorapid with 'stuff in' to make it work quicker. For some of us its more resistant than Novorapid at higher BGs so might not work as well. Also was more resistant (for me) if I'd used injections sites for a longer period - might not be the answer you're looking for here.
3. Nice thing about Fiasp is its faster to do stuff - instead of 40mins-1 hour to kick in, its 5-20 mins so you don't need to pre-inject.

I'd recommend trying new sites before switching to Fiasp, as that might just muddy the water.

 

[bmtest]

Just lately I would not even class it as fast acting which is strange, i have put it down to age & will be picking up the Fiasp at weekend from pharmacy.

 

[TonyBlue]

Hi MikeEMike I do think this happens more than we think.
I have at least 1 day a month when I’m sure someone changes my insulin into water as it has little or no effect on my BG after eating.
I do as you 15-30 prior to eating see my bg staying level for an hour and think perfect then watch as my BG rises like a rocket on the 5th November then pump more in then more as we know we shouldn’t but still nothing.
The next day fine…
It’s an odd anomaly but one to be aware of and not beat yourself up with frustration yes but I try now to accept.