Novorapid stopped working?

[joelcam]

Hi all,

This is my first ever post and would appreciate some helpful replies.

I have been a T1 since August this year, just had first HBA1C back which was 6.6% that I am pleased with as it will include some time where I was dangerously high and not knowing about it

I am however concerned that the regime I was on up until 2 weeks before HBA1c was novomix only twice a day, which wasn;t getting my levels right for lunch. This saw me go onto Levemir and Novorapid. Immediately things were sorted, and I was always about 4mmol before and always below 8mmol 2hrs after eating. Over the last 2 days, my readings have been weird after each meal (taking me into double figures after lunch and evening meal). I was having 4 units of Novorapid with breakfast and 5 before lunch and evening meal. Is the last 2 days a blip or is it a case of the 'honeymoon period' being over? If it is the latter, does this mean by upping my novorapid to the right level then I'll be cool again, or does the end of the honeymoon period mean you are more likely to get weird and unpredictable / uncontrollable readings?

Any help greatly appreciated.

<--This face is off my 5 yr old that won't let me type unless he can put a face on the message!!

 

[Dillinger]

Hi,

You should be changing your novorapid to match what you are eating; so you need to work out the carb content of your meals; are you doing that? Apologies if you are! I don't know what newly diagnosed diabetics get told nowadays; if you haven't been told much have a look around here for book recommendations to get some information.

If you are carb counting and matching novorapid then possibly you could increase the Levemir a bit if your levels are high in general; I found when moving from Lantus to Levemir I had to increase my dose by about 1/3rd.

But it sounds like the spikes are coming from your food/basal insulin levels to be honest.

Also, there are lots of bugs going around at the moment which will throw your blood sugars off course for a few days; could it be that?

The honeymoon period is a time when your body is still producing some insulin so maintaining good levels is slightly easier, when it ends it will probably require a bit more insulin and a careful look at what you are eating.

All the best

Dillinger

- for your son...

 

[Celtic.Piskie]

Awhh... cute kid.

Anyway... yes the honeymon period being over does mean it will be a little harder.
Your body used to have a pancreas, and you were kind of supplementing it with insulin.
If your sugars went high, there was enough left in it to bring them down.
Now, there's none left. You're completely reliant on the Novo.

The 'off' honeymoon period can be a bit twitchy, it's not 'on' or 'off'....
It'll be a while, sorry have no idea how long, but eventualy you will get settled.
I'd advise trying to eat th e same amount of carbs at breakkie and dinner etc, just so you can see if you need an increase over the next few days, you might have to up your lantus too.

That's if you are coming off the honeymoon period.
You could have a small infection somewhere, or you could be fighting off a bug.
Either of those sends my sugars higher.

Welcome to the club, and it's trial and error from now on.

:mrgreen: << For your son

 

[joelcam]

Thanks for the reply's guys.

I am not carb counting but I have not changed my diet...I always have 3 pieces of wm bread with lunch and a protein filling...

I am wondering if my protein shake is messing me up as I have only started back on these recently. When I had them when I worked out it was fine but now have one as mid morning snack..saying that though today was 3.9 before lunch (as I ate too late) then 2 hours later was high so nothing to do with the shake I think?

JC

 

[kegstore]

Protein is unlikely to raise your blood sugar so much and so quickly. Carb sounds like the culprit to me, so counting them is something you're going to have to think about at some point soon. But very tricky while (if?) you're still honeymooning.

Good luck! 8)

 

[sugarless sue]

Do you know exactly what is in these protein shakes ? Are they a branded product ?
You need to work out just how many carbs you are eating to see if you are taking enough insulin or alternatively cut down the carbs to match the insulin dose.

 

[joelcam]

I am taking a whey protein product that has 4g of carbs per serving so nothing much really..

I understand the importance of counting carbs but if my lunch has not changed at all yet suddendly my readings are out then I am really confused...

today had lunch at 1pm and was just under 4 then 2 hrs later was over 10 then before tea which was 4 hrs later I was still only just under 8..

normally I am low before lunch then back down to 6 2 hrs after then at 4 before tea....something definitely not right at the moment..

I am in really good shape if this matters...work our 3 times a week with weights and did boxing for years so without trying to sound like a big-headed idiot (which I am not) I still have the physique of a middleweight boxer. I eat only good carbs and nothing fatty apart from nuts and fish..

Also just had a thought!! Last 2 days I have been sat on my @ss in work in workshops with the other Managers where as normally I am running a section with about 200 people so have to run about and am hardly in my seat...could this single thing be what's messed up my last 2 days??

JC

 

[cugila]

Hi JC.

Can you clarify, what exactly did your lunch consist of ? Loads of exercise and possibly stress will all affect your Bg levels too.

 

[joelcam]

Thanks for replying..

My lunch today was 3 sandwiches and a small apple. The sarnies were chicken, lettuce and cucumber, no spread very thin amount of low fat mayo...3 pieces of wholemeal bread in total.

JC

 

[kegstore]

JC I reckon Celtic.Piskie nailed it with the honeymoon comment: "twitchy". One slice of bread can contain between 10 and 15g of carb, but don't worry too much about that until your levels have settled. Honeymoon can last many months, during which time your bg levels will be even more unpredictable than for an old timer (!), even on the same food eaten at the same time of day. Not the answer you want, but hope you get it sorted. :wink:

 

[lilibet]

HI
Read this with extreme interest. Am in exact same position. Been on mix for a year, last hba1c's all in the 5's but wanted to change for increased flexibility and to eat a bit more having been very low carb and missing some things from diet (fruit, as opposed to pasta!)

However, I may be as well injecting water for all the good Novo is doing. TDD of mix was only just 20 when wanted to change and DNS were worried it would be hard to titrate as so insulin sensitive (aye right!).
Am fairly sure basal is set right, had lots of opportunity to test it so therefore ratios must be wrong I thought. However, eating much as I did and getting NOWHERE. EG 4u Novo for a bit of Burgen toasted - getting me back, just, to what it was after 4 hours. However, the spikes are something else. Appreciate higher starting bg skews figures a bit but

However, inexplicable higher bg, and now on the treadmill as just cant get it down at all.
EG last night, 20g dinner, 5u novorapid and then bg hell.

Appreciate trillions of folk have great results on it. I am going to call DNS today and ask to come and show her diary. End of honeymoon aside - I would at least expect SOME change in bg on taking novorapid with no food. Not even moving

Giving it another week before I insist in moving rapids

 

[joelcam]

Lilibet,

That seems really weird..have you checked expiry dates etc,,,would expect some movement if you had not eaten anything at all?

JC

 

[CLP]

Lilibet

I came off novomix about a year ago and am also quite sensitive to insulin as well as having a very high insulin to carb ratio. In the morning I have to take 1 unit of insulin for every 3g of carb I have (funnily enough I also have bergen bread and its 3(and a bit) units for 1 piece) in the evening it goes to 1 unit to 5g carb. 1 unit of insulin however will drop me by 3 points so it can be very tricky getting things right. So i really understand and empathise with what you are going through.

If you have a problem at a particular time of day, eg go high after your evening meal, it might be that your basal insulin is running out?

My Levemir lasts about 18 hours and the point where it runs out corresponds to an hour or so before my evening meal. When I couldn't get my evening meal insulin right and kept going high my DN suggested adding extra novorapid to counteract the fact that the levemir had run out. So in actual fact for an evening meal I base my dose of novorapid on 1 unit for 5g of carb PLUS 3 units extra. I know its a bit of a strange way to do it but it does work.

Don't know if this will help at all? If it does happen at a certain time of day then it might be worth testing every hour or so around that time (without eating) to see if your BG starts rising.

Good luck

CLP

 

[lilibet]

Cheers claire et al

Trying to look at correction doses and on at least 3 occasions, bg starting and at 3 hours were the same so yes it is unusual, if not downright scientifically impossible in theory!

I split my levemir but as soon as novo is out system (even if it doesnt lower it that much) bg is bouncing back up again so think it might be basal running out. Seems to keep me steady, until a certain point so rather than it be not right basal, it just seems that it runs out. I believe lower doses (and mines only 5u) make it more likely. I was on NPH as part of the mix and it actually seemed to work better as the 'basal' bit but the short acting in the mix was rubbish.

Noticing a pattern if I dont eat lunch - jumps up mid afternoon and then continues, eventually hitting a ceiling so think its running out and therefore at some point in the day is going to have to be propped up with novorapid, which is unfortunate as mines doesnt seem to work!

I inject at 8am and start to notice a rise from about 2pm onwards, so all in all not great though overnight seems to be ok - go figure.
Am going to put basal up (though in theory it might not stop it running out still as its timing, not stability that seems the prob, though of course if you have high fbg and cant correct it then that stability is at higher numbers BOO :evil: )

Any thoughts on this would also be welcome - have been preparing for mechanics of b/b but like all things diabetes, knowledge is power but only if your insulin WORKS

 

[caitycakes1]

Hi Lillibet,

You say you notice a pattern of rising if you don't eat lunch. Could it be that your body being used to pre-mix which automatically means regular eating is giving you a liver dump when you miss a meal? Your basal wouldn't help you in this situation (unlike the pre-mix).

Caitycakes x

 

[lilibet]

Aloha CC!

Bet Ive put you right off the b/b now!

I dont think its liver dumps cause Ive skipped meals a few times at different times of the day (ie brekkie, dont eat a snack at bed etc) and no rise per se. Also, when I eat lunch and Novorapid is out of my system (takes ages to kick in, and tails off at 3 hours - my dead granny is more rapid!) it rises so dont think so to the liver dumps

I never used to get liver dumps with the premix - was able to skip mid morning snack no problem. Oh how i long for bg in the 4's once more.

Lots of sighing going on in my house these past weeks

 

[janabelle]

Hi,
I would agree with Dillinger and think your basal is at fault. Unless you're having huge amounts of carbs without knowing it!!
Don't know wot basal you're on,but while I was on Lantus had unexplainable highs ( and lows), and only since changing to pork have acheived stable control. Even if I miss a meal, or have a low or no-carb one, I have NO uneplainable highs.
This term 'liver dump' seem to be churned out on this forum more regularly than the liver churns out glucose unnecessarily Having been type-1 for nearly 21 years, I can relate to getting highs due to stress,emotional upset and sometimes following exercise, and the rise in adrenalin causing rise in BG due to this. This is well documented and the reason for it explainable.
I experienced 41/2 years similar to what you describe;of not knowing what was causing my erratic and inconsistent BG control, I discovered that the source of the prob was not me( as I thought), but the Lantus just not working. I threw out many bottles of Humalog,thinking it was faulty, when it didn't seem to work on some days,but the humalog was not at fault. Discovered this because I stayed on it when I changed my basal to pork. For 6 months I had no probs with Humalog, that I had when I took it alongside Lantus.
If you've considered everything else, and still drawing a blank, consider your basal,(which I presume is one of the "L"s) to be the prob, not the Novorapid.
If so, you'll be joining an ever-increasing club.
Best of luck
Jus

 

[caitycakes1]

Hi Lilibet,

Yep, I am in no hurry to come off pre-mix!!!! I use Humalog as a fast acting to correct any highs (always caused by overindulgence of forbidden foods :roll: ) It takes ages to kick in and drops me on my ass by hour 3. Strange stuff. It will also bring me down by anything up to 4 points per unit!!!! Too scared to go anywhere near b/b but if I am honest I just can't be bothered with the hassle. Being on pre-mix works so well for me that It allows me not to have to think very much about my diabetes which is just the way I like it. I'm just so lazy I can't be bothered having to re-calculate etc. Dreading the day the old pre-mix doesn't pass muster.

Keep at it Lilibet, I'm sure you'll get it all working smoothly soon. Hope you are keeping notes for when it's my turn :lol: :lol:

Caitycakes x