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Novorapid with meals

Discussion in 'Insulin' started by CranberryIce, Apr 23, 2018.

  1. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Hello,

    How long should Novorapid take to kick in? I seem to go high (in the teens) for up to 2-2 1/2 hours after meals and then it drops.

    My bloods from today:
    Pre Breakfast (7am)- 3.8 (treated hypo). Ratio of 2 units for every 10grams.
    9am- 14.9 (Was very tempted to correct).
    10.30- I had dropped to 2.8
    Before lunch (12pm)- 5.5
    2pm - 15 (again tempted to correct)
    6pm- 6.6

    From patterns in my readings over the last few days- it appears it takes my body about 4 hours to bring myself back down to my target range. Is that 'normal'?
    Are these spikes of highs after meals going to impact my overall Hba1c?

    I take Lantus as my basal- intend to do a basal test. Just need to stop waking up on lows first.
     
  2. Deleted Account

    Deleted Account · Guest

    Wow, that’s a lot to answer.
    I assume you are seeing these rises and falls on a Libre?
    Trying to work out how to avoid the rises when eating depends on what you are eating - different foods are absorbed/concerted to glucose at different rates. This varies per food per person but the glycemic index (GI) gives you some ideas. Basically, the higher the GI the faster it is absorbed. Pure sugar has a GI of 100. Fat slows the absorption so something fatty, such as chocolate will have a lower GI (and, hence, not good to use to treat a hypo).
    The rate NovoRapid works also varies per person but it tends to start working after 15 minutes, last for between 3 and 4 hours with a peak at an hour.
    Using the Libre, with some trial and error, you can try to get the peak carb absorption to match the NovoRapid peak for different meals.
    You may find some heavy carbs/fatty meals, such as pizza, last a long time so may need multiple injections.

    Given the NovoRapid profile (lasting up to 4 hours), it is not unreasonable for it to take up to 4 hours to bring your BG down after eating some meals.
    As the hb1ac provides an average BG for the last 3 months, it could have some impact on your test. But, matching the amount of insulin to your food is most important compared to when to take it ... the “how much?” is learning to walk whereas the “when?” is learning to tango.

    You mention waking on a low. What is your usual BG when you go to bed? If it is lower than 5, it maybe worth eating a small snack like a digestive biscuit or slice of toast without insulin before going to bed to stop the lows.
    If you go to bed higher and always wake low, you may want to tweak your Lantus down by 1 unit and giving it a few days for your body to stabilise.

    Sorry about the essay in response. Good luck ... and don’t stress about a few highs ; our bodies are not computers, they are not always predictable.
     
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  3. Diakat

    Diakat Type 1 · Moderator
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    Are you attending the pre-pregnancy clinic yet? Might be worth having a chat with them.
     
  4. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    I would love to say that this is an off day- but most days are like this.
    Sounds really silly (as I type this out) but I've never really thought about the types of foods I am eating- just as along as I am carb counting. (Saying this I have been trying to eat cleaner).

    I had 'Special K' for breakfast- I weighed and gave me usual ratio. Could that have caused a spike? (I know its not the most healthiest breakfast!)

    My tea reading of 6.6 rose to a reading of 10 after an egg salad (no mayo, no dressing)?

    I have been going to bed on between 8 and 9. Yet wake up low.

    argh :(
     
  5. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    No- I am trying to find the closest one to me.
     
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  6. slip

    slip Type 1 · Well-Known Member

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    When do you take your lantus?
     
  7. catapillar

    catapillar Type 1 · Well-Known Member

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    I think your bloods prove not correcting for post prandial highs is the correct course:
    What would that 2.8 have looked like if you ha corrected at 9am, just two hours after your breakfast bolus of 2:10?

    Remember, if you are waking up hypo you have probably been hypo for a significant portion of the night. Your body will have tried to correct the hypo with a glucagon response, emptying your livers stocks of glucose and post hypo your body will be prioritising restocking your liver making you more vulnerable to hypos.

    The timing of your bolus is important. Novorapid takes about 20 minutes to work. If you bolus and then eat it is very likely carbs will be digested well befor the bolus starts eating. Then glucose surrounds your cells as you end up with high blood sugar and the insulin taken to deal with this needs to fight it's way through the crowds of glucose to get to the cells where it needs to be to start working.

    Gary Schneir explains well the impact of pre bolusing - https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/strike-the-spike/
     
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  8. Tony337

    Tony337 Type 1 · Well-Known Member

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    How soon before meals do you take your novorapid?

    Tony
     
  9. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Usually straight after eating (or within 5/10mins of eating).
     
  10. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    should be before eating ideally.......its takes about 10 minutes, but can vary per individual.....you can also manipulate that 'lead in' time to better suits certain meals...
     
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  11. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Ahh so maybe testing in the night to see whats happening?

    Thank you for the link- Bedtime reading sorted for tonight.

    I have had a steadyish day today.
    Went to bed on 8 based on previous nights I know I drop and wake up on a low with that. So I had a small banana.

    That made me wake up on 10.1.
    After correcting and my usual breakfast ratio I have been steady on/around 7 for the morning.

    I also noticed my spike only lasted an hour and a half (went up to 15.7) and then it started coming down. I changed my breakfast (ditched the cereal). Could that have impacted the spike?
     
  12. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    ah why was I never told this...?
     
  13. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    I was never really told either until DAFNE but even then it wasn't touched on as an important point.....

    its all about how you understand the action of the insulin.....you want the insulin to start working fully as the digestion of your meal begins, which for most, is almost immediately....you want to try and match the peak of the insulin with the peak of the digestion....

    the quick acting analogue insulin's like novorapid, Humalog and apidra start to work 10-15 minutes after dosing, peak around 1.5 hour mark and is done between 3 and 5 hours..
     
  14. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    I did Dafne too and don’t recall them touching on it.

    Having the libre has defo made me more aware of ‘trends’ with my sugars. Don’t feel comfortable with these peaks after my meals.
     
  15. novorapidboi26

    novorapidboi26 Type 1 · Well-Known Member

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    There will always be peaks but yeah, keeping them down to as low as possible is best.......

    timing is the key......get the insulin before you eat and see how it works for you....
     
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  16. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Thank you will give that a try.
     
  17. dancer

    dancer Type 1 · Well-Known Member

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    @CranberryIce , I presume you were talking about Novorapid here, but @slip asked when you take Lantus.
    When I was on Lantus I was waking low in the morning but when I reduced the dose, I went high. My DSN told me to change from taking my Lantus before bed, to earlier in evening (around 6pm before eating dinner.) This stopped the morning hypos. This shows that the timing of long acting insulin can also be important.
     
  18. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    Oops. Yes Lantus I take between 7-7.30am and 10pm in the evening.
     
  19. CranberryIce

    CranberryIce Type 1 · Well-Known Member

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    I’ve also noticed at/after 7pm my bg starts to rise (slowly)- could that indicate my morning Lantus is running out?

    I would love to discuss this with my DSN but I’d be waiting over 2/3 weeks to get an appointment with her :/
     
  20. dancer

    dancer Type 1 · Well-Known Member

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    I never required more than 1 Lantus injection per day but was under the impression that if two were required, they should be taken roughly 12 hours apart. If your levels are rising in the evening, it could be a sign the Lantus is running out.
     
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