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Question about fast acting insulin

M

Mad76

Well-Known Member
Messages
319
Location
London
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,

Ive been reading on here lots of people advising on injecting 20 mins before their meal.
Im on novorapid, and i asked yhe nurse at the gp wjen girst diagnosed and she said inject just before meal. She said when the plate of food is in front of you, not before this.so thats what ive been doing..

But ive read lots of people on here saying injecting earlier reduces spikes after eating..

So i guess my question is is this the case with novorapid??
And is there any danger of its effects wearing off if i inject too early???

Thanks in advance!
 
Hi, @Mad76 , when you're just starting out on your T1 journey, DSNs and docs will be very conservative about treatment, because they don't want to have you doing things which might send you into hypo-land.

Pre-bolusing, injecting 20 mins or so before a meal, is a very useful technique to minimise spikes after meals, but it does take a bit of experience and knowledge about how insulin works in relationship to the type of meal you're eating, the GI value of it, the order in which you eat the various bits of the meal, whether you're trending up or down, and a few other things.

Older T1s who have been doing this for a while can scheme those factors in without thinking about it much, but it is difficult for newbies.

You'll pick it up as time goes by, but for now, safest to follow dsn advice.

A doc, can't remember his name, called T1, "the ultimate self-treated condition".

To start with, we follow doctor's orders, but eventually, we get loose and we make the calls on bolus doses and timing - that can be both liberating and scary!

Stick with what your team are telling you for the moment. You'll have plenty of time to experiment with pre-bolusing once they let you off the leash!
 
Thanks gor your great advice will go by what they're telling me then.im definatly not ready for anything too complicated !
 
From my experience, if I don't inject 20-30mins prior to my meal, my food will spike my blood sugar then insulin will play catch up so I'll be high for some time. From my libre, I spike really badly compared to giving time for novorapid to have some fun and then have some food.

I'd say for the time being follow your DSN for now and if there are spaces available for a carb counting course like DAFNE, which it will teach you the flexibility in prebolousing. DAFNE will teach you that Novorapid has a 4 hour window, so if you inject at 8am, have breakfast around 8:20/8:30, your next check is 12:00 or so in time for lunch.
 
When I was diagnosed, I was told to inject 10 minutes before. (I rarely do that, but that's another thread..!)

It can be really dangerous though; food can be delayed even when you're making it yourself, let alone in a restaurant. You need a bit of time being conservative and recording meals and pre and post blood glucose results. Then you'll start to see how higher/lower carbohydrate foods and meal with higher fat and protein content affect your body.
 
I’ve only been type 1 for a few months now (was hospitalised with dka).

I use novorapid and was also told to try injecting 10 mins before, but often find I go hypo. As said earlier by others, it really depends on the type of food.

Also, I inject into my tummy. Depending on if it’s on my belly or just below my belly button (ie into fat or muscle) I find that this can vary the speed at which the novorapid is absorbed.
 
I used to pre-bolus in the old days of Actrapid, which took a long time to kick in, and had a couple of nasty hypos when food was delayed, gave me a real scare. When I switched to Novorapid, they said to inject at the time of eating, which I did - it wasn’t until I got my Libre that I realised I was spiking very high after eating. My approach to avoid spikes is to follow a very low carb diet, and I’ve found the rise pretty much matches the action of the insulin when I dose just before I eat. Many here happily prebolus.

There’s many methods to deal with T1, it’s just a case of working out which suits you best.
 
What defines a nasty hypo Mel? When I hypo, I basically just get a slight juddery effect when I look around. Don’t think I’ve been lower than 2.0 though. Thanks.
 
drew900uk said:
What defines a nasty hypo Mel? When I hypo, I basically just get a slight juddery effect when I look around. Don’t think I’ve been lower than 2.0 though. Thanks.
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It was two decades ago, so can’t remember the numbers, but I hadn’t long been diagnosed! I was just doing as I was told at the time But I had all the classic symptoms - cold sweat, shakes, slurred speech, felt like I was about to pass out, stroppy, the whole nine yards. I’ve never actually passed out due to low blood glucose, I think I’ve only used the glucogel maybe twice in my 20 years with T1.
 
I’m keeping too tight a control. Correcting hypos almost every other day which is not right. I’ve got the Freestyle Libre which allows me to check all the time. My Hba1C was 41 last time it got checked.
 
drew900uk said:
I’m keeping too tight a control. Correcting hypos almost every other day which is not right. I’ve got the Freestyle Libre which allows me to check all the time. My Hba1C was 41 last time it got checked.
Click to expand...
How low are these hypos and do they last long? And what basal insulin do you use? (My last HbA1c was 40, but I don’t have much by way of hypos. I try to maintain normal, non diabetic levels.)
 
They don’t last long really. 20-30 mins. I use levemir.
I will aim to be more conservative with my insulin measurements going forward but I think in general I’m doing quite well for a newbie!
 
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