(rapid) short-term insulin no longer "short"

buckmr2 · Sep 12, 2019

I changed to Fiasp from Novorapid some years ago too and also suffer from dawn phenomenon.
I find the time the Levemir is taken the evening before effects the BG from waking when it starts rising before eating.Best way for me is Levemir at 6am and 9pm (used to be 8pm) which minimises but doesn't eliminate DP.
Get up at 6am during the week and have my 1st Fiasp and 1st Levemir then so by the time I'm showered and ready my DP BG rise is halted and as it starts to fall it is then caught by breakfast.The spike after breakfast also doesn't last as long as the insulin peaks nearer to the BG spiking.
Maybe look at the timings of your basal and bolus.
Also found this better to keep in target longer than injecting when food is infront of you as per Daphne guidelines.
If you're using the Libre this also can help to see what your BG's are and when so you can tweak the timing of your injections.

Wjohn · Sep 12, 2019

jmackinnon said:
I've had diabetes for more than 25 years. I am always changing my eating habits, and take my insulin shortly before my meals in most instances, and always circulate my injection locations (short-term in stomach, long-term in butt).

For the past few months my morning insulin doses have not been "kicking in" within 10-15 minutes like they are supposed to, but instead take 2-3 hours. I wake up, take my insulin, eat my breakfast (which varies - and yes, I take the appropriate amount based on carb intake). An hour or more later, my blood sugar spikes (based on the amount of carbs, but typically to 19-20's mmol/L = 360 mg/dl) as though I didn't take any insulin at all. Then finally - up to 3 hours later - the insulin kicks in and drops me back down to the appropriate level based on the dosage I took for my breakfast. Has anyone experienced this before? I am very concerned and my doctor and endocrinologist don't seem to have a solution for the problem (besides changing injection locations or insulin types, both of which I have done). Odder still, later in the day, my insulin kicks in as normal, within 10-15 minutes after injection, like nothing is wrong. Most injections I take before lunch (if more than one) take 2-3 hours to react. So frustrating! Any thoughts are welcome!

Hello I’ve been a Type 1 and injecting for nearly 57 years with daily injections of at least 5 daily, in 9 body areas . I say this because I’m now suffering hard/ solid in my injection areas ,ie arms ,thighs ,back of legs, bum and tummy but overuse here has caused areas where the insulin does not or is very erratic in dispersal .The only solution suggested is longer and longer needle length ?Some of my symptoms are similar to yours ,ie Novo Rapid not kicking as it used too ,or or long after it should kicking in with an almighty surge ,I’ll watch and see how you get on ,good luck Wjo

CaptainCOBOL · Sep 12, 2019

MeiChanski said:
Oh I'm sorry to hear. It is troublesome that you just want to eat breakfast and wait. I was wondering if you can speak to your team again or possibly a dietitian. I know I've been doing low carb and adjusting my insulin for breakfast does lighten the morning frustration. If I eat a full carb breakfast, I'll be high until afternoon if it was on novorapid. Fiasp does seem to help and unfortunately it's not an option for you. Another option would be Humalog which I can't comment how it works. I only know novorapid and fiasp. Fiasp being the cooler one out of the 4 rapid insulin options in the UK.

I use Humalog, and also notice it takes up to 2 hours before it takes effect. Very frustrating. So, rather than delaying breakfast, even though I eat pretty low carb, I just endure sugars in the 140s to 180s until Humalog kicks in. I've only been using insulin (Toujeo long acting, Humalog rapid) for 5 months now. Type 2... 65 YO.

TJR56 · Sep 12, 2019

adeel.mahmood@hotmail.co.uk said:
I have a similar issue with breakfast, been diabetic for 23 years and it's when I have cereal mainly that it happens, then as you said around 2-3 hours later sugar levels are normal

Hi there. I found a cereal combination of no-sugar muesli and no-sugar granola based on oats or just home-made plain porridge - oats, with a little plain natural live yogurt and a few blueberries (but not a large serving) has worked for me, along with a split dose bolus. Keep at it - there will be an answer, but it may take some experimentation! PS. Your DSN may well be of help, and don't switch between one thing and another without a week or so of trialling of one (at least), including the odd 3 a.m. blood test (sorry!). All best wishes.

kitedoc · Sep 13, 2019

Please read diabettech.com Lantus: Lethal or Saviour? as a cautionary tale about Lantus.
And changing needle length as suggested by @jmackinnon is a good thought. How do any of us know whether a site is old or new after some many years and at what depth?
In my experience any intake of cereals is bad news for BSL. Avoid 'em like the plague!!!
Low carb seems to encompass intakes between approx 100 g to 20 g per day. I am suggesting that there may not be a proportional effect in comparing the upper and lower ranges and low carb diet = either low carb high fat or low carb high protein, or a combo of those two.
On very low carb high fat/protein diet (carbs < 30g per day) I count 50% of the protein intake as carbs for purposes of total carbs per day).
Finally, has your endo thought about possible antibody formation to your injected insulin?

Happy2bepart · Sep 13, 2019

jmackinnon said:
I've had diabetes for more than 25 years. I am always changing my eating habits, and take my insulin shortly before my meals in most instances, and always circulate my injection locations (short-term in stomach, long-term in butt).

For the past few months my morning insulin doses have not been "kicking in" within 10-15 minutes like they are supposed to, but instead take 2-3 hours. I wake up, take my insulin, eat my breakfast (which varies - and yes, I take the appropriate amount based on carb intake). An hour or more later, my blood sugar spikes (based on the amount of carbs, but typically to 19-20's mmol/L = 360 mg/dl) as though I didn't take any insulin at all. Then finally - up to 3 hours later - the insulin kicks in and drops me back down to the appropriate level based on the dosage I took for my breakfast. Has anyone experienced this before? I am very concerned and my doctor and endocrinologist don't seem to have a solution for the problem (besides changing injection locations or insulin types, both of which I have done). Odder still, later in the day, my insulin kicks in as normal, within 10-15 minutes after injection, like nothing is wrong. Most injections I take before lunch (if more than one) take 2-3 hours to react. So frustrating! Any thoughts are welcome!

Hi,
It might just be that you are insulin resistant in the mornings. I am and I have only just found that out by being on the free style lines sensor. I have been in insulin for over 55 years. I use Humalog fast acting insulin. It can take up until mid afternoon for me to get much response from the insulin.
Also your digestive system is usually slower when you have diabetez, as it affects the digestive process.

Peterinkiel · Sep 13, 2019

jmackinnon said:
I've had diabetes for more than 25 years. I am always changing my eating habits, and take my insulin shortly before my meals in most instances, and always circulate my injection locations (short-term in stomach, long-term in butt).

For the past few months my morning insulin doses have not been "kicking in" within 10-15 minutes like they are supposed to, but instead take 2-3 hours. I wake up, take my insulin, eat my breakfast (which varies - and yes, I take the appropriate amount based on carb intake). An hour or more later, my blood sugar spikes (based on the amount of carbs, but typically to 19-20's mmol/L = 360 mg/dl) as though I didn't take any insulin at all. Then finally - up to 3 hours later - the insulin kicks in and drops me back down to the appropriate level based on the dosage I took for my breakfast. Has anyone experienced this before? I am very concerned and my doctor and endocrinologist don't seem to have a solution for the problem (besides changing injection locations or insulin types, both of which I have done). Odder still, later in the day, my insulin kicks in as normal, within 10-15 minutes after injection, like nothing is wrong. Most injections I take before lunch (if more than one) take 2-3 hours to react. So frustrating! Any thoughts are welcome!

I too use Novorapid insulin three times per day. It usually kicks in after about 2 hours or even

Peterinkiel · Sep 13, 2019

jmackinnon said:
I've had diabetes for more than 25 years. I am always changing my eating habits, and take my insulin shortly before my meals in most instances, and always circulate my injection locations (short-term in stomach, long-term in butt).

For the past few months my morning insulin doses have not been "kicking in" within 10-15 minutes like they are supposed to, but instead take 2-3 hours. I wake up, take my insulin, eat my breakfast (which varies - and yes, I take the appropriate amount based on carb intake). An hour or more later, my blood sugar spikes (based on the amount of carbs, but typically to 19-20's mmol/L = 360 mg/dl) as though I didn't take any insulin at all. Then finally - up to 3 hours later - the insulin kicks in and drops me back down to the appropriate level based on the dosage I took for my breakfast. Has anyone experienced this before? I am very concerned and my doctor and endocrinologist don't seem to have a solution for the problem (besides changing injection locations or insulin types, both of which I have done). Odder still, later in the day, my insulin kicks in as normal, within 10-15 minutes after injection, like nothing is wrong. Most injections I take before lunch (if more than one) take 2-3 hours to react. So frustrating! Any thoughts are welcome!

Like many of you on Novorapid insulin, after nearly 70 years insulin treatment for my type 1 condition, I find that it now takes upwards of two hours for the morning dose of some 10 units to kick in. This is not new, but I have noticed it for the last five years or so. The only solution has been to eat a smaller breakfast in terms of carbohydrates and to take a second breakfast about 2 hours later, in order to avoid a hypo when the insulin finally kicks in.
Using Levemir twice a day early morning and late evening allows my overnight blood glucose levels to stay fairly stable, with the odd low level between 6.30 and 7.30 in the mornings.

I have not considered changing my Novorapid for another insulin, but it may be a possibility. My diabetologist has never suggested changing.. time perhaps for another chat.

(rapid) short-term insulin no longer "short"

buckmr2

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Wjohn

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TJR56

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Peterinkiel

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(rapid) short-term insulin no longer "short"

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