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Switching insulin

Discussion in 'Type 1 Diabetes' started by Steve14, Oct 22, 2019.

  1. Steve14

    Steve14 Type 1 · Well-Known Member

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    Hi all,

    I've been using Insuman Rapid ever since my T1 diagnosis (2015) and my diabetic doc has prescribed a new form of insulin called Apidra. She said that now I can inject even after eating and it should ease my life, and from now on I should eat 3 meals a day. However, I'm used to eating 5 meals a day (technically 3 with 2 snacks in-between and an extra 1 prior bedtime). So what do I do? According to this, to make up for the two snacks, I'm supposed to increase the calories of two meals (either breakfast and lunch, lunch and dinner etc.).....however, I have an awful morning appetite and already eat two sandwiches for breakfast. Two and a half hours past breakfast I'll usually have a banana. With the new insulin I'm supposed to eat all at once. If I tried to do that, then I'd throw up because it's too much for my stomach and I don't have the appetite in the morning. But if I don't have a snack between breakfast and lunch, then I'll lose my energy and feel sickly. When I told her about the difficulties of eating more at one sitting, then she told me to ask online so now I'm here. Please help me because this is my first day on Apidra and I'm anxious.
     
    #1 Steve14, Oct 22, 2019 at 12:23 PM
    Last edited: Oct 22, 2019
  2. Antje77

    Antje77 LADA · Moderator
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    That's strange advice. With modern insulins you should be able to adjust your insulin to your food, not the other way around.
    Have you done a DAFNE course or such? That could be very helpful.

    Can it be he meant you don't need to eat 5 meals a day anymore if you don't want to, not that you cannot eat them if it suits you?
     
    • Agree Agree x 2
  3. Steve14

    Steve14 Type 1 · Well-Known Member

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    Thank you. Up until now I had 3 bolus and 1 basal. My question is: if I have snacks in-between the three meals, then do I have to give myself insulin separately for the snacks? So do I have to inject myself more than 4x times a day from now on? I wouldn't be a fan of that.:shifty: I'm not from the UK and there isn't a DAFNE course here.:(
     
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  4. urbanracer

    urbanracer Type 1 · Expert
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  5. kitedoc

    kitedoc Type 1 · Well-Known Member

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    From googling Isuman Rapid, (e.g. Isuman Rapid insulin profile) it appears to have an action similar to Regular insulin.
    If you google 'Apidra insulin profile' the graph shows a more rapid action profile and is often quoted as similar to other faster acting insulins like Novorapid and Humalog.
    One use of Isuman Rapid insulin is in a regime promoted by Dr Bernstein in his book 'Diabetes Solution' (and exemplified on sites like True Grit Type One - which also reports the advantages of lower HBAiC and loew BSL variability and very low rate of hypos) where he shows that it is possible to achieve normal or near normal BSLs and HBA!C. Part of this regime, as he writes, involves a very low carb diet.
    In contrast to what @Antje77 says about Apidra and DAFNE (Dose Adjustment For Normal Eating), the Bernstein approach, which I use, adapts the diet to the action of the insulin.
    The question is, can you eat want what you like and dose for it (DAFNE) with Apidra and maintain HBA!C of less than 6% and BSL variability of 4 to 6.4 mmol/l and minimal hypos?
    I wish you luck with Apidra and sorry if you were not given the opportunity to use Isuman Rapid to its full potential but felt that in switching insulins it might be helpful to contrast the effect and potential of each insulin.
    The above is not medical advice or opinion, just based on my own experience of 53 years on insulin and my diabetes education.
     
  6. karen8967

    karen8967 Type 1 · Expert

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    when i was first diagnosed i was put on apidra and you dont have to stick to 3 meals a day if you snack inbetween just be aware of i.o.b its all trial and error your eating habits should not have to change :)
     
  7. Antje77

    Antje77 LADA · Moderator
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    No contrast here, @kitedoc . If you're comfortable dosing for different foods, like they teach you at DAFNE, you can choose low carb foods as well if that suits you. If you don't know how to adjust your dosing, you can't use Bernsteins approach either.

    Right now it seems you're struggling to eat 2 sandwiches and a banana for breakfast because your doctor has told you you must eat that much, @Steve14 . If a course can give you a better understanding of how to use your insulin it will give you much more freedom with food, be it a Bernstein like approach or the food you're used to eating.
     
    • Agree Agree x 1
  8. scotteric

    scotteric Type 1 · Well-Known Member

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    You might have to take more injections than that honestly if you want good results. The idea is to take insulin whenever you need it, so yes, everytime you eat basically anything you have to inject, as well as when you need to correct highs. There are days when I might inject 10 times, but it's really not a big deal. It's better than having to stick to a strict schedule, and it's better than the days before pens and the crazy small pen needles that you can get now. You just get used to it after a while and it shouldn't hurt unless you hit a bad spot or re-use a needle too many times.
     
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  9. Steve14

    Steve14 Type 1 · Well-Known Member

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    Sorry I took my time to respond back, but I wanted to test this new insulin before saying anything good or bad about it.

    It hasn't been 3 days, but my levels haven't been this stable before. With Insuman Rapid I used to wake up with e.g. glucose of 7, then inject, then my levels would climb up to 12-13+, and then by the 4 hour mark I'd go hypo:dead:. I could try and prevent the hypo (sometimes overshoot), but couldn't deal with the initial hyper.

    Now with Apidra I stay stable (+/- 1-2 glucose before injection). I found that for certain snacks I don't need the extra shot, but for others I should. It will take some time to get the levels right, but so far no more roller-coaster rides and that's a miracle in itself! It hasn't made such a drastic health improvement as I'd have expected it to, but steering clear of hypos and remaining under 10 is good enough for me.
     
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  10. kitedoc

    kitedoc Type 1 · Well-Known Member

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    As far as I am aware DAFNE is not about dosing for protein and thus there is a distinct contrast.
     
  11. tomfalc

    tomfalc Type 1 · Member

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    I've been on Apidra for a while, although using a pump rather than injections. I would agree with the statement about taking it after meals, and I try to take it 15 minutes before eating.
     
  12. LeeLeeLeeLee

    LeeLeeLeeLee Type 1 · Member

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    I don't take insulin because I hate needles. My doctor is trying to put me on inhaled insulin instead.
     
  13. porl69

    porl69 Type 1 · Well-Known Member

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    How long have you been type 1 AND how are you keeping your bloods in check with no insulin??
     
  14. LeeLeeLeeLee

    LeeLeeLeeLee Type 1 · Member

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    About four or five years now. I've been avoiding foods that are sugary and trying to switch to other foods that will help lower blood sugars. SO far in four months I dropped two points on my AIC.
     
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