Type 1 Type 1 Novorapid sensitivity changes

[ColSB]

Last week I had a terrible Hypo episode.
Normally (or prior to last week) my Novorapid dose is 1 unit per 10gs of carbs or 1 unit per 1 unit of blood sugar.
I was becoming aware that it started to be 1unit per 40gs of carbs/4 units of blood sugar.
Thus after golf on Thursday I injected on the 4 to 1 ratio.
I got back to my area and couldn't find my way home, sweated through 2 layers of clothing and became disorientated.
I called a friend and asked for help, not knowing where i was.
He immediately took me to C&W A&E and they tried testing my body temp, no reading, changed the temperature gauge and still no reading. My blood sugar was 2.2mmol. They lay me down on a bed, put 4 water bottles on my body and 4 warm blankets and a hot air blanket. Slowly my body temperature rose to above 33 degrees C. With the glucose gel they gave me my blood sugar rose back up above 4 and I became lucid again.
I stayed in overnight until my body temp rose back up above 36 degrees.
Now it seems my Novorapid does is 1 unit per 60grams of carbs and 6 units of mmol blood sugar.
Actually the next day I chose to inject no Novorapid and the background brought me back down to 6 having been in the late teens.
I've now reduced my background from 27 at night and 22 in the morning to 20 at night and 16 in the mornings.
Is this normal?
Anyone else had a similar change in sensitivity to Novorapid?
Thanks very much for reading and I hope someone has some pearls of wisdom,

Colin

 

[Jaylee]

Hi @ColSB ,

Welcome to the forum!

How long have you been diagnosed..?
What "background" basal insulin are you on.?

 

[Poosecat]

Hi Colin. My novarapid sensitivity changes a lot. I think I differ a bit because I never mastered carb counting. BUT - I'm least sensitive in the mornings. Instead of injecting more which causes my sugars to crash, i inject and hour before I eat my brekkie. Hot weather also can affect insulin sensitivity. Was it during the hot spell? Many people see insulin working faster in heat

 

[ColSB]

Hi @ColSB ,

Welcome to the forum!

How long have you been diagnosed..?
What "background" basal insulin are you on.?

Jaylee I've only been diagnosed for 2 years.
I use Levemir for my background.
My background never used to touch my carb intake. So this is new as well.
Thanks for your reply.

Col

 

[ColSB]

Hi Colin. My novarapid sensitivity changes a lot. I think I differ a bit because I never mastered carb counting. BUT - I'm least sensitive in the mornings. Instead of injecting more which causes my sugars to crash, i inject and hour before I eat my brekkie. Hot weather also can affect insulin sensitivity. Was it during the hot spell? Many people see insulin working faster in heat

I was in Turkey the week before and there was no issue with over sensitivity. But I did inject less. But nothing like it is now.
Thanks for your reply.
Get carb counting! Use carbs and Cals. Pretty useful I think.

Col

 

[Jaylee]

Jaylee I've only been diagnosed for 2 years.
I use Levemir for my background.
My background never used to touch my carb intake. So this is new as well.
Thanks for your reply.

Col

No problem Col. I was thinking possible "honeymoon period"? Which can throw "curve balls"..

Sounds like a nasty experience..
Had you opened started a new batch of Levemir prior?

 

[noblehead]

I've now reduced my background from 27 at night and 22 in the morning to 20 at night and 16 in the mornings.
Is this normal?
Anyone else had a similar change in sensitivity to Novorapid?

Insulin doses are not set in stone and do change over time @ColSB

My insulin-to-carb ratio's rarely change that much, however my basal usage has changed by quite a bit over the years. Several years ago I was taking up to 36u of lantus a day, before moving to a pump two years ago I was down to around 20u and now average around 16u.

In the book Think Like a Pancreas the author says things like age, activity, diet & weight loss can effect both basal and bolus usage.

 

[Juicyj]

Hello @ColSB In hotter weather my insulin needs decrease alot and I am more prone to hypos particularly when exercising, it seems to be a common occurrence in type 1, just keep a very close eye and always make sure you have a hypo treatment on you at all times, jelly babies are good in hot weather or glucogel, it's literally your medicine to treat your hypos so essential to carry with you at all times.

 

[Poosecat]

I was in Turkey the week before and there was no issue with over sensitivity. But I did inject less. But nothing like it is now.
Thanks for your reply.
Get carb counting! Use carbs and Cals. Pretty useful I think.

Col

I've got the app and the book. Still really rubbish at it. I've been diagnosed for 20 years or so and only heard about a few years ago when I was pregnant. I will get my diabetes team to help me out with it again I think. Now I just use guess work..... eek!

 

[jackois]

Hi Colin,

I'm also on Lantus for basal & Novorapid for bolus.

MY sensitivity has markedly changed over the last 6 months. At the turn of the year, I was taking 16-18 units of Lantus and worked on 1 unit to 15g of carb for bolus. urrently I'm down to 9 units of Lantus, take no Novorapid with breakfast or Lunch and still work with 1 unit to 20 grams for my evening meal.

I tend to have 50g of carb for breakfast & lunch and 60 to 70 for the evening meal. I also play golf and have to snack my way around the course to avoid hypos. Generally my blood sugars run between 5 and 6, except when golfing where I push my sugars up to between 7 and 9 as I seem to play much better at those levels.

I have no real idea why this has happened, but you aren't alone.

 

[ColSB]

Insulin doses are not set in stone and do change over time @ColSB

My insulin-to-carb ratio's rarely change that much, however my basal usage has changed by quite a bit over the years. Several years ago I was taking up to 36u of lantus a day, before moving to a pump two years ago I was down to around 20u and now average around 16u.

In the book Think Like a Pancreas the author says things like age, activity, diet & weight loss can effect both basal and bolus usage.

Thanks for your comments

 

[Final]

Last week I had a terrible Hypo episode.
Normally (or prior to last week) my Novorapid dose is 1 unit per 10gs of carbs or 1 unit per 1 unit of blood sugar.
I was becoming aware that it started to be 1unit per 40gs of carbs/4 units of blood sugar.
Thus after golf on Thursday I injected on the 4 to 1 ratio.
I got back to my area and couldn't find my way home, sweated through 2 layers of clothing and became disorientated.
I called a friend and asked for help, not knowing where i was.
He immediately took me to C&W A&E and they tried testing my body temp, no reading, changed the temperature gauge and still no reading. My blood sugar was 2.2mmol. They lay me down on a bed, put 4 water bottles on my body and 4 warm blankets and a hot air blanket. Slowly my body temperature rose to above 33 degrees C. With the glucose gel they gave me my blood sugar rose back up above 4 and I became lucid again.
I stayed in overnight until my body temp rose back up above 36 degrees.
Now it seems my Novorapid does is 1 unit per 60grams of carbs and 6 units of mmol blood sugar.
Actually the next day I chose to inject no Novorapid and the background brought me back down to 6 having been in the late teens.
I've now reduced my background from 27 at night and 22 in the morning to 20 at night and 16 in the mornings.
Is this normal?
Anyone else had a similar change in sensitivity to Novorapid?
Thanks very much for reading and I hope someone has some pearls of wisdom,

Colin

Hi Colin, Your report encouraged me to respond to you with interest. Big swings in dosage but given low sugar result after exercise not surprising.
Difficult to know where to start so if I tell you about my control levels etc
Been type1 since 1968, 17 yrs old then.
Current wt 188 lbs, Jog 3 miles per week
Lantus background dose 18 units (constant) taken 6pm.
B/fast 8:30am 30g rice crispies / banana 17 units nova rapid. Between then and 6pm I tend to graze as per sugar required. This could be 4/5 jelly babes & or 2/3 tangerines. Tea time is normally a reasonable plate of pasta / beer, 2 choc digestives. Units at tea time vary 20/24units nova rapid depends on blood levels and around 9:30pm 1 x 25g bag of crisps. Levels can vary from 4% to 11%. (3 months average 6.9%) over many 3 month periods.
Exercise:- I usually, prior to golf, have a bacon roll and around 9th have a Mars bar. After a game say 5pm I cut my insulin intake by around 25%. The physical exercise will act upon my sugar levels well after game finished. If I go for a jog Sunday morning I will cut my insulin by 50% for any given amount of food. Based on 3 mile jog or no food no insulin ( normally I'll come back with a higher blood sugar level than I started with ie 6% > 8%. If I run further it will then go lower - keep an eye on it.
After physical exercise the body becomes more sensitive therefore needing less insulin to balence levels so after a run ( jog) that day will need less insulin even several hours later on in the day.
These notes are just a snap shot of different circumstances and adjusting dosage to suit. This is never easy but testing often is the best way of staying in control. Body wt, stress, physical exercise, alcohol all play a meaningful part of control levels. Injecting in less fatty parts of our body will allow the insulin to work faster. Thighs stomach area & upper arms.
Hope this helps,
All the best
GH