Unpredictable insulin action

[Matheus Andrade]

Hello, everyone. I've been diabetic for over 10 years now and lately, I've been having some serious issues with the action of my insulin bolus doses. I noticed that its peak of action sometimes started occurring way before the expected, and as a consequence, I had to adjust my bolus doses for several minutes after eating, to avoid hypoglycemia. Moreover, when the insulin peaks before the expected (20-30 minutes after the injection, as opposed to 1h-1h30min, which is the normal time for an Aspart or Glusiline insulin), it works way more than it should and I had to lower my doses as well. It's extremely frustrating because sometimes the doses just work and function as expected, with their peak at the right time and correct power. Does anyone have some idea of what's going on?

I'm monitoring my BG with a Libre 1 and I take 25 units of Lantus every day in one injection. I'm not using expired insulin pens and my insulins' appearance is water-like.

I'm considering changing to regular insulin, as I already have changed from Apidra to Novorapid due to these issues.

Thanks.

 

[Juicyj]

Hello @Matheus Andrade

Can you give a little more information - so is this an ongoing pattern at certain times of the day ? What are you eating ? How long has it been going on ? Do you have a diabetic team supporting you ?

If you looking to adjust insulin/doses then you need to see a consistency with patterns before making adjustments, also it's worth trying basal fasting tests first to check your basal is doing the required job.

 

[Matheus Andrade]

Hello @Matheus Andrade

Can you give a little more information - so is this an ongoing pattern at certain times of the day ? What are you eating ? How long has it been going on ? Do you have a diabetic team supporting you ?

If you looking to adjust insulin/doses then you need to see a consistency with patterns before making adjustments, also it's worth trying basal fasting tests first to check your basal is doing the required job.

Hello. No, this does not follow any pattern throughout the day. I usually eat regular amounts of carbohydrates and protein. Generally white rice or pasta, various meats, and some vegetables for lunch and dinner; integral bread, eggs, canned tuna, and cold platters for breakfast and afternoon snacks. Lately, though, I have been lowering a little my carbs to avoid the need for higher bolus doses. Since I moved to a new city, 4 months ago, these issues have been happening. I don't have any medical support yet since moving.

I have not tried the fasting test to adjust my basal doses yet.

 

[Erin]

Hello, everyone. I've been diabetic for over 10 years now and lately, I've been having some serious issues with the action of my insulin bolus doses. I noticed that its peak of action sometimes started occurring way before the expected, and as a consequence, I had to adjust my bolus doses for several minutes after eating, to avoid hypoglycemia. Moreover, when the insulin peaks before the expected (20-30 minutes after the injection, as opposed to 1h-1h30min, which is the normal time for an Aspart or Glusiline insulin), it works way more than it should and I had to lower my doses as well. It's extremely frustrating because sometimes the doses just work and function as expected, with their peak at the right time and correct power. Does anyone have some idea of what's going on?

I'm monitoring my BG with a Libre 1 and I take 25 units of Lantus every day in one injection. I'm not using expired insulin pens and my insulins' appearance is water-like.

I'm considering changing to regular insulin, as I already have changed from Apidra to Novorapid due to these issues.

Thanks.

Recently (approx. a few months or so) I have been having hypoglycemic numbers, and reducing my insulin dose and glyclazide and Metformin. My insulin is Humalin N. I have seen some other complaints about this, and I am wondering if there may be a change in the insulin preparation that the FDA may have not reported. I have changed meds, and that may be my particular cause.

 

[Yaya10_10]

does the weather affect insulin sensitivity?

 

[Juicyj]

Hello. No, this does not follow any pattern throughout the day. I usually eat regular amounts of carbohydrates and protein. Generally white rice or pasta, various meats, and some vegetables for lunch and dinner; integral bread, eggs, canned tuna, and cold platters for breakfast and afternoon snacks. Lately, though, I have been lowering a little my carbs to avoid the need for higher bolus doses. Since I moved to a new city, 4 months ago, these issues have been happening. I don't have any medical support yet since moving.

I have not tried the fasting test to adjust my basal doses yet.

Are you in the UK ? If so, find out where your diabetic support is and get in touch.

Insulin doses can change for many reasons, so starting with doing some basal fasting tests to check your background dose is right would be my first action, then review your carb/insulin ratio, but also keep a diary to record carbs eaten/dose taken/BG readings too to track this.

 

[Juicyj]

does the weather affect insulin sensitivity?

Yes heat can increase insulin sensitivity and colder climates the opposite, but depends on you as an individual too.

 

[Yaya10_10]

Thank you so much @Juicyj
that's great explanation