Active insulin duration

E

ellevee

Member
Relationship to Diabetes
Type 1
Hi all,
I'm recently diagnosed Type 1 and on small amounts of levemir and novorapid . I'm finding my novorapid takes 6 hrs to get me back to anywhere near where I started and if I try and do a mealtime correction (ie shave off a few carbs to bring me down a bit It come off all at once after 6hrs . I'm about to try some basal testing this week - could it be my basal isn't strong enough or is the novorapid really that slow, My two units of night time levemir holds me steady but i Can see from the night time graphs the flatline doesn't happen till 6 hrs after my last meal. If I increase my daytime it also seems to affect the night time causing a drop rather than hoding me steady During the day it drives me nuts because I feel like i have to eat breakfast at 6 am to fit in lunch and then dinner in the evening with my family . Any thoughts or similar experiences? I have an appointment with nurse on Tuesday and wanted to try some basal testing before then to see if I could gather some evidence before then as it could be weeks before I get to speak to her again. Thanks in advance . I also suffer from foot on the floor which makes matter worse and have tried a correction dose of one unit which sometimes drops me sometimes doesnt.
 
How far in advance of your meals are you injecting @ellevee ? And are you sure your meal ratios are ok? As you say, the first thing to do is a basal test, but cautiously moving your bolus time earlier should help. Can you post a Libre graph?
 
Hi @Inka thanks for replying usually around 20 mins pre bolus . I’m questioning everything just now my mealtime ratios aren’t right I know if I do one to 15 for example I drop after the 6 hours - one to18 / 20
Takes me back to same place in six hours . I’ll post a graph to give you an idea
 
I find different meals need different pre-bolus times - eg I need 30 mins for breakfast. So, after you’ve got your basal tested, you could experiment with timings. Do one meal at a time, move your bolus in 5 min increments and hold it at each stage for a few days before you judge whether to move it again.
 
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ellevee said:
Hi @Inka thanks for replying usually around 20 mins pre bolus . I’m questioning everything just now my mealtime ratios aren’t right I know if I do one to 15 for example I drop after the 6 hours - one to18 / 20
Takes me back to same place in six hours . I’ll post a graph to give you an idea
Click to expand...
So steady overnight tried then takes forever to work i can sit happily at 5.5 overnight if i get evening bolus right and still
Have this trouble the next day .
 
Inka said:
I find different meals need different pre-bolus times - eg I need 30 mins for breakfast. So, after you’ve got your basal tested, you could experiment with timings. Do one meal at a time, move your bolus in 5 min increments and hold it at each stage for a few days before you judge whether to move it again.
Click to expand...
Thank you the reason I got into this mess is when I went back to exercise my insulin sensitivity was so sharp I dropped before I finished eating so it’s set me back now things are going backwards I’m thinking I need to get more active or increase Basal . Will
Try a test tomorrow
 
Don’t forget top-up carbs @ellevee If you’re, say, 6, and you’re about to exercise, you can just top up with glucose and carbs as needed. I think that’s not mentioned enough.
 
Did you eat your breakfast at 6am on your graph above? Your blood sugar seems to take a little while to peak. What times do you take your Levemir? I wonder whether your evening dose has run out before your morning dose has kicked in.
 
Novorapid takes 20-30 minutes to start to work, peaks at about an hour after injecting and then stays in your system for around 4 hours. We noticed sometimes up to 5 hours when our kid was younger but it’s much nearer 4 now. If you do the basal testing then you can get that right. Then look at your breakfast ratio - you may have different insulin needs at different times of the day. Once you have your basal and your breakfast more or less right then you can sort your lunch etc. but yes you might need pre exercise carbs.
 
Inka said:
Don’t forget top-up carbs @ellevee If you’re, say, 6, and you’re about to exercise, you can just top up with glucose and carbs as needed. I think that’s not mentioned enough.
Click to expand...
Great point! I've always been a keen cyclist, even before I was diagnosd with LADA (eight years ago). Apparently cycling's the most efficient way in the whole animal kingdom of burning calories (a salmon swimming upstream is in second place!) and so it's easy for cyclists to run out of available blood sugar (called 'the bonk', or 'hunger knock'): as I know myself from bitter experience, it's essentially a hypo :( . Once that happens, it's sayonara if the cyclist is in a race, as it's too late to replenish the blood sugar without actually stopping cycling. So, cyclists learn to 'drink before you're thirsty and eat before you're hungry'. For example, today I did a four-hour ride, which meant that I used a combination of electrolyte drink and energy bars, with an energy gel to get me through the last few miles. Looking at my Libre profile afterwards, I managed to keep my blood sugar between 4.0 and 7.0 throughout the ride. I had 500mls of recovery drink (a combination of protein and carbs) immediately after I finished: that sent my blood sugar up to 9.5 - but as soon as I finished the drink my blood sugar started dipping again, so that just before dinner (pizza and salad) I was at 4.8. I had no insulin before dinner: the pizza sent my blood sugar up to just over 9 - but it's already gone back down to just over 5. I won't be taking any insulin before I go to bed, as the likelihood is that, even without any insulin at all today since before breakfast (and a high intake of carbs since then), my blood sugar will dip below 4 overnight - as presumably it would with any cyclist having had that workload today.
 
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