Insulin and being ill

[New-journey]

Sorry to hear the insulins you are on seem to be messing you about a bit

It was Fiasp I tried - Initially it was noticeably quicker than NR, and I needed to change my dose strategies / prebolus timings to take account for the forward weighting of the insulin (pharmacologically these insulins have the same overall duration, but the added special sauce front-loads the insulin so much more of it acts in the initial 0-2 hrs)

After a few weeks I had to start upping my ratios (other users and bloggers had mentioned this was a thing, so I wasn’t unduly worried).

By about the middle of the second vial (I had an initial order of three vials to try) ratios were continuing to rise, my bolus timings had reverted back to NR ones, it wasn’t acting any quicker for me any more. I was getting stinging when bolusing and red / angry sites. It was also occasionally ‘disappearing’ and not apparently acting at all. By the third vial I’d decided to call it a day, carried on experimenting a bit, but there were no speed benefits, I was resistant to it, it was unpredictable for me, and my body was obviously struggling with it with the angry sites and stinging/itching.

Returned to NotVeryRapid, and sluggish, but reliable normality restored.

Your Lantus doesn’t sound right. Have you been adjusting the dose? When do you take it?

Thanks and this is helpful. I was on Fiasp first and then changed as I was getting red sites, it stopped being effective and I was putting on weight. The last 4 months I have been on Lyumjev and now I feel I am insulin resistant, also itchy sites. I take Lantus in the morning and have upped it from 16 till 25 units with no difference.
I am going to see if changing back gives me some normality again!

 

[everydayupsanddowns]

Hope the swap back to NR works for you @New-journey

 

[New-journey]

Hope the swap back to NR works for you @New-journey

Thanks, I will let you know!

 

[void]

Hi all, I was put on Lyumjev a few months ago and the three times I have been ill, it doesn't seem to work. I literally need 10 times as much insulin and I am still high. I have a stomach bug now and I am taking so much insulin and through the night as well. This never happened when I had Covid and on a different insulin.
Anyone else ever had this? I am going to contact my consultant tomorrow as well.

I take novorapid and have noticed that when ill, my insulin requirement becomes unpredictable.
I think, (but check this with your provider), that a histamine response (allergic, itching etc) makes one much more (unpredictably) resistant.

like i say, don't take my word for it - check with your provider. Hope you feel better soon.

 

[SB2015]

Thanks and this is helpful. I was on Fiasp first and then changed as I was getting red sites, it stopped being effective and I was putting on weight. The last 4 months I have been on Lyumjev and now I feel I am insulin resistant, also itchy sites. I take Lantus in the morning and have upped it from 16 till 25 units with no difference.
I am going to see if changing back gives me some normality again!

I am another one who tried FIASP. It behaved well to start with but did not seem as effective when I was high. I soon developed some very skanky cannula sites which became very painful and ineffective. I switched back to Novorapid and that works well for me.

 

[New-journey]

I am another one who tried FIASP. It behaved well to start with but did not seem as effective when I was high. I soon developed some very skanky cannula sites which became very painful and ineffective. I switched back to Novorapid and that works well for me.

Thanks for sharing, I am now waiting for the prescription for Novorapid. I can't wait!

 

[New-journey]

I take novorapid and have noticed that when ill, my insulin requirement becomes unpredictable.
I think, (but check this with your provider), that a histamine response (allergic, itching etc) makes one much more (unpredictably) resistant.

like i say, don't take my word for it - check with your provider. Hope you feel better soon.

Thanks Void, it is challenging when we are ill!

 

[helli]

@New-journey have you done a basal test to make sure your Lantus dose is correct? Adjusting your bolus when you have "unsteady foundations" could mean that you are using bolus to make up for a low basal dose.
For example, does it hold you steady overnight? If not, your basal needs to be higher.
Does your Lantus last a full 24 hours? It is common to find it only lasts 20 hours and, if you take it in the morning, it may be running out at the same time as dawn phenomenon kicks in.

I would wait until you are better before doing any testing and making changes because the illness will impact your insulin needs.

I hope you feel better soon.

 

[PattiEvans]

There is an insulin that is faster than Novorapid that no one has mentioned and it's far more stable than the other fast insulins. It's Apidra. I have been using it for around 12 years. It was brought home to me when I went away for a weekend and discovered my frio was empty (hubby had told me he'd put my insulin in the car, but he'd only put the empty frio in) - I had to go to a hospital and get a Dr to dispense Novorapid as they didn't have Apidra. I was shocked at how much slower it was than the Apidra I was used to.

 

[helli]

There is an insulin that is faster than Novorapid that no one has mentioned and it's far more stable than the other fast insulins. It's Apidra. I have been using it for around 12 years. It was brought home to me when I went away for a weekend and discovered my frio was empty (hubby had told me he'd put my insulin in the car, but he'd only put the empty frio in) - I had to go to a hospital and get a Dr to dispense Novorapid as they didn't have Apidra. I was shocked at how much slower it was than the Apidra I was used to.

Apidra is certainly worthwhile trying.
However, its textbook action profile is quite different to the textbook NovoRapid one - longer and flatter rising later than the NovoRapid spike.

I am not disagreeing that it works faster for you as we are all different. I was given a chance to trial Humalog because it may be faster than NovoRapid but it was much much slower for me.

And it is interesting that Apidra is so rarely mentioned, especially when it can work faster than the usual.

 

[SB2015]

It is so easy to stick to what you are used to. If it ain’t broke ….
However it is good to read on here of other options to try.

 

[SB2015]

Thanks for sharing, I am now waiting for the prescription for Novorapid. I can't wait!

Let us know how you get on.

 

[PattiEvans]

Apidra is certainly worthwhile trying.
However, its textbook action profile is quite different to the textbook NovoRapid one - longer and flatter rising later than the NovoRapid spike.

Hi Helli - do you have a link for that please? The only comparison I can find (https://products.sanofi.us/apidra/apidra.pdf) compares it with "regular" insulin. I remember my original pump nurse, who was lovely, saying it was faster and I never queried it as I transitioned from Humalog, which was very definitely slower and had a nasty kick in the tail. Plus the Novorapid I had to use for a weekend did seem considerably slower, but as you say, how it works for one person may not be typical. At that time my clinic had all their pump users on Apidra. That's no longer the case, but the head pump nurse has changed and the current one is very inflexible in her views. If the literature says an insulin is out of your system in 3 hours then she firmly believes that to be true. I think it would be interesting if all DSNs had to be T1 themselves! The DSN who is her assistant now is T1 herself and a lot more flexible I think (if she could ever get a word in edgewise!).