Insulin Sensitivity

[KD86]

hi,

New to forum. I have been diabetic for 29 years and always been relatively well controlled. I got my libre sensor a year ago which is great but I feel like my control is worse now purely by being more actively aware of my readings and over thinking it all.. HOwever, in the last month or two I have noticed my insulin is taking so long to take effect and no matter what I eat I am getting major highs before insulin takes effect and then I get lows. The ups and downs are making me feel poorly but also putting on lots of weights.

has anyone experienced this or have any advice? I use lantus and humalog.

thanks

 

[Ljc]

Hello @KD86 . Welcome to the forum.
I have no experience with your insulin’s but others here have , so I will leave that side of things to others. Except to ask if you have done any Basal testing recently.

Those lows then highs must be making you feel so rough.

Are you treating the hypo’s on the basis of the scan or a a finger bodge ?.

 

[rebrascora]

Hi and welcome

So pleased you have found us as I am sure you will find the knowledge and experience here helpful. I know I have.

As regards your problem. I too wonder if it is a basal insulin issuer. My basal needs have increased quite significantly at different times of the day in the last couple of months which coincides with my Covid Vaccine. My BG did go noticeably haywire for a few days after the vaccine but since then I have had to progressively increase my basal insulin and/or spend my days injecting corrections. Doing a basal test is a good idea. I often skip meals or eat very low carb so it is relatively easy for me to see when my basal insulin needs are increasing. It is unusual at this time of year as normally they would be decreasing in spring and I would be reducing my basal dose a little. I wonder if the vaccine triggered my immune system to kill a few more beta cells, but I am hoping it is a more fleeting issue and eventually I will be able to return to my lower basal dose.
As regards weight increase, I would be looking more at the stresses and strains of the pandemic and perhaps an increase in food consumption as a result or less activity than you would normally do perhaps.

My other thought with your rollercoaster levels is are you taking into consideration the 15 min lag between Libre and BG or do you need to change the timing of your bolus insulin to give it more time to hit your blood stream as your food is being digested. For me that is the beauty of Libre, that I can actually watch for the insulin starting to kick in and then eat, particularly at breakfast time when I need to give my Fiasp about 45 mins head start, depending upon my waking reading... if I am in the 4s it might only need 10 mins with a low carb meal but 6s or 7s or above and I have to wait a lot longer.

I know those peaks and troughs are really awful so I hope we are able to suggest a strategy which will help you to get things back under control.

 

[SB2015]

Welcome to the forum @KD86 . Sorry to hear that you are having bother with your levels.
It was when I got the Libre that I realised just how spiky my levels were after a meal, and I then started to adjust the timing of my Bolus insulin. I started on a conservative pre meal Bolus time and then gradually/worked out what I need for each meal. We all respond to our insulin in different ways so it is a case of trial and improvement (so where @rebrascora has mentioned 45 mins for her I would not recommend starting there. For my pump and my insulin they recommend 15 min before a meal as a starting point. Perhaps go from there) . Then I find that when the weather changes I might need to alter the timings again, (or perhaps in this case it is the ‘lockdown bulge’ I have noticed that has reduced my sensitivity!)

By timing my Bolus for each meal I have reduced the spikes and feel so much better. It is horrible being on a roller coaster, (both a Diabetes one and on one of those fair ground rides!!)
Do talk to your DSN about this and do lots of testing if you alter this.

 

[rebrascora]

Gosh yes! Not suggesting anyone preboluses by 45 mins straight off! Slowly experimenting with 5 minute increases from wherever you are now is the way to go until you hit the "sweet spot" for you where glucose from the food hits the blood stream at about the same time as the insulin. Just really wanting to highlight than it can take quite a bit longer than the recommended 15-20 mins so careful experimentation beyond those guidelines can be helpful to iron out the peaks.

 

[KD86]

Thanks for your responses.

I have been diabetic along time and over a period got complacent. My 3 month average was always reasonable pre sensor so just assumed I was doing ok. The sensor has really made me realise the impact of foods and the spikes, food I took for granted before I really notice the imodvt on my body, tiredness, alertness etc more now.

I do try to take insulin in advance but always rushing around at last minute, i guess it really is that lifestyle change...diabetes first and other things second. Priorities maybe a little out of sync.

out of interest, what is a Basel test?

I have got better at reading the sensor with 20 minute lag in mind and also much more conscious not to over do it when eating my way out of a hypo ha ha and then getting the spike that ruins your day.

every day is an experiment with it.

 

[trophywench]

Here is a Basal Test home lesson -

Basal insulins « Diabetes Support Information Exchange

www.diabetes-support.org.uk

... and now they've invented the Libre to assist us with doing it - it's easy peasy !

 

[nonethewiser]

I do try to take insulin in advance but always rushing around at last minute, i guess it really is that lifestyle change...diabetes first and other things second. Priorities maybe a little out of sync.

That's the thing, notice if forget to bolus in advance bg can go into double figures, get timing right stays in single digits, libre is good at pinpointing this.