Is NovoRapid supposed to take over 3 hours to lower blood sugar after meals?

V

Vicki Tamblin

Member
Relationship to Diabetes
Type 1
Hi, ️

I am on NovoRapid and I'm not sure it's actually working correctly. I take it before I eat, but my blood sugars ate still running high after 2/3 hours after I eat.

My team told me not to take extra units about 2 hours after to try and bring it down as apparently I be storing the insulin? (I be doing this for over a year, by taking extra units to bring it down and it did).

I occasionally eat a heavy carb meal, so take extra, but I mostly eat protein and have lunch and dinner.

Is this how NovoRapid actually works by taking it before meals and takes 3+ hours to work?

I'm t2 I've been told, but I'm thinking I might be t1.5.

BTW, I'm in the UK

Thanks
 
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How are you calculating yout insulin dose?
Are you including a bolus for the protein if you are eating low carb?
Are you sure your badal dose is correct?

Sorry for all the questions but if you need extra bolus, it is likely you need more insulin .
To answer your question, NovoRapid lasts about 4 hours but this will vary from person to person and is mostly "front loaded" - most NovoRapid is used on the first half. Google "NovoRapid profile" to see this in a graph.
 
Novorapid’s profile is generally that it takes about 30 minutes to start to work, peaks about an hour in and then stays the system for 4 hours or so. If you’re eating low carb that may mean you’re not taking the right ratio. Or your ratio may not be quite right to begin with. If you’re consistently high after meals then it’s safer to alter your ratio instead of stacking insulin by correcting while you have insulin onboard.

I’m going to immediately contradict myself though now: the theory with low(er) carb is that if your body isn’t getting easy energy from carbs then it converts fat and protein into glucose. This is a slower process than converting carbs so while the profile of your insulin is supposed to mimic the conversion of carbs it may mean that you’d actually be better taking your insulin after you eat so that it matches the slower conversion of fat and protein into glucose. It’ll depend on how many carbs you’re having with meals vs how much glucose you’re getting from fat and protein as to where you need the insulin profile to be so it may be that you need to try a few different timings and ratios. If your consistently high it may just be the ratio that is wrong and I may be overthinking the timing issue.
 
Provided your carb to insulin ratio is right, then, yes, in my experience blood sugars can stay high a couple of hours after eating.
What do you count as high? In the 7s, or in the teens?
A walk can help bring blood sugars down. Sometimes too sucessfully!
 
Welcome to the forum @Vicki Tamblin

Sorry to hear you are seeing higher levels than you’d like after your meals.

Trying to balance insulin with meals often involves an understanding of the theory of Diabetes Maths, along with some personal adjustments and workarounds based on how your body seems to respond in practice.

It’s not clear from your post how you have been taught to use insulin. Are you taking fixed doses which are the same every day? or have you been shown how to calculate / estimate the carbohydrate content of your meals and adjust each dose based on the food you are about to eat?

Have you been told to ‘prebolus’? Giving the insulin a little while to get going, on order to better match the absorption of the food?
 
Some of us refer to it as Novo(not so)Rapid or NovoSluggish.

When you inject is as important as how much you inject. Injecting in advance of eating (ie pre bolusing) gives the insulin a chance to be absorbed before the carbs you eat start releasing glucose or in the case of morning time, start working on the glucose your liver releases. Figuring out the right pre-bolus timing for your body and the meal you are about to eat and the time of day is part of the diabetes maths Mike mentions above.

To give you an example, when I used NovoRapid (NR) I started out injecting 20 mins before I ate breakfast and I would spike up to about 15mmols every morning and then come crashing down later when the insulin started overwhelm the surge of glucose from my breakfast and my liver output. I gradually increased that timing by a few mins each day and found that FOR ME IN THE MORNING I needed to inject more than an hour in advance of eating breakfast (creamy yoghurt seeds and berries) to prevent that spike. I highlight that bit because this only works for my body with NR at breakfast. Many other people would hypo long before this and we have to carefully experiment on ourselves to see what works for us as individuals. At other times of the day I would only need 20-30 mins, but in the morning it was always much longer.

As others have mentioned, if you follow a low carb way of eating, you may experience protein release. This starts to happen about 2 hours after a meal if there was not sufficient carbs in the meal and I find that I have to inject extra insulin about 2 hours afterwards to deal with this, BUT I am on a faster insulin that NR now, called Fiasp which only lasts about 3 hours and is most effective in the first 2 hours, so my small dose before a low carb meal will be pretty well spent by the time the protein starts to release it's glucose and the release is slow and steady, so if my levels start rising 2-3 hours after a meal then I can reasonably assume the protein is raising my levels marginally faster than the tail end of my insulin and I need a bit more.

If you are using NR and going high and not coming down, before the next meal (4-5hours) then you didn't have enough insulin.
If you go high but come back down before the next meal, then you had enough insulin but didn't take it far enough in advance.
If you eat a low carb meal and you get a bit of a spike which comes back down but then starts to slowly increase, that is usually protein release.

All of the above assume your basal insulin is holding you reasonably steady and it is really important to get your basal dose(s) right first and foremost, in order to be able to interpret anything much from your meal time results and make appropriate decisions or adjustments to them.
 
Thebearcametoo said:
I’m going to immediately contradict myself though now: the theory with low(er) carb is that if your body isn’t getting easy energy from carbs then it converts fat and protein into glucose. This is a slower process than converting carbs so while the profile of your insulin is supposed to mimic the conversion of carbs it may mean that you’d actually be better taking your insulin after you eat so that it matches the slower conversion of fat and protein into glucose. It’ll depend on how many carbs you’re having with meals vs how much glucose you’re getting from fat and protein as to where you need the insulin profile to be so it may be that you need to try a few different timings and ratios. If you’re consistently high it may just be the ratio that is wrong and I may be overthinking the timing issue.
Click to expand...
Hello, I was under the impression fat is broken down into fatty acids and glycerol? (Which shouldn’t raise BG by itself.) I would agree about the protein content though. Process of gluconeogenesis.
 
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