New to insulin

[Elleinad]

Hi, I have been taking sitagliptin for 10 years but my team recently added in 1 unit of Apidra at meal times. Things have slightly improved but as you can see I’m still spiking, they aren’t reviewing for a few weeks. Do you think the Apidra needs to be increased? My time in target has gone from 65% to 75-80% with that small dose.

Thanks in advance

 

[Inka]

Welcome @Elleinad 🙂 Those aren’t dreadful spikes. Even people without diabetes spike after a meal. So you’re doing ok.

Do you carb count for your meals? How far in advance of eating do you inject the apidra?

 

[Elleinad]

Ok that’s good to hear I don’t carb count right now but the dietician did take an in depth look at my carb intake over a 1 month period and she said that my diet and the amount I was consuming was really healthy so she had no concerns with my diet at all (I’m not overweight etc). I have been taking the Apidra 10 minutes before eating.

 

[Robin]

If you are returning to a normal blood glucose figure afterwards, then increasing the insulin is not the answer, it would probably bring you down too low afterwards. It might be a question of timing, trying the Apidra an extra 5 minutes in advance, then another 5, if that doesn’t improve things. If the food gets into the system before the insulin, the insulin may be the correct amount, but it is playing catch up and is dealing with the carbs a bit later than you’d like.
We all get spikes, though, and as @Inka says, your spikes aren’t at all bad.

 

[Inka]

Ok that’s good to hear I don’t carb count right now but the dietician did take an in depth look at my carb intake over a 1 month period and she said that my diet and the amount I was consuming was really healthy so she had no concerns with my diet at all (I’m not overweight etc). I have been taking the Apidra 10 minutes before eating.

It’s not to do with being overweight. The 1 unit of Apidra you take will cover a certain amount of carbs. If you eat significantly more carbs than that, you’ll go high, and if you had significantly fewer carbs you could go too low. Although ‘carb counting’ is used as a ter, by some Type 2s who limit carbs for dietary reasons, in Type 1, 3c and associated types, it simply means balancing your insulin to carbs 🙂

To answer your question, no I wouldn’t increase my Apidra in your situation. I would look at very cautiously moving my injection forward, or simply ignoring the mild spike if it’s brief and you come back into range.

 

[Elleinad]

Thanks both, very new to this! I’ll try 15 mins prior today. This is how it looked prior to adding in the small amount on insulin on top of the sitagliptin so it’s definitely improved.

 

[Inka]

Be cautious and be aware that although you might need 15mins+ for some meals eg breakfast, you might only need 10mins for other meals. Always err on the side of caution and take tiny steps rather than make big changes. I’d take one meal at a time and perfect that advance time personally.