Novorapid & injecting into stomach ... any tips?

[DaveB]

I'm slim but never pinch and rarely have bruising. I used to use the stomach but the flesh gradually became hard so I now use the upper arm just below the shoulder as suggested by my DN. I used to inject my Levemir in my thigh but the flesh also become hard so I now use the buttocks.

 

[SB2015]

You are doing brilliantly @pawprint91 and have so clearly got your head round things.

Great to hear that you have DAFNE of the equivalent soon as that will then teach you how to make finer adjustments to your premeal injections (bolus/Novorapid) and also how to use the Novorapid to do corrections, if you are still high 4 hours after a meal, or when you are I’ll which tends to raise our levels. (Mine raise the day before I get a cold so I get an early warning!!!)

I can’t remember whether you are using a half unit pen, but they are very useful when on small dosesas it allows you to do smaller adjustments. With regard to pinching I did at the start as I was using 8mm needles and just carried on, even when the needles got down to 4mm. Just habit. Bruises happened if I was unlucky to catch a blood vessel, and I had the odd bleed too. Just one of those things.
Like others I developed a routine, using R leg am, R abdomen lunch, Labdomen supper and L leg bedtime. I tried to ’choose a spot’ each time follow tracks, and avoiding automatically injecting as that would tend to end up in the same places. I found above the waist was more painful so stuck to below.

I look forward to hearing how your course goes.

 

[nonethewiser]

I have never taken high doses (5 units is a big dose for me) and I still got bruises. I think some of us are just unlucky.

Blimey that is low dose.

Before moving to pump basal dose was 20u, now its around 16u, would have to go back to honeymoon days to recall doses under 5u.

Think we all bruise from time to time, had fair few of them over years, some really bad ones but that was when needles were like chopsticks.

 

[pawprint91]

Yes, bolus insulin is the fast 🙄 acting insulin you take to cover the food you are going to eat. Corrections are extra units of fast acting 🙄 insulin and can be added to that bolus with a view to bringing your BG back into range if it is high at that premeal reading.... or at other times when not eating to bring levels down into range.
So if your premeal reading was say 10.6 for some reason (as @Proud to be erratic has explained so well, it is not necessarily a miscalculation on your part from the previous meal but just all the variables which can throw things off) you can add a bit more insulin to the bolus dose to bring you back into range. You would usually be advised to do this once you are more confident and have a correction factor. Without that correction, if you have calculated your bolus correctly, you would still be around that level of 10 four hours later which is still above range, so not ideal.
So for me, I have a correction factor of 2 so for every unit of insulin I inject, it will drop me approx. 2 mmols, so 2 units would drop me 4mmols from 10.6 to a much better in range reading of 6.6, so I would add 2 units to my pre meal bolus injection in that situation and by the next meal I should (hopefully) be nicely back in range..... assuming my basal insulin is holding me steady.
You can also do corrections at other times when not eating but it is generally advised not to do one within 3 hours of a previous injection as that insulin will still be active (this would be referred to as stacking and can result in a hypo) because the insulin still on board may bring you down into range without you needing to inject more.

Hopefully that makes sense, but if not just ask.

PS. I have used rolling eyes emojis after "Fast acting insulin" because even Fiasp isn't exactly "fast" for me.

This makes perfect sense, thank you! I'm guessing that the extra one unit the nurse suggested if my levels are high the following day is my 'correction' unit for now - just had my first slices of pizza since diagnosis ... we'll see what happens! 😱

 

[pawprint91]

You are doing brilliantly @pawprint91 and have so clearly got your head round things.

Great to hear that you have DAFNE of the equivalent soon as that will then teach you how to make finer adjustments to your premeal injections (bolus/Novorapid) and also how to use the Novorapid to do corrections, if you are still high 4 hours after a meal, or when you are I’ll which tends to raise our levels. (Mine raise the day before I get a cold so I get an early warning!!!)

I can’t remember whether you are using a half unit pen, but they are very useful when on small dosesas it allows you to do smaller adjustments. With regard to pinching I did at the start as I was using 8mm needles and just carried on, even when the needles got down to 4mm. Just habit. Bruises happened if I was unlucky to catch a blood vessel, and I had the odd bleed too. Just one of those things.
Like others I developed a routine, using R leg am, R abdomen lunch, Labdomen supper and L leg bedtime. I tried to ’choose a spot’ each time follow tracks, and avoiding automatically injecting as that would tend to end up in the same places. I found above the waist was more painful so stuck to below.

I look forward to hearing how your course goes.

Thank you for your kind words! I don't have a half unit pen currently, but they sound very helpful. Yes I agree about not just 'automatically injecting' - it would be so easy to just jab it in pretty much the same place each time!

 

[Proud to be erratic]

Thank you so much for taking the time to reply in such detail to my post, I really appreciate it. I have actually just managed to get in touch with a diabetes nurse from the team and asked her advice with the weekend coming up, and she gave me really helpful advice too - of sitting and waiting and being patient rather than panicking about a knee jerk reaction to a higher reading before bed should it happen. She said to me that if the readings end up higher due to eating more carbs/the level of novorapid being fixed and don't come down, the next time I use novorapid I could maybe add in an extra unit (and if this were the case, I think I'd check my glucose levels before eating, as you advise) to correct the high level as well as to manage the food I am about to eat? (I may not have reported this correctly, but it made sense when she said it, I hope it makes sense to you too!) So between you and the nurse I have spoken to, I feel 10x more reassured about it all than I did when I first posted - thank you!

I haven't, but I will certainly be having a look now. I only know about food, exercise, illness, hydration and temperature, so a search is well needed - thank you!

Edit: Incase anybody is reading this thread and looking for these factors, I found them on this link: https://diatribe.org/42-factors-affect-blood-glucose-surprising-update
My mind is blown!

The risk I've taken in introducing the 42 Factors at this early stage for you, is that you could let the options overwhelm you. DON'T. Just see them as explanation why D is complicated and confusing and why, despite your best endeavours, sometimes the "plan" didn't work. You might find an explanation within the 42 factors and so you might learn from that experience; but when more than one of those 42 conspires with another one or more then the chances are you won't easily spot the "what and why". In these circumstances just take note and move on to a fresh start tomorrow!

 

[pawprint91]

Another question ... can you drink with novorapid on board? I know alcohol can be more likely to cause hypos - and I don't mean to excess here, just a glass of wine or two with/after dinner?

 

[Bruce Stephens]

Another question ... can you drink with novorapid on board? I know alcohol can be more likely to cause hypos - and I don't mean to excess here, just a glass of wine or two with/after dinner?

You can, yes. You may find you need to change something (maybe inject slightly later when you're having wine) but most likely it won't make any difference.

 

[pawprint91]

You can, yes. You may find you need to change something (maybe inject slightly later when you're having wine) but most likely it won't make any difference.

Thank you!

 

[SB2015]

I stick to the same drinks in general. g&T with tonic light, and a glass of wine at weekends.
I know how I react to those and the consistency helped me come up with a plan.

If I drink more than that I might put in a bit of extra carbs to counter the drop caused by alcohol, especially whilst you are on your fixed doses.