Spikes

[Purls of Wisdom]

Dear all,
During the early days after diagnosis, when the spikes are frequent and prominent, despite trying varying amounts of insulin, do the spikes cause damage somewhere or the other in the body?

 

[rebrascora]

Hi. I don't think insulin can have side effects as such other than hypos when we overdose of course 🙄 but very rarely people can develop allergic reactions to particular types of insulins.

As regards spikes (and indeed hypos) I believe it is now recognized that reducing the variability of your BG levels ie reducing the height of the spikes and the depths of the troughs, can reduce the risk of complications over the longer term.... but it really is longer term rather than just a few months, as long as your levels are mostly returning into range after the spikes.
To reduce the height of the spikes most of us find that we need to inject our insulin a bit earlier before we eat. For instance, I used to inject 20 mins before I ate breakfast and my levels used to spike up to 15 and then come crashing back down to 5. This happened every morning and made me feel rough, particularly when it was dropping back down fast. Through careful experimentation and increasing that prebolus time by a few mins each day, I found that I personally need 45mins between injecting my insulin and eating my breakfast and ideally, injecting my insulin before I get out of bed, in order to prevent those morning spikes. Now I rarely go above 8 after breakfast and I feel so much better for it. It is about matcing the insulin's activity to your digestion of the carbs in the food. I have really fast digestion but slow response to insulin, so the insulin needs more of a head start. We are also more insulin resistant in the morning so whilst many people would find that 45 mins was too long for them and they would hypo, they often need longer for breakfast than other meals. I only need 15-20 mins prebolus time for lunch and my evening meal, but breakfast is a very consistent 45mins FOR ME.
If you want to reduce the spikes, you need to carefully increase your prebolus timing by a little bit more each day, until you find the point where the spike is less high and that will be individual to you and the insulin you use. I actually used to need 75 mins prebolus time with NovoRapid but now just 45mins at breakfast time with Fiasp which is a little quicker.

Hope that makes sense, but if it doesn't, just ask. Having Freestyle Libre really makes it easier to see when the bolus insulin is kicking in and get this timing right. Not sure if you have Libre??