When to take fast acting insulin

[Ali11782]

I was just wondering how long before eating before people take their insulin or is it dependent on what their blood glucose reading is?
So if you were sitting at between 4 and 5 when would take yours?

Thanks Alison

 

[Inka]

Welcome @Ali11782 🙂 It depends what insulin you’re taking. I take Humalog and inject anywhere from 10-30 mins in advance with a normal blood sugar. The time varies for each meal. Breakfast needs the longest time in advance.

 

[Lucyr]

For me it depends on the food I’m going to eat, how active or not I’ve been, and the time of day. It’s something you need to gradually experiment to find out what works. I prebolus between 0 and 45 minutes before eating depending on these things.

A BG of 4.5 in the morning before breakfast, I’d still prebolus my usual 30-45 minutes for that time of day as i know my bg rises when i get up

A BG of 4.5 before lunch of say a sandwich or jacket potato which I know rise me quickly, I’d prebolus by the shorter end of my usual 15-30 mins

A BG of 4.5 in the evening, with a food i know rises me slowly and when I know my bg is more prone to hypos that time of day, I’d probably not prebolus.

Edited to add:these are examples based on personal experimentation of what works for me with apidra, not recommendations

 

[mum2westiesGill]

Hi @Ali11782 it's up to you really - for me I bolus and eat straight away - a few weeks ago I bolused but not by choice ended going over 10 minutes and ended up hypo

 

[Sally71]

My daughter usually boluses just before she eats, there are certain foods though which spike her really quickly where it’s better if she does it 15-20 minutes early, the problem is remembering to do it in time though!

 

[helli]

Depends on a number of things
- what is my starting BG. If my dose includes a correction, I will take it earlier
- do I have insulin on board (taken some bolus in the last 4 hours). If so, I bolus later/when I eat.
- what am I eating? High fat/protein meals, I will bolus later - probably a split bolus.
- what insulin I am using - I now use Fiasp which is taken later than NovoSluggish
- which meal - I have some insulin resistance in the morning so pre-bolus earlier for breakfast than other meals
- how active have I been recently - if I have just been for a run or cycle ride, I bolus later/when I eat
- what is convenient - sometimes it is just not possible to pre-bolus. I don't stress about it.

And don't forget we are all different so what works for me, won't necessarily work for someone else. Whilst we can use other people's experience as guidance, we need to work out what works for us with trial and error.
If you have a CGM or Libre, the graphs should help you show what timing is working best for you.

 

[Ali11782]

Thank you for all your replies.
I was diagnosed type 1 a couple of weeks after I found out I was pregnant, kept good control during it then in last few months I've been in denial so trying to get it back on track.
I take humalog and as from today I properly taking the time to work things out.
The minute I get out of bed my blood sugar rises usual by 2 or 3mmol. Before I wasn't correcting this but I take it I should be. So this morning I woke to 7.2 but then it went up to 9 so I took a unit when I got up. Was a little later than getting breakfast so started to go low but I still took my 1.5 for my porridge. Does this seem like a good idea. Suppose I will find out at 10am when I do my two hour check lol.

 

[Inka]

It depends what your correction factor is (how many mmols one unit of insulin drops you). It seems you have a half unit pen for the Humalog? You should be able to work out whether half a unit correction on getting up works best. Foot on the Floor syndrome (blood sugar going up when you get up) is very common. You’ll find strategies that work for you in different situations. I find having breakfast ASAP after getting up helps.

 

[Ali11782]

It depends what your correction factor is (how many mmols one unit of insulin drops you). It seems you have a half unit pen for the Humalog? You should be able to work out whether half a unit correction on getting up works best. Foot on the Floor syndrome (blood sugar going up when you get up) is very common. You’ll find strategies that work for you in different situations. I find having breakfast ASAP after getting up helps.

Thanks. Yes I have a half pen. Well I worked out my correction factor should take me down just under 3 mmol. It bothers me that if I hadn't eaten should it have stayed stable once corrected? I'm guessing it should have which if it didn't it would mean background too much.

 

[Inka]

If you want to see if your basal insulin is right, then it’s best to do a proper basal test, and for a basal test it’s best to avoid corrections as they can mess things up and potentially skew your results. So I wouldn’t judge your basal rightness by how you respond to that correction. I hope that makes sense!

 

[Ali11782]

Sorry not quite understanding. Though being honest I've only been taking my morning basal properly, my evening one I miss most of the time (long story lol) but from today I plan to get better. I think my basal should be 8 in morning and 10 in evening... Hopefully it I am good I will know in a few days if that is ok.

 

[trophywench]

Er - could we go back to square one please @Ali11782 - are you telling us you are still pregnant (in which case in the last few months you need more and more insulin and couldn't be expected to do a 'standard' basal test) or are you post pregnancy and have let things slip? And which insulins are you actually on - Levemir twice daily or splitting a different basal - and what fast acting bolus one?

Tell us more please - fill in the gaps!

 

[Ali11782]

Er - could we go back to square one please @Ali11782 - are you telling us you are still pregnant (in which case in the last few months you need more and more insulin and couldn't be expected to do a 'standard' basal test) or are you post pregnancy and have let things slip? And which insulins are you actually on - Levemir twice daily or splitting a different basal - and what fast acting bolus one?

Tell us more please - fill in the gaps!

No am not not pregnant, post pregnancy and yup let it slip.
Levemir twice a day
Humalog is my bolus.
Thank you for replying

 

[Inka]

Sorry not quite understanding. Though being honest I've only been taking my morning basal properly, my evening one I miss most of the time (long story lol) but from today I plan to get better. I think my basal should be 8 in morning and 10 in evening... Hopefully it I am good I will know in a few days if that is ok.

No problem. Put more simply, what I was saying is that to measure if your basal is working, you avoid food and also avoid corrections because they could affect the picture you get of whether your basal is at the correct level or not.

As you’re not taking your evening Levemir, I wouldn’t bother about basal testing until you’ve got things up and running. Please don’t be afraid to say why you’re not taking your evening basal. We all understand the nuisance and the stress so no-one will ‘tell you off’ here. I have 3 children and it is difficult fitting all the diabetes stuff in sometimes. It’s a proper pain in the bottom really. The way I deal with it is not to think about it too much, just do it automatically.

 

[Ali11782]

No problem. Put more simply, what I was saying is that to measure if your basal is working, you avoid food and also avoid corrections because they could affect the picture you get of whether your basal is at the correct level or not.

As you’re not taking your evening Levemir, I wouldn’t bother about basal testing until you’ve got things up and running. Please don’t be afraid to say why you’re not taking your evening basal. We all understand the nuisance and the stress so no-one will ‘tell you off’ here. I have 3 children and it is difficult fitting all the diabetes stuff in sometimes. It’s a proper pain in the bottom really. The way I deal with it is not to think about it too much, just do it automatically.

I have three kids to, 13, 11 and 16months. So yeah that's part of the evening problem and also my fear of weight gain due to insulin. Just hate taking my insulin quite frankly.
I've done the don't eat anything to see if basal is OK, that's how I know it should be about 8 and 10.
Determined to nail things this time.

 

[Ali11782]

No problem. Put more simply, what I was saying is that to measure if your basal is working, you avoid food and also avoid corrections because they could affect the picture you get of whether your basal is at the correct level or not.

As you’re not taking your evening Levemir, I wouldn’t bother about basal testing until you’ve got things up and running. Please don’t be afraid to say why you’re not taking your evening basal. We all understand the nuisance and the stress so no-one will ‘tell you off’ here. I have 3 children and it is difficult fitting all the diabetes stuff in sometimes. It’s a proper pain in the bottom really. The way I deal with it is not to think about it too much, just do it automatically.

Yes I think I am thinking way too much about it. When I get it wrong I think about, when I get it right I think about it lol.

 

[rebrascora]

So this morning I woke to 7.2 but then it went up to 9 so I took a unit when I got up. Was a little later than getting breakfast so started to go low but I still took my 1.5 for my porridge. Does this seem like a good idea. Suppose I will find out at 10am when I do my two hour check lol.

Can you confirm that you didn't take any Levemir last night but woke up on 7.2 this morning because if so, I would be very surprised if you need an evening dose of 10 units as that would be very likely to hypo you through the night in my opinion. Even 2 units could be too much. What was your bedtime BG reading?
Do you have Freestyle Libre or are you finger pricking for BG results?
Who told you that you need those doses? And when where they worked out? I am assuming it was since you had the baby?
Not sure if you are aware but basal needs change for a whole variety of reasons and need regular reassessment. If that dose was worked out by a DSN many months ago it may be well out of date with what you need now and potentially dangerous to suddenly start it, especially as your waking level looks to be quite reasonable.

As regards weight gain due to insulin, the only reason it happens is if you are taking too much insulin and then eating to keep your readings from dropping too low. If that happens then you need to recognise that and adjust your doses so that they hold you in range without the need to keep eating carbs. It is not the insulin which causes weight gain but usually the wrong dose.... or eating too much of course.

 

[Inka]

I have three kids to, 13, 11 and 16months. So yeah that's part of the evening problem and also my fear of weight gain due to insulin. Just hate taking my insulin quite frankly.
I've done the don't eat anything to see if basal is OK, that's how I know it should be about 8 and 10.
Determined to nail things this time.

Don’t be afraid of your insulin. It’s a lifesaver. Type 1 was a terminal illness before insulin was discovered and manufactured for use. I remind myself of that fact every time I get fed up with the whole thing. Although it’s a nuisance, we are privileged to have a way to treat our condition and stay alive. Sounds trite, but it’s true.

Insulin doesn’t make you put on weight. I’ve been taking it for almost 30 years and I’m still slim. I really hate that myth because it causes so much stress and hassle for people. Put it out of your head. All you’re doing is providing your body with the insulin it can no longer make.

It’s brilliant you’re determined to get on top of things 🙂 You’ll get lots of help and support here - and understanding too. None of us are perfect and we all have rubbish days. Type 1 is hard work. One thing I’ve found that helps is to stick to the same breakfasts and lunches most days. That way I don’t have to think or count the carbs. Also, when I have, say, pasta, I tend to have the same cooked weight 95% of the time simply for ease. Those sound little things to do, but I find they help.

 

[Ali11782]

Can you confirm that you didn't take any Levemir last night but woke up on 7.2 this morning because if so, I would be very surprised if you need an evening dose of 10 units as that would be very likely to hypo you through the night in my opinion. Even 2 units could be too much. What was your bedtime BG reading?
Do you have Freestyle Libre or are you finger pricking for BG results?
Who told you that you need those doses? And when where they worked out? I am assuming it was since you had the baby?
Not sure if you are aware but basal needs change for a whole variety of reasons and need regular reassessment. If that dose was worked out by a DSN many months ago it may be well out of date with what you need now and potentially dangerous to suddenly start it, especially as your waking level looks to be quite reasonable.

As regards weight gain due to insulin, the only reason it happens is if you are taking too much insulin and then eating to keep your readings from dropping too low. If that happens then you need to recognise that and adjust your doses so that they hold you in range without the need to keep eating carbs. It is not the insulin which causes weight gain but usually the wrong dose.... or eating too much of course.

Thank you that is good to know about weight gain.
The reason I woke up with this I had a hypo after dinner so then ate too much after that took not levemir and no humalog. Basically just didn't care and scared if I took the insulin I would put on weight. But then I woke at 2am with it sitting at 18.5 (this is a regular routine, binge don't take insulin and it's usually up at 30). Anyway I decided to take my leviemir and correct my levels at 2am hence why at 6am I was 7.2. Hope thst makes more sense

 

[Ali11782]

Yes

Don’t be afraid of your insulin. It’s a lifesaver. Type 1 was a terminal illness before insulin was discovered and manufactured for use. I remind myself of that fact every time I get fed up with the whole thing. Although it’s a nuisance, we are privileged to have a way to treat our condition and stay alive. Sounds trite, but it’s true.

Insulin doesn’t make you put on weight. I’ve been taking it for almost 30 years and I’m still slim. I really hate that myth because it causes so much stress and hassle for people. Put it out of your head. All you’re doing is providing your body with the insulin it can no longer make.

It’s brilliant you’re determined to get on top of things 🙂 You’ll get lots of help and support here - and understanding too. None of us are perfect and we all have rubbish days. Type 1 is hard work. One thing I’ve found that helps is to stick to the same breakfasts and lunches most days. That way I don’t have to think or count the carbs. Also, when I have, say, pasta, I tend to have the same cooked weight 95% of the time simply for ease. Those sound little things to do, but I find they h