Rapid acting insulin

[sparrow1]

As I am new here, I apologize if this question has been discussed already. As a Type 2, I started long-acting insulin NPH about 5 years ago, 13 yrs after I was diagnosed. I am now having problems spiking so about 10 days ago, my doctor changed me to Levemir and has added Novorapid. I got some education from the Novo rep, but I am a little confused. I would ask her, but she is not available on weekends. We've found so far that I need 1 unit of Novorapid per 10 carbs, and 1 unit to correct by 2mmol/L.

So that's clear, but as a grazer I find myself eating something almost every hour. I might eat lunch, and then an hour later an apple. An hour later a cookie and so on. Do any of you do this while on Novorapid, and if so, how do you calculate how much you need?

[Funnygrl]

I did that and injected everytime I ate. Yes, that meant 10+ shots some days.

[ant hill]

As I am new here, I apologize if this question has been discussed already. As a Type 2, I started long-acting insulin NPH about 5 years ago, 13 yrs after I was diagnosed. I am now having problems spiking so about 10 days ago, my doctor changed me to Levemir and has added Novorapid. I got some education from the Novo rep, but I am a little confused. I would ask her, but she is not available on weekends. We've found so far that I need 1 unit of Novorapid per 10 carbs, and 1 unit to correct by 2mmol/L.

So that's clear, but as a grazer I find myself eating something almost every hour. I might eat lunch, and then an hour later an apple. An hour later a cookie and so on. Do any of you do this while on Novorapid, and if so, how do you calculate how much you need?

Hello sparrow 1, Novorapid is what i use before i have a meal and it's a fast acting insulin. It's onset is fast!! and that's 10 minuets DON'T WAIT ANY LONGER!!! then eat. How many times do you test yourself? as i do a test before i inject and in between times i test for curiosity.
Levemir is a long acting insulin and that takes care of your base insulin during the day or night commonly called basal insulin. I see that you are also having Metaformin too. Because that we use an artificial insulin you will find control harder to master.
About how much you need of the novorapid that you need then this is open for experiment on how meny carbs that you plan to eat. Because everyone is different it is something that you have to work out for yourself so there is no real hard and fast calulation to say for what you need.

[cheryl]

Hi you must take insulin every time you eat, but then with that you have to figure how much insulin you have on board when you want to eat an hour or so later.....I have something I wrote down to figure now this is with humalog not novarapid but they are almost the same and it might help better then dropping like a fish when you inject an hour later.....for a snack

original bolus 1hr 2hr 3hr 4hr

1 unit .7 .4 .1 0
2units 1.4 .8 .2 0
3units 2.1 1.2 .3 0
4units 2.8 1.6 .4 0
5units 3.5 2.0 .5 0
6units 4.2 2.4 .6 0
7units 4.9 2.8 .7 0
8units 5.6 3.2 .8 0
9units 6.3 3.6 .9 0
10units 7.0 4.0 1.0 0




Now what i wrote is from a book called using insulin and it tells you how much active insulin you have left over after you take your original bolus like you stated for lunch and you want to eat an hour later well it lets you know how much active insulin you have left, so you can kind of dose correctly without too much of a drop from taking more insulin in an hour........this is not 100% accurate........it sometimes depends on the food i eat, i really would wait 2hrs after a meal honestly to have a snack so you can see more what your particular meal does to you, sometimes food lasts longer than the insulin so there is a lot to take into consideration, but i used this chart with foods I was familar what did with my body and it was pretty good not 100% accurate, but as everyone knows with diabetes and insulin nothing ever is.....good luck.....

Cheryl

[RLK]

what Funnygrl said. I "stack" food boluses all the time and don't have any trouble as long as I accurately count the carbs. Stacking correction boluses has been known to get me in trouble with hypos, so I'm very careful not to re-correct until it's been at least 4 hours after the first correction bolus.
Good luck with the insulin switch!

[ant hill]

what Funnygrl said. I "stack" food boluses all the time and don't have any trouble as long as I accurately count the carbs.

Heh me too, even when i'm low but there is lunch, Dinner there i still bolus hard but make sure that you are well covered though. Just make sure that there is food to be had!!

[Geoff]

Hi Sparrow1, I have been on Novarapid for the last 18 months and find it very flexible to use. I personally find that each dosage that I give lasts up to 4.5 hrs, and for snacks between main meals I can eat up to 20grms of carbs without having to give a correction dose. Here are some facts about duration of NovaRapid that I have got off one of their sites.

4hr insulin curve using NovaRapid

1st hr = 30% used
1.5 hr = 50% " "
2hrs = 70% " "
3hrs = 90% " "
4hrs = 100% " "

I hope this helps you with working out what you require.

[sparrow1]

Thanks to all of you for your helpful replies.

I know that at this stage of using rapid-acting I should really wait 2 hours before I eat again, so that I can get a better handle on how my post-meal numbers are. My rep said not to inject unless there are at least 3 hours between meals and looking at the NovoRapid info you gave me Geoff, that now makes sense. You have all been so helpful. Iit's going to be a lot of trial and error I think.

Thanks again to all of you. This forum is a wonderful resource. There is nothing like being able to talk with others who have experience.

[Funnygrl]

If you're waiting 2 hrs before you eat, the rapid acting insulin is practically gone by the time you eat, and you are using bolus insulin to make up for basal insulin you are obviously lacking if you aren't going low by the 2 hrs mark.

[sparrow1]

If you're waiting 2 hrs before you eat, the rapid acting insulin is practically gone by the time you eat, and you are using bolus insulin to make up for basal insulin you are obviously lacking if you aren't going low by the 2 hrs mark.

Sorry Funnygrl - I don't understand.

[Funnygrl]

Did you mean that you take your insulin, then wait to hours, then eat? I might be the one who's not understanding here...

[cheryl]

lol, i think he meant he should wait two hours after he eats when he bolus for a meal to have a snack wait two hours to snack so he can bolus for the snack

[Funnygrl]

If that's the case, disregard my previous post.

[sparrow1]

What I meant about the 2 hours, is that I should try not to snack on the hour, but wait at least 2 hours until I eat again, so that I get a good handle on my post-meal readings. (I usually bolus immediately after eating - Novorapid is very flexible like that). I bolus 2 units per 10 carbs. Then when I test 2 hours later I should see if that worked and also what effect certain foods have. I discovered yesterday that 1 Matzoh board (27 carbs)really made me spike 2 hours after eating and even though I compensated with extra bolus later, I stayed high until this morning. As I said before, it's going to be a lot of trial and error.

[RLK]

(I usually bolus immediately after eating - Novorapid is very flexible like that). *snip*
I discovered yesterday that 1 Matzoh board (27 carbs)really made me spike 2 hours after eating and even though I compensated with extra bolus later, I stayed high until this morning.

If you're finding that you spike after meals, you may want to try bolusing before eating, even as much as 10-20 minutes before eating. I struggled for a long time with post-meal spikes at 2 hours and "pre-bolusing" by 15 minutes whenever possible has made all the difference in the world for me.
Good luck!