Replies to This Discussion

Permalink Reply by Benjamin McLaughlin on May 16, 2012 at 8:52am

Sam, how long are you saying the Novolog is lasting? Not sure if any other super insulin sensitives are like me, but I have checked duration of my novolog and I have found that it keeps dropping me up to 6 hours! I found this out becuasemy lunch is 5 hours after breakfast, and with no basal I was always going low mid afternoon. So basically the last hour of my breakfast dose was stacking with my regular lunch dose, and it was killing me. Between the hours of 4 and 5 is where it brings me down the most, obviously because the food has been completely digested.

I too don't think that by going off your basal will affect much at all. I think it will even be helpful to try and see how long the Novolog actually is working. All about eliminating as many variables as possible.

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Permalink Reply by Sam on May 16, 2012 at 8:58am

I've just assuming that the advertised duration was about 4 hours like the manufacturer says was accurate for me. Haven't really thought about the possibility it could be lasting a lot longer than that.-- It'll be easier to get a better feel for it now without the lantus affecting things as well. Good pointer on something to look out for. When I'm at home I try to space me meals a little better than is working out here. Breakfast is only about 4 hours before lunch here, normally I would go at least 5 hours... The picture is very slowly starting to get more clear with all of this.

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Permalink Reply by Shawnmarie on May 16, 2012 at 9:09am

I've experienced the same thing with Apidra, but I don't think I can be sure whether it's the tail of the Apidra or some effect of a sluggish pancreas still kicking out insulin, but not necessarily doing it at the right time. With whole blood glucose control mechanism being out of whack it is indeed difficult to pinpoint the true issue.

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Permalink Reply by Benjamin McLaughlin on May 16, 2012 at 9:17am

I was thinking the exact same thing Shawn! What helped me decipher my own pancreas vs. Novolog was by a CGM. I would assume that ones own pancreas, once food is digested, automatically starts slowing down, as opposed to artificial, which if you have too much, will bring you down like a freight train. Those days where I was "stacking" I would drop substantially after 4 hours. Although I am sure some of that is my own, the dramatic drop has to come from my bolus. Not sure if it makes sense, or even plausible, but once I started subtracting the insulin on board for a 6 hour duration, I have yet to go low and almost always am within 20 points of my target pre-meal range for dinner.

Without testing about every halfhour for 6 hours, I am not sure if there is a way to figure this out. If you can get your hands on a CGM, do it.

Remember that what you eat factors how much you will go low. The higher the GI, the higher the spike, but then the more dramatic the fall. With more fats/proteins, will help keep the fall from 4-6 hours to a minimum.

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Permalink Reply by Shawnmarie on May 16, 2012 at 9:21am

Thanks, this is very good info to have. I was thinking of a CGM, but I'm afraid I might start to obsess even more than I already tend to do. I tend to need more insulin for lunch than other meals and that's with only a four hour break between breakfast and lunch. I wonder how much more I would need if I went longer -- that might explain why some days I go higher with the exact same meal at lunch than others. Perhaps on those days, I ate breakfast earlier than usual and that bolus was completely gone. Not exactly the kind of mysteries I'd like to be solving, but I guess I'll probably be a blood glucose Sherlock Holmes for the rest of my life.

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Permalink Reply by Benjamin McLaughlin on May 16, 2012 at 9:46am

I am a math teacher, therefore I love everything to come out to an answer. From what I have found in my very short time in dealing with this is, there is very little black and white, and a whole lot of gray. I try not to worry too much about the science of it all, just know enough to where my pre-meal readings for every meal are stable. I am doing that now and I am happy. In my first couple of months, I wanted everything to work out like an equation, and as everyone can attest, that doesn't work at all. If it works 80% of the time, I can correct/treat the 20% that didn't work out. One thing is for sure, we are all on the right track.

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Permalink Reply by MissKitka on May 19, 2012 at 6:06pm

Shawnarie,

I use slow and fast insulins together every 12 hours so overlapped 4 ways. The slow starts in 2 hours and lasts 8 hours and the slow starts in 8 hours and lasts 24 hours. Compared to modern analogs even my fast is slow so today this could be seen as all Basal. It works well but I have to plan ahead by at least 12 hours. T1 for 53 years and doing great. I still use the exchange system for diet and have no idea how to count carbs and never will.

Everybody is different and this fact is never understood by any breed of doctor.

DOn

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Permalink Reply by Shawnmarie on May 22, 2012 at 12:22pm

Thought those who participated on this thread might find this article interesting: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901038/

Not sure that it adds anything to the mix, but at least I'm understanding a bit more about what's going on with my pancreas as far as first and second phase insulin release. I ended up finding this article while researching that issue.

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Permalink Reply by Parrformance on May 24, 2012 at 4:35am

Very interesting article, Shawnmarie. Thanks for posting the link.

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Permalink Reply by A on September 14, 2012 at 2:20pm

Thanks for this article... I think I was struggling with 'reactive hypoglycemia' for years before T1 diagnosis..

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Permalink Reply by A on September 14, 2012 at 2:19pm

Thanks for pointing me towards this thread - wow, it's been so helpful to hear about others' experiences with low insulin needs.

I think I smiled the most about reading about another adult using the 'junior' pen to get 1/2 units. The instructions do say it starts at 1u, but I did some 'tests' dropping insulin onto a plate and it seemed to provide a uniform volume of a 1/2u and I've been using the pen as such ever since, ignoring the childish green frog on the package that made me think it was only for kids.

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Permalink Reply by Shawnmarie on September 14, 2012 at 2:29pm

I got one last month, but ended up suspending my Novolog experiment because my I:C was fluctuating like crazy and I didn't want to add another factor. I like the looks of the kid pen!

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