Replies to This Discussion

Permalink Reply by Laddie on April 22, 2012 at 7:23pm

How many carbs are you eating per day? Dr. Bernstein continues to use Regular for meals but a fast-acting such as Humalog, Novolog, or Apidra for corrections.

I'm eating about 50g carbs per day now. I pump and use a lot of dual wave boluses, usually about 2/3 of dose upfront and then 1/3 spread out over 2 hours. Sometimes it seems hard to match insuin to low carb eating. But it's still easier than the BG peaks and valleys of eating higher carb.

If I were you, I'd try to get a sample of Novolog from your endo and see if it works better for you than Apidra. Really the only way to know what will work best for you is to try out all the options.

• ▶ Reply

Permalink Reply by DeeJay on April 22, 2012 at 8:30pm

From my experience with novolog, it works very well for me with my low carb diet. I eat an average of 40g of carbohydrates a day and most of those are fiber carbs, Anyway, you should experiment and see how it works for you, Most of my Type 1 D-Friends using apidra tell me its the perfect insulin for High carb and high sugary meals because it knocks out that spike perfectly. if you're on a high fat diet (low carb) Novolog has that lasting effect we need ;-) as long as I've been doing the low carb I had no issues. Except for when I try to bolus for Cheese (i love cheese!), every type 1 knows cheese is a pest when it comes to its looong lasting affects :-)

• ▶ Reply

Permalink Reply by Gerri on April 22, 2012 at 10:25pm

I use Apidra & Regular on low carb, using split bolus doses (MDI). I have gastroparesis & need slower acting insulin that stays around, though I can see how Regular would be helpful for low carb without delayed digestion. You sure don't want to use R to correct highs:)

• ▶ Reply

Permalink Reply by Holger Schmeken on April 23, 2012 at 2:13am

Like Desiree I experience that the NovoLog has a rapid onset combined with a longer tail. But you have to find that out for yourself. The fastest analog Apidra is for some people like water and for most it is a blessing. The reason is not know to me. It could be caused by some individual differences in the insulin receptor or the environment of the receptor or the body chemistry in general.

• ▶ Reply

Permalink Reply by Brian (bsc) on April 23, 2012 at 5:07am

We often test at fixed times after meals, and while this may be a good strategy for deciding whether to correct, it doesn't help us answer questions about how well our insulin has matched our meals. And as you and others have noted, low carb, high fat/protein tends to result in meals that have a glucose curve over 2-4 hours rather than 1-2 hours.

So it may be good to just do some "experiments." Eat a typical low carb meal and test at 1hr, 2hr, 3hr and see how well your insulin matches your meal profile. You can adjust your insulin timing (I actually often take my humalog at my mealtime rather than 15-30 minutes before). Your dose should result in a return to preprandial at 4-5 hours. But if you are back to preprandial at 2hrs and you still have food remaining to be digested, you may have some mismatch. Some people split their insulin shots, half when you eat and another half a half hour or hour later. But mostly, your glucose curve should be your guide. The key indicator that the insulin is just too fast is going hypo at 1-2 hrs and then rising back up at 2-4 hours.

• ▶ Reply

Permalink Reply by andrea on April 24, 2012 at 4:05pm

thanks everybody, always so helpful! i'm going to ask for a sample of novolog at next weeks appointment. hope everybody else is doing well!

• ▶ Reply