Novalog isnt fast enough.

[miniheli]

Hello Im not new to this website but new to this forum. Ive been diagnose with type 1 diabetes not to long ago when I was 17. I just turned 18 about 1 month ago. Im gonna get a pump soon, as soon as my endocrinologist gets my nurses email thats been sent 3 weeks ago. Heres the problem, im using novalog and it doesnt seem to be fast enough to lower my blood sugar. I have a extremly odd diet. Im a very skinny person and eat almost about every 1 and a half. I take many many shots per day. I also take 17 units of Lantas glargine.
Ok . Before I eat something I take the exact number of units for the food I am about to eat. I am taking 1 unit for every 15 grams of carbs I eat. I take my shot, wait 10 minutes and eat. After 2 hours I test and my blood sugar is about 250. Then I take a correction which is 1 unit for every 50mg. After an hour I check my blood sugar. It 190mg??
So what am I doing wrong here. I talk to my nurse everyweek and she keeps changing my dosage and it still doesnt do much. Im very upset. I always have headeachs and pains on my foot when my blood sugar is high. I do everything I can to get it right. Nothing works. I told my nurse about this problem and she told me to increase the units I take for breakfast, this didn't help much Should I change insulin?? Again im using novalog and I run at school for P.E. I run my fastest and try to lap everyone at least 4 times . Still it doesn't help.

Thankyou

[Curlzzz2002]

Mini,

I've had Diabetes for 24 years, I'm 33....wow, that just hit me. I've been a pumper for the past 11. Not quite sure what to tell you about your immediate problems with your post-meal highs. But, what I can tell you is this. Bug the heck out of your nurse, endo, and diabetes educator to get you on the pump ASAP. Basically, what you're doing now with the carb counting and frequent shots is exactly what you'll do with your pump. But, the one thing that won't happen is the peaks after meals because of the basal rates that you'll program in your pump. I use Humalog in my pump, more expensive than Novalog, but my theory is it works so don't mess with it.

The sooner you can get that pump, the better you're going to feel. Before I got my first one, my feet would tingle and sometimes I would be in the 50's and not even know it. After about 3 months on my pump, my feeling came back in my feet and now when I slip into the 70's I am aware of it. Trust me, is's going to change your life. Pump on!

[Coravh]

Originally Posted by miniheli

Hello Im not new to this website but new to this forum. Ive been diagnose with type 1 diabetes not to long ago when I was 17. I just turned 18 about 1 month ago. Im gonna get a pump soon, as soon as my endocrinologist gets my nurses email thats been sent 3 weeks ago. Heres the problem, im using novalog and it doesnt seem to be fast enough to lower my blood sugar. I have a extremly odd diet. Im a very skinny person and eat almost about every 1 and a half. I take many many shots per day. I also take 17 units of Lantas glargine.
Ok . Before I eat something I take the exact number of units for the food I am about to eat. I am taking 1 unit for every 15 grams of carbs I eat. I take my shot, wait 10 minutes and eat. After 2 hours I test and my blood sugar is about 250. Then I take a correction which is 1 unit for every 50mg. After an hour I check my blood sugar. It 190mg??
So what am I doing wrong here. I talk to my nurse everyweek and she keeps changing my dosage and it still doesnt do much. Im very upset. I always have headeachs and pains on my foot when my blood sugar is high. I do everything I can to get it right. Nothing works. I told my nurse about this problem and she told me to increase the units I take for breakfast, this didn't help much Should I change insulin?? Again im using novalog and I run at school for P.E. I run my fastest and try to lap everyone at least 4 times . Still it doesn't help.

Thankyou

It sounds more to me like your insulin to carb ratio is incorrect. If you are finding that the insulin is not peaking quickly enough, try using rapid, rather than the humalog. Some folks find a difference. But first I would try to adjust the ratio. If you need extra insulin and you don't go low later, you aren't taking enough in the first place.

Cora

[blondy2061h]

How are your fasting blood sugars? It sounds like you're not getting enough insulin overall to me. Eating that often though, it's hard to tell, and it's gonna be very hard to even out your blood sugars.

[Mark1e]

Originally Posted by miniheli

.... So what am I doing wrong here. ... Should I change insulin?? ...

Changing insulins is not going to make any difference. Getting a pump won't make getting a handle on your control easier either. Your first priority needs to be establishing how much basal insulin you need. It is probably quite different to what the nurse started you on. As blondy2061h mentioned, your fasting blood sugar is a good starting point. Ensure that your blood glucose is in the target range before going to bed and adjust your Lantus until your morning blood glucose is also acceptable. To find out if this amount of Lantus is suitable for the rest of the day, skip a meal and see what happens. Your blood glucose shouldn't change much. If it does, you will have to change your basal insulin regimen, in terms of the timing, amount, type of insulin or using a pump.

When you have got your basal insulin sorted out, you will be able to refine your carb:insulin ratio and correction factor. There is not much point in doing this if there is too little or too much basal insulin action. The difference has to made up by adjusting your meal boluses, and you get hopelessly confused.

Having all those meals makes it difficult. Novolog peaks an hour after injecting it and acts over 5 hours, although most of it is after 3 hours. Meals need to be 5 hours apart to avoid an insulin stacking effect. Eating every 1.5 hours means that the insulin:carb ratio is meaningless and your insulin dosing is basically guesswork. Maybe changing the foods you eat will enable you to eat less often. You will also have to take physical activity into account as it increases insulin sensitivity. Good luck.

Mark