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I only started on Lantus 4 weeks ago and barely have it s dosage stabilised. Then last week the doctor put me on a rapid insulin (NovoRapid it is called in Australia) before meals, because Lantus was still leaving the really high BGLs after meals.

The doctor said that if I only plan to eat a small amount then I need not take the NovoRapid. However what about -

-if I change my mind and then eat far more carbs than I had originally planned? Can I take NR after the meal?

-if I have a quite carby snack between meals -can I take NR then if I have not had any for hours?

-if I do not take NR before a meal and then my BSL is really high after the meal, can i take NovoRapid then, to reduce the level?
 

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Those are good questions and very difficult to answer. AS with everything diabetic it depends... the Nova Rapid has an action time and a peek. it fits well with the carb absorption rate. If you take the insulin AFTER the meal you run the risk of having the insulin still working in you and the carbs already gone, thereby running the risk of Hypoglycemia. you could eat extra carbs after the shot... but this is tricky as its easy to end up with over compensating with fist insulin then carbs, hi BG then insulin then hypo... gets into a viscous cycle.

Also depends on how soon after you eat, and what you eat. a high carb meal with lots of fat will have a lower longer spike and taking the shot within 10 minutes mite work out.

basically being new I think you may want to just go with the one shot before and learn how your body reacts. Plenty of time to learn and try.
 

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I only started on Lantus 4 weeks ago and barely have it s dosage stabilised. Then last week the doctor put me on a rapid insulin (NovoRapid it is called in Australia) before meals, because Lantus was still leaving the really high BGLs after meals.

The doctor said that if I only plan to eat a small amount then I need not take the NovoRapid. However what about -

-if I change my mind and then eat far more carbs than I had originally planned? Can I take NR after the meal?

-if I have a quite carby snack between meals -can I take NR then if I have not had any for hours?

-if I do not take NR before a meal and then my BSL is really high after the meal, can i take NovoRapid then, to reduce the level?
I take my rapid acting insulin after I eat. I have gastroparesis and my digestion is slow. I have not experienced any problems with taking my rapid acting insulin after meals. Be sure that you match your carbs correctly. If you have a snack with carbs then you need to take some NR. You can take a shot of NR after a meal if your BS is high, but you need to know what your insulin sensitivity factor (ISF) is. If your blood sugar is say 200 and you want your BS to be 140, I would take 1 unit for every 20 points over 140, which would be 60, so you would need 3 units of NR. You will need to test to see if the 3 units lowers your blood sugar enough, if not then you may need to use 1 unit of insulin for every 15 points over 140. Trial and error will help you find out what your ISF is. Be careful the first couple of times you correct a high.
Also, at your next doctor visit, be sure to ask your doctor the questions that you asked here. There is an excellent book out called "Using Insulin" written by John Walsh, PA, CDE. Buying this book is an excellent investment and will help you with your insulin questions.
 

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You need your NR every time you eat, for meals and snacks. It is normally best to take your insulin before eating. I always do. If you plan your meals carefully and know what you will be eating beforehand, then you should not be eating more than you had planned. It takes practice sometimes. Establish the habit.

If you take two boluses less than 4 hours apart then you need to know how many units are still on board before taking the second bolus. If you take 8 units at noon and eat something else at 2 pm, then half of your previous bolus (4 units) is still on board. If you need 5 units for the food at 2 pm then you can subtract the 4 units on board and take only one unit. All of this assumes that your blood sugar is at a normal level. If it is high or low then that is also involved in determining your correct dosage. If you have high blood sugar between meals then you may need a small bolus to help bring it down, but again you need to know the amount of insulin on board and take that into consideration.

The book recommended by Breeze is excellent, I hope you buy it.

Richard
 

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Hi Annieliese,

I'm on novorapid too, and was on Lantus for a while but my doctor changed me to Levemir.

I take my NovoRapid after meals sometimes, when I'm not sure how much I'm going to eat. I've heard that it's not the most ideal way, as you're chasing your tail a bit, but I'm a fussy eater and I don't want to worry about having to eat something because I've already injected for an extra serve than I have eaten. I've had no problems with injecting post-meal.

I also use NR when my BGL is too high. I just inject a small amount, like 1 or 2 units, depending on what my BGL is.

My doctor told me to always have some NR whenever I eat carbs (depending on glucose level of course), so if I want a carb snack in between meals, I'll inject NR for it.

My doctor also told me that one unit of NR will reduce my BGL by 2 points. So if my BGL is 12 and I inject 1 unit, theoretically it would go down to 10 (I think we Aussies must use a different system of BGL measuring.. we only have two digits!). Not sure if that is just how the insulin reacts in my system, or if it is a general insulin thing.

Hope that helps Annieliese! Of course, ask your doctor about your concerns - he/she is only there to help you! :)

stripes
 

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Richard: When you eat at say noon and you have matched your carbs with insulin, how can you still have insulin working at 2PM to cover carbs? I am going to be taking a diabetes self-management class starting at the end of the month called "Think Like a Pancreas" it is for T2 on insulin-hopefully I can get some of these complicated questions answered. There are so many factors involved when taking insulin...you almost need a doctor on call 24-7!
 

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Breezeonby,

My doctor told me it (novo rapid) has a life span of about 4 hours, going down 30% or so each hour.

stripes
 

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When I was taking my rapid acting insulin before meals, I was going low just about every meal. I am a slow eater and I am also a fussy eater and I have prepared a full meal and then started to eat and then I wasn't hungry-thank goodness I didn't have a bunch of insulin in my system!
 

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Yep! That's why I've taken to injecting after meals. And with some foods, the insulin kicks in way before the food does, so I go low in like 20 minutes. Not fun.
 

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If I take my Humalog at meal time I will have a high of 150 or so one hour after eating and then about 100 two hours after eating. If I took insulin after eating I would have a terrible high one hour later. I take my insulin 30 minutes before eating if I am going to eat a lot of fast acting carbs. We are all different.
 
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