Hi!
I am trying to learn how to use Regular(Actrapid) for my meals and have questions. Thankful if anyone can help.
I understand that Regular should be injected like 30-40 minutes prior to a low carb meal. But, I experience that I still need coverage for those "fast" acting carbs.
Can I use 0,5-1 units of Novorapid 15 minutes before meal and my TAG calculated (proteins and fat) amount of Actrapid(Regular) 30 min before meal. Does it make sense?
Can those mix up somehow and give me hypo?
How should I proceed if after 2 hours after my meal I am high (like now, around 7,4 mmol)I usually correct this with novorapid or better put - I do extended bolus with novorapid)
Thanks!
Hi,
What you are doing doesn't sound good to me. Are you taking BOTH NovoRapid AND Actrapid? Nothing else? You are basically taking 2 types of fast acting insulin. One is much faster working than the other.
You should take NovoRapid (for meals) and some kind of Basal insulin like Lantus or Levemir for background insulin.
Please clarify...
Sorry to confuse you :-). I do take levemir :-). I want to use regular for my low carbs meals, because novorapid is too quick. It never covers my proteins
Okay, thanks for the clarification. Conversion of Protein to Carbs in the body is very inefficient. You don't need a lot (if any) of insulin at all when eating Protein. How many grams of Protein are you eating at a meal anyway? I personally would stay from Regular insulin.
The goal is to get your blood sugar back to the normal range (85-120) as soon as possible after a meal. You can't do this with Regular. It takes too long to lower BG. If you are getting lows with rapid acting insulin you are likely: taking too much insulin, bolusing too soon before meals, or have pending low blood sugars when you take a bolus.
First, you should never mix these in a single injection. And second, don't believe that the cumulative effect of two separate concurrent injections of NovoRapid and R will necessarily react as anticipated.
It has been my experience that very low carb, moderate protein meals such as those from 6-12-12 do not require insulin dosing to cover simple carbs. You shouldn't be eating any significant amount of them and their effect on your blood sugar will be diffused by the fat and protein.
The goal is to achieve a total dose of insulin that restores you properly to a normal fasting in the 3-5 hour range (more like 5 hours after a high protein meal). And then an insulin profile that matches the glucose surge from your meal. Different people have different absorption. If your blood sugar rises too high right after a meal, but them properly falls to a normal fasting after about 5 hours, the answer is not more insulin (which will give you a hypo), instead you should adjust the timing. Perhaps you need to take your R 45-60 minutes before eating.
ps. And you might look closely at the carb counts of your meals and see whether you are eating more than say 12 g for dinner as that could be a key reason you are higher than expected.
Hi Brian, thank you for your answer.
I have a couple of more questions:
1) Do I remember correct that DrB uses Apidra for correction?
And he says that one should never inject earlier then 5 hours after last shot.
Does he mean that regular/rapid should not be mixed? Or am I totally confused?
So If I took Actrapid to my meal, and after 4 hours I am say, 7 mmol or higher. Can I use Novorapid to bring it down?
2) Can lowcarb make my body to be more efficient in breaking proteins to glucose faster? I started fasting experiments, and one day everything went crazy when I've started to eat, got very high BG on almost only protein meal.
3) If I use Regular an I accidentally exceed amount of carbs, say I was more hungry than I thought, and had more broccoli :-) or something, what should I do? More Regular?
I understand that the best way is portion control and do the same thing everyday, but I can not make it work somehow. Regular seems to be for very disciplined people :).
4) From your experience does Regular need more planning & timing? I am lost right now and it seems like Novorapid and my "extended" bolus give me more freedom. But then again, the idea with Regular was to bring my postprandial down, without needing to inject so often, as I do with Novorapid.
If I bolus more than 2 units of Novorapid at a time, I get hypos. I usually have 1,5 unit before meal and 1,5 -3 units a couple of hours later.
Thanks again!
I try to eat moderate protein, about 80 gr a day (otherwise I am hungry), but it seems like my body got more efficient in turning it to glucose.
