I just recently switched from Humalog to Novolog in my omnipod and I was wondering why I now am staying in range within 1 hour of eating (with Humalog I always spiked really high within 1 hour of eating and then came down after two hours) but now I am going high two hours after eating? Should I not dose 20-30 mins before eating anymore?
I would think that you would want to be in range within 1 hour of eating, unless you are crashing out afterwards or something?
Maybe the Novolog is working faster in you than the humalog was? Have you changed at all what you're eating (i.e., anything that would slow down digestion, like more fats and proteins)? When I tried Novolog, I didn't notice any appreciable difference, but I think some people said that they thought it worked a bit faster. Are you still bolusing a few minutes before you eat? Perhaps with the Novolog you should try bolusing right when you start to eat to give it less of a head start.
I think novolog for you peaks sooner: try bolusing only 15 mins before or use a double wave bolus.
My experience with my 3 years old daughter is quite opposite: novalog (novarapid) is really slow and we are turning back to humalog.
YDMV
The analog insulins are faster because of small variations in the sequence of proteins. Foremost the modifications will prevent the insulin molecules to create larger structures in the vial. As a result the analog insulins show different behaviour from individual to individual. For example I can inject just before and if I am lower like 80 mg/dl I can also inject after the meal. I would be in great trouble if I would dare to inject 20-30 mins before eating with a normal glucose level.
In your situation I would try to reduce to 10 or even 0 minutes - just to get a feeling for the spike this would cause. Another question is the duration of the insulin. In general there should be some activity left at the 3 hour mark. But again this can differ from brand to brand. This is why I always recommend to try different analog insulins. It can have great impact on the quality of life: reduction in waiting time, spikes and the frequency of lows due to the fact that the insulin is leaving the system much faster. It is really worth the efford to find the right one. Most endos should have some probes available from pharma reps.
I'd love to be in range within an hour of eating! Thinking of an Apidra trial, as I am (with Novolog) the way you were with Humalog.
This is why I always recommend to try different analog insulins. It can have great impact on the quality of life: reduction in waiting time, spikes and the frequency of lows due to the fact that the insulin is leaving the system much faster. It is really worth the efford to find the right one. Most endos should have some probes available from pharma reps.
+1+1+1+1 Just my thought, expecially these days ....
I agree with Holger. Assuming your diet hasn't changed try other insulins. Do you have software for your Omnipod? Perhaps you may see trends by using other insulins. My suggestion......write separate logs for each type of insulin and give it to the doc or endo on your next visit. Also read up on the glycemic index.......that way you'll know what foods are giving you those spikes.
Thanks everyone, I tried dosing right when I eat and that helped. So far I like Novalog better because it was hard to dose 20-30mins before eating with Humalog. Now I need to figure out blouses so I don’t go too high at all after eating. What does everyone here aim for? 140, 160???
I aim for 120. I don't always hit it but I like to be sort of OCD about it. I also have a CGM so, when I have time, I'll watch. 110-115-120 usually means that it'll keep going for a while but if I see a 119-120-121-121-120 I like it. I don't beat myself up if I miss but I will usually have a second look at the carbs and figure "well, maybe I missed 10..." and have a "nudge bolus" to cover the oversight?
what is nudge bolus? Are you just stacking insulin by using your correction factor or do you just pick an amount to give? I have a cgm and would love to learn how to stay under 120!
I use the pump and think about what I ate, if I think "Maybe there were more carbs..." I'll go ahead and bolus for them to trade a 140 and some "oops now I'm low" potential for a 150+ situation that I'd still have to "clean up" later? It could be stacking but I don't devote a huge amount of energy to being super accurate with carb counting. I dunno if anyone else uses the term "nudge" but that's what I do.
I've never heard that term before, but I assume it's a small bolus used as a correction. I tend to test fairly often after eating, and occasionally make several small corrections if needed. Not sure if this is stacking per se, but does help keep me within range…
If I hit 120 pp I corrrect if it's over 2 hours. 'Nudge bolus' is a great term ar. I did a lot of that on the cruise. If the CGM shows me going up, I'll correct sooner. More often than not I SWAG carbs, and I'm usually pretty accurate, but not always.
Good topic! I did the same thing you are about a year ago. I was on Humalog and now I am on Novolog which I seem to like better. Not sure if anyone else has mentioned this...but, I think the Humalog insulin burns a bit more (nothing bad) and is more noticeable when the insulin is injected/pumped in.
If you really study the activity curves of each insulin, you will see that there is a difference as I note below:
NOVOLOG: Peaks in 40 minutes (20 mins quicker than Humalog), has about a 4 hour duration before it flat lines.
HUMALOG: Peaks in 60 mins, peak time duration is double that of Novolog (flatter peak plateau), in 4 hours about 10% of the insulin is still active, total duration is about 5 hours
I am still experimenting after all these years with when to bolus....sometimes early is good. Other times, bolusing when I eat is better. It depends on the food you eat and how fast you think it will convert to glucose and get into your bloodstream. I too shoot for a my 2 hour post meal BS to be <120. If I am still high after 2 hours...I usually take more insulin.
Thanks for the info! Humalog burned a little for me as a well. I am still trying to learn how to keep my bg less than 120. I am assuming everyone follows a low carb diet to do that? Or do you just take a lot more insulin? I am not doing low carb, but I have always ate less carb than average. I tend to eat around 130-150 grams a day. Is it still possible to keep low bgs eating this way?
You bet! I am also on a low carb plan for the most part. Not as low as the Bernstein plan but about in the range you are doing...maybe a tad less. I am more in the 100 to 120 carbs per day range. This is a lot lower than the carbs I took 4 years ago. Unfortunately age seems to have a lot to do with carb needs. Obviously when I was younger.,..all I ate were carbs! :) Ken
PS: keeping BS below 120 very hard. So, don't feel bad if you have a bad day. You have to really micro manage yourself being careful how and when to bolus along with eating low carbs. Oh, exercise works good for me too. If I am in the 180-200 range for example...my BS will drop quicker by going for a brisk 20 min walk than taking more insulin.
With Novolog, I "bolus" half the amount 20 min before eating and take the rest as a "square wave" for 30 min. Works for me
I normally eat around 30 carbs a day, 34-ish TDD. I was on an 8 night cruise a couple of weeks ago and averaged 96 carbs a day (gulp). My average TDD went up to 51.1 but I kept my average bg at 118. So yes, more insulin for more carbs, less insulin for fewer, but it's possible either way. Lots and lots and lots of testing, and a CGM help tremendously.
Actually that is a great idea too TS. I use the Dual Wave more than the square wave. But, both are good to incorporate also!