Intramusular because insulin takes too long

I was vegetarian for 25 years and it was the worst possible diet for me, I now eat less than 30 carbs a day mostly from vegetables and the rest is meat cheese eggs etc. For anyone reading this topic I just want to reiterate that its not something that happens randomly, its a permanent way insulin works in us, it’s ALWAYS two or longer hours, then it just works like normal, it will start coming on really strong, it’s just like a giant delay and then wham business as usual. It’s not from the time you take it or the diet etc, I’ve had diabetes in every life stage, toddler, child, teenager, adult, middle age, this has only been happening for 6 years or so, everyone who has this happen all of them have had diabetes for many decades (obviously though not everyone who has had it for decades will have this problem), so there is some link with time there.
Fred, great topic, until your thread I thought I was alone in this. I too am unaware of hypos now and have a dexcom g5 so I literally sleep with my phone on me. I had a few really scary hypos that were like bad acid trips, I was terrified of having another one. The dexcom g5 on my phone is a life changer.
Becky I saw Bernstein doing IM shots and another girl. The reason I do them all the time now is they are very reliable for me. Bernstein recommended them specifically for bringing high BG down. I saw how useful they were for that and just started using them all the time, It was either 10 mins or 2 hours. I also have a fairly low carb diet so my BG doesnt swing to far out, my high warning is set to 8.1 mmol (140 ). Even with a fairly low carb diet and small standard deviation, waiting two hours for insulin to begin can really get me into trouble, it’s very easy to get distracted waiting that long for all bolus’ and corrections to begin.

I am sorry a vegetarian diet didn’t work for you, I just wanted to let people know a vegan/vegetarian diet is completely possible for most people. But I am for whichever diet works for you!

I am a type 1 and a strict vegan and eat what I want as long as it’s vegan. My last A1C was 6%. I love my whole grains, fruits and veggies!!! I do prebolus half my dose a half hour before I eat. High fat with my food can delay absorption for me and there are a couple of items I have to have a bolus a half hour after I eat. I use humalog in an insulin pump and a Dexcom G6.

So sorry to hear about your insulin delay having nothing to do with high glucose levels. That has to be extremely frustrating. After 60 yrs of having type 1, so far I have seemed to bypass many of the problems long term diabetics have. I have no idea why. I do have two heart stents though which were partly caused from high LDL, because of the Bernstein diet which I followed faithfully for 11 yrs. We all need to follow the diets that work best for our own bodies. My body apparently doesn’t like fat at all. I too was a vegetarian for many years, but it too included fat so it wasn’t healthy for me either. For me at this point low fat plant based with plenty of fruit and vegetables works beautifully.

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I never followed the Bernstein diet and my cholesterol went throught the roof. I ate a vegetarian diet purely out of ideology, I grew up on farms and the killing of animals was horrendous and I quickly became vegetarian. They have now apparently linked statins to causing type 2 diabetes. I like you (I think it is you) can also take one statin a fortnight, I realised this when I had taken about 5 in a 3 month period and the Dr said your cholesterol is great! . I can’t eat fructose anymore as it makes me very ill. I tried to do the raw food plant diet and I was vomiting every day for 6 weeks. I had diahorea and I was very I’ll. Turned out it was the ratio of frucrose to glucose in the apples and other fruits I was eating, frucrose intolerance they call it. So I eat a few veges and some meat to make more bulk otherwise I would be too hungry. With my thread topic I can have a BG of 4.5 mmol (roughly 81) and have 8 units of (say) novorapid and sit down and it wont do anything for two hours (almost set a clock to it), then as the time comes round it will hit me with as much strength as it would on anyone else, the effect isn’t degraded at all, this is the what makes it so strange. At first I thought maybe I had insulin resistance or something but it is purely a delay in action. So now I do IM shots so I get a nice response time. There arw others who have this problem and I would love to get data in them to find out what is going on.

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I share your desire to not harm animals, so was very happy to stop eating them. I hope that I don’t end up with a problem with fructose. Man, we are all such strange creatures. Yes, I just took a very low dose of a statin and was so pleased when my LDL was reduced, but even on a very low dose the side effects, for me, were awful. So, I am sure my LDL level is rising again now that I am once again trying to control it only through exercise and the low fat diet. Sometimes we just can’t seem to win.
We just have to keep trying and celebrating finding what works for us.

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Does it hurt more ?

What other things are their to consider like maybe hitting a nerve or something.

I ask these questions because I am very thin and if the only difference of muscle shot is time why not ?

Too fast a drop no thanks of course.

I do my shots in the rear cause that’s my thickest fat deposit. And the stomach area shots just freaked me out in the beginning.

I do need to start reading again. I was all about learning everything I could in the beginning then I found it was making me worry too much. Then my friend with T-1 calmed me about it , he has been at it 17 years.

I think it was Dr Bernstien stuff I read about doing insulin in the muscle.

I just had my first diabetes burnout, drank excessive alcohol too. No fun, got sick. Watching my health and the gym was a better track.

Interested in this IM use. If I go too high bring it down fast with a very small amount maybe. I am just guessing they don’t want us dropping too fast so IM use is not promoted.

The issue you spoke about partly (not entirely) concerns the fact that injection sites are often different with respect to time for insulin action. Some sites might give delayed response for exactly the same s.c. bolus quantity compared to another. Some burned out site after decades of use can yield delayed and inadequate response due to cutaneous changes over time due to injection trauma and tissue challenges. I think everybody knows this in our culture. OTC Humulin R and NPH are old school and not the best choices unless the cost for the reli-on brand is why one get’s them. First of all the NPH is not really long and most people use less fast to get the same results compared to intermediate R which is out of fashion for a reason. For instance, Degludec is far superior to NPH. So when I hear you combination I sigh a little.

It is commonly known that bolus insulin used for correction takes 4 hours to achieve its effect. Your endo is misinformed. I believe IM works, but I could never stand to do it, OUCH! It makes my hair stand on end just thinking about it, but more power to ya’ if you got the guts to do it.

That’s what I say with the idea if an IM shot but that’s where I was at doing the skin shots in the beginning. Terror actually “you are going to have to learn to do this yourself” wait what , no I am going to wake up from this this is not true…

In an hour I fill a needle and poke push done. No biggy. The dart at the dart board, made that up in my head a few weeks in.

But yes if they told me I had to start doing IM shots right now, I would be troubled.

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It has nothing to do with that at all. Ive been at this game for 43 years, since I was three, I am well aware of all this stuff. I specifically put how long I have been treating myself right at the start to avoid this. I am one of the few who have had this problem my entire life, and approaching half a century. The problem is it now takes 2 hours no matter where I inject it, I’m not alone, this happens to many type ones after multiple decades of type one (not all) most at least 40 years. I must rewrite the thread because it wasn’t meant to be about things people should know in their first few years of the disease, it was how do others with delayed onset insulin absorbtion combat and work with managing it, ie IM injecrions.

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I have to be careful what I say. The first thing to understand about insulin injection, it is some like but mostly NOT like injecting drugs (of any type). For a start it is a hormone, an altered hormone, but after all is said and done it acts like a hormone. Like drugs, the faster the route the quicker the half life (ill get backnto this). So for insulin, there are three main routes, subcutaneous (SC), intramusular (IM), and intravenous (IV). Each one increases with time taken to begin reducing BG. SC being the slowest (all things being even) and IV the fastest. Here is where it takes a turn though, with SC insulin the time to wear off can be (for fast acting) anywhere from 1 hour and 15 mins to 5 or 6 hours. For IM the half life shortens to maybe half that (in me it is an hour and a half), so it will begin quicker but wear off much faster. IV generally being the fastest (although often it can be the same as IM) also is removed from the body very very quickly, sometimes in minutes. When in hospital IV insulin is usually given in a drip because of this fact, it wears off often before it has a chance to act, so is given in small amounts very often, usually in cases of DKA. Another interesting quality of insulin is that it must go through a metabolic process, it wont just start working fast because you introduced it quicker. Many think erroneously that because they have IV insulin it will work immediately and they will come crashing down. It can and generally does start working within 10 minutes but may take up to an hour or two to complete its full cycle, however it can and often does wear off and does very little. You can see there is more to changing routes than meets the eye and this intro, is by no means rigorous. IV is never recommended or needed in the home as it can lead to a host of problems and more importantly it provides very little real time advantage over IM.

Regards IM, I thought it would hurt also but it doesnt really, although like SC it can hurt sometimes, really bad. Ive had some excruciating SC injection over the years, one every few years or so that’s so painful I pull it out and jump up and down and must have another go but none this painful with IM, ymmv. The biggest problem I have had with IM Is hitting a blood vessel and blood coming out of and running down my arm. There is a video of a girl on youtube showing how easy it is. Dont worry, your more likely to not go deep enough than to go too deep

Ok I’m going to stop writing. It is becoming a book.

Its never too early to learn.

“IV insulin has a very short duration of action (minutes)”

“The only type of insulin that should be given intravenously is human regular insulin . There is no advantage to using rapid-acting analogs in preparing insulin infusions because the rate of absorption is no longer a factor when administering insulin intravenously and can only result in added costs to the institution.”

I don’t believe that. I think its still a factor even if small, cutting corners for cost is of less importance.

My search term was “iv insulin administration”

My curiosity about IV insulin administration is for future technology in managing type one. Maybe with trustworthy medical equipment using IV infusion it could be possible to more closely mimic the natural action of beta cells in the pancreas.

And that looping. I would want sugar infusion option too to correct a low as I think the so far somewhat unpredictable nature of insulin would require this.

I would trust that more then artificial intelligence algorithms making predictions. I would want both in a system.

I was writing the same book at the same time. We were both typing and both came up with IV administration independently.

You just hit the reply button first !

I have experience in such matters but Its frowned upon to talk of it. It is a great option but its the whole messy vein issue that gets in the way of regular use. As far as insulin pumps there is the portal vein i think that is near the liver that is best for inserted devices for insulin if I remember correctly.

Hmm, I find I’m spending most of my time reading your posts. We have very similar interests.

Commonly known? By whom? Between 4 and 5 hours is complete action time with peak effect at 1 to two hours, at 5 hours the half life is reduced to zero and it ends. You may want to recheck that, even nph wears offbin 6 hours, of course you may be different but those are the standard deviation. The only thing she is misinformed with is that many of us after 40 years of injecting insulin have delyed onset. The problem is quite well known in people who have this disease for a very long time and many doctors must wait until a paper is written on the subject to ‘know’ it. Where we have seen it decades before because we live with it.

That’s right.

I have been in the advocacy section stuck on the idea their are 7.5 million of ‘us’ in the US alone and we don’t need ‘them’.

Organizing people is not an easy task. My brain hurts. I got to go chill.

LOL…for arguments sake. Approximately 1.25 million type 1’s in the US and about 30 million type 2’s and an untold amount prediabetic.

The amount of type 1’s did vary depending where you looked, but most have settled on this number now. The type 2 figure can is still very much all over the place. These were pulled from the ADA.

I know nothing about Im or intravenous, I just know Fred was having an issue with it taking a long time and now Edward. I think Fred really liked Afrezza, hopefully it is still working for him. My suggestion because of that is to try Afrezza and see if it works for you.

I will quietly step out now…:grin:

to IgotT1,

IV admin of insulin may occur in hospitals but not commonly. IM admin of insulins I am not familiar with.

Let’s say a case is a hypothetical Pt BG = 950 POC with Kussmaul compensation for metabolic acidosis with blood gases showing base excess that is severely negative and a low partial pressure of CO2 in conjunction with low bicarbonate because of a forced increased respiration (blowing off the carbon dioxide, in other words) and thus the invol urge to deeply breathe (air hunger), and the daignosis is obviously osmotic diuresis resulting in hypovolemia and subsequent underperfusion of the tissue, then it’s likely treated by:

(1) fluid replacement (lactated Ringers or 0.9% saline then later changed to 0.45% saline to match losses due to osmotic diuresis was the common protocol); and (2) You never give this Pt bicarb, 3. use either fast-acting insulin given SLOWLY as replacement ONLY AFTER initial volume resuscitation is complete, probably not as a bolus, but given all or mostly all by adding to a new IV for slower drip. (4) Probable supplement K and also add a little dextrose to IV when glucose falls to 200 mg/dL to stabilize and prevent a glucose crash downward.

This scenario is one every T1 ought to know because it’s very common. Emerg Dpt staff know it well. DKA normally ends up well.