I just started on the pump using Novolog a few days ago and have noticed of few things and was wondering if anyone had these symptoms. Within an hour after a bolus the last two days I have gotten cottonmouth really bad. My 2 hr. BG was 112 last nite and 88 tonite…I have also noticed a funny feeling in my head, almost kinda lightheaded, hard to explain. Is my body just adjusting to new the insulin? I was on Lantus before for about 8 years. So thankful for this site!!
Have a great nite!!
Scottie:… me talking out loud : probably as bit low after 2 hours ?? What happened after 2 hours ??
Are carb ratio’s set correctly ; is basal rate set correctly ? Are you weighing your carbs ?
…may have more to do with these variables , than the insulin brand itself .What other type of insulin ( bolus ) besides
the " basal " Lantus did you use prior to pumping ?
I use NovoRapid ( as it is called in Canada ) in my pump.
Would echo what other’s have said and would add…are your blood sugars a lot different since starting on the pump? You numbers look great if your basals and carb ratios are correct…suspect still working those out if recent start on the pump…, but if they have been high…a sudden decrease can feel very much like lows all the time. Sounds like you switched from Lantus/some other short acting to pump w/ Novolog…is this correct? I know I had no where near the type of control I have on the pump…on shots…although much worse because we did not have Lantus at the time (remember UL anyone?). The other thought is that if you “recently”…meaning within days…switched, you are going to have lower blood sugars until the Lantus moves out of your system (longer 1/2 life than most people think). Check w/ you Endo or DB Educ and check blood sugars frequently. If these “feel” like lows and you usually ran well over 100mg/dl…I would take a little glucose to get you up to above 100mg/dl. Just some thoughts…best to talk w/ your health care team because they know you better:) Good luck. PS: I have used Novolog through a pump for a long time…never had these symptoms other than if I was running a little low…well, at least the lightheaded part:)
People are not allergic to insulin but each brand uses different bases and preservatives in the insulin solution. You could be sensitive to one of these in the Novolog if you had never used Novolog before… Novolog, Humalog and Apidra can all be used in insulin pump so you may want to talk with your doctor about sampling another short acting insulin to see if the symptoms disappear.
Actually…this could be debated since all of the rapid acting insulins have changes in AA sequences to make them fast acting. I pasted a link to a summary document…but, you can find original research articles (some at bottom of text) that corroborate claims. I know I have read many of these because my degrees are in biology. I was shocked since none of my docs or anyone ever told me this information and certainly was not considered in the choice of insulin to use. Novolog has the least (so most like real insulin) w/ 1 AA change, Humalog second w/ 2 and Apidra most…with 3. Now question is…are the AA changes significant enough to trigger our immune systems…are they really any different from one another…especially in diabetics w/ a skrewed up immune system? Would be a specific study design that I have not seen. Bottom line is that they give us better blood glucose control…so, we use them. Not complaining…but, should recognize these are really not insulin…hence, they must call them “analogues”. Ideal would be as close to real as possible and delivered into a vessel…not subcutaneously. Dare to dream:) these issues are those of utility, safety and economics.
I use Novolog because it works good enough for me and I suspect lower risk of immune response. Do not have local irritation w/ Novolog like I did w/ Humulog…that is why I switched. PS: can have an immune response w/o frank signs like hives, etc…and implications are greater also. Medicine is finally understanding the implications of inflammation.
I am also on Lantus in the morning and Novolog at lunch and dinner. I am not on the pump but I do notice I get lightheaded sometimes after injecting Novolog. I think it does take some time to adjust. I had a lot of lows for a while, so I cut back a unit on both doses and my BG has been more stable. How do you like the pump verses MDI? Good luck and let me know how you are doing? I love this site too!
Patricia,
Interesting comment on “real insulin” vs. analogues. I never thought about why they called them analogues – I just knew that their onset, peak and duration were all shortened to better match the food curves. Took me a minute of puzzling to realize AA = amino acid.
I was on Novolog (with a pump) for several years but recently switched to Apidra due to infusion site inflammation and redness. I have no infusion site irritation at all with Apidra.
Thanks for your insight. I learned something new.
Oh my gosh…you people are amazing! Thank you so much for all your responses! I have been having some lows and just adjusted basal and maybe the carb ratio will need to be adjusted as well. I am not weighing carbs as of yet …just measuring and counting so maybe my counts are a little off? After 2 hours seems to be fine. I had tried Humalog for a short time for bolus but had too many lows…scared me so decided to go with a pump as my dr. had recommend for a year or so. I also just started on Lisinopril, to protect kidneys? Maybe that is causing cottonmouth? Yes my bg’s are lower so I’m sure my body will take some to get used to what they are supposed to be. Thank goodness no itching or burning!! I am also on Janumet which I read is not for type 1’s (which they just told me I am according to c-peptide) so I will ask about that as well. So far I love the pump and overall feel MUCH better.
Thanks again!!!
Good info, Dave. Thank you for the link.
Sounds like you have some great questions for your medical team…and are on the way to finding out what is going on…and staying safe while you do. Yes…I take Lisinopril also…it definitely causes dry mouth in me, and a dry cough… but great ACE inhibitor for controlling blood pressure while decreasing risk of renal dysfunction over time. I was on Accupril before that…Lisinopril works better at controlling my blood pressures. Just FYI…I am 30 yrs of T1 and Creatinine is normal:) I started on Lisinopril within 8 years of my diagnosis because of a very insightful doctor. I had pretty normal pressures but, he anticipated that ACE’s would be proven to protect kidneys. I have never found someone as good as him…sorta like a first boyfriend:) Take care Scottie and hope you benefit as much as many here on Tu, from the pump and advanced technologies.
Thank you Patricia! My dr. wanted me to start Lisinopril a year ago as well but I was resistant to taking another med. when my blood pressure has always been good…duh…listen to the dr. !!
Hey Terry:) Yes, I was surprised when I first read an article that showed up in Diabetes years ago. It is true…but, like I said…we have no real idea how significant these changes are to our immune system. The future will definitely expose us to more tweaked insulins as we strive for tighter post-prandial control. Again, not apposed to using them…I just evaluate the benefit I derive every time a new one comes on the market. Apidra also did not cause site inflammation any different than Novolog, for me…but, somehow the absorption or utilization was unpredictable. I wondered if my body was disabling some of the insulin (immune response), but gave it some time. The trend never improved…so I switched back after that 1st vial. I have thought of trying it again, especially when I see comments that it works so well for some. I guess that is the rub…we are all (immunity, cell function, etc.) a little different and no direct way to measure these differences:) Sorry about using the short hand for amino acids…habit:) Take care, and be well.