Why does my fast acting insulin not kick in for several hours? I can take it at 8 am; eat a light breakfast (piece of wheat toast) and my sugars don’t start dropping for 4 or 5 hours. Then they plummet!
What is the best; fastest acting insulin?
Thanks
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@needdiabetichelp Thanks for joining FUD and posting!
I think we could use a little more info to provide you a reasonable answer. What fast acting insulin are you using, and do you experience the same thing at all times of the day? Morning can be a disaster due to hormones and things. I see that you are Type 2, are you also on basal insulin or just fast acting?
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Agree… Waking up and getting up can trigger glucose dump from liver, along with stress and other factors.
You may also have insulin resistance, and some meds may help with that.
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I wake up and after 10 or 15 minutes will bolus 1u because of Feet on the Floor, maybe I should keep my feet in the bed. 
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The thing is; I didn’t use to do that. I used to get up and be 120 to 150. Now I get up and it hits 250 by lunch time
when I hadn’t even eat a dang thing!!!
I’m with you on the keeping my feet in the bed!! LOL. Of course; when the insulin finally kicks in and my sugar drops into the 50s
I’m back in bed anyway!!
Thanks for your response;
Tim
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Thanks Chris. Tresiba for the basal; 40 units; once a day. Novolog; 12 up to 25 for the fast acting depending on how high
my sugar is; 3 to four times per day!
My problem is that the so called “Fast Acting” doesn’t kick in for 3 to 4 hours later???
Trying to get my Dr to write a script for Lyumjev which is supposed to be the fastest but he says it’s the same as the Novolog???
Thanks again;
Tim
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So the reason I asked my questions, and thank you for answering them, is that if you were my type 1 son, I would do some basal testing. When his basal is not dialed in correctly he is often chasing things which could look like what you are experiencing. The hitting 250 by lunch also sounds like you don’t have a optimally dialed basal dose. So potentially what you are experiencing as a time delay of action is just the reaction of covering for missing insulin and so doesn’t lower your blood sugar like you are expecting. When you do hit 3 hours later you should be at the tail of the insulin action, does the insulin cover the correct amount of carbs? Just with a 3-4 hour delay?
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What it sounds like your are experiencing increased insulin resistance, something as a type 2 I am intimately familiar. Also the drop later is almost like reactive hypoglycemia.
There are type 2 medications that can increase insulin sensitivity, Actos and Metformin (a bit). You might speak to your endo about this.
As to rising BG while fasting, our livers are chock full of stored glucose which gets released. There is a cocktail of hormones released some 3 hours before waking (dawn phenomenon). This occurs in all vertebrate, but those of us without endocrine insulin or it doesn’t function correctly, BG can rise too high. Feet on the Floor Syndrome is iirc the same hormonal storm.
One thing that really works is regular exercise. I find aerobic/cardio is best, but resistance training like weight lifting that increases muscle mass is also helpful. Exercise in the evening tends to reduce DP and FOTF. Also forgoing the bedtime snack, unless one is prone to nocturnal hypos.
You don’t mention your age. Sadly when we pass 40 our muscle mass tends to decline. We have to work at it to slow that down or maybe increase it.
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My experience is that the effect doesn’t kick in until I actually eat, or drink, something. At that point I need 10g in excess of whatever I eat/drink.
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How were you dx’d T2? Any tests for T1 (GAD, etc.)? Any significant changes to foods eaten, exercise routine, other work/lifestyle changes (started shift work vice standard days)? All of these significantly impact any analysis/advice. Your description of the Novolog dosing seems odd; you take it based on the meals/food right? (I’m not familiar with T2 fast acting dosing, perhaps its different than T1s)
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I am for me. It varies because of the underlying insulin resistance which varies. Using a Tandem pump with Dexcom G6 I will sometimes do a prebolus correction an hour before a meal, with a meal bolus anyway from 0 to 20 minutes pre and on occasion waiting until BG starts trending up. It is not consistent.
What I do works fairly well for me. My HbA1c and GMI have been steady at 6% while my time in range of 70 to 145mg/dl is 96% with a standard deviation of 17mg/dl.
I am also prone to overriding corrections and meal boluses, because C-IQ is more conservative than I like and I have an issue with BG rising 4-5 hours after meals.
While I no longer produce much endocrine insulin, the cellular insulin resistance will be with me until I close my eyes for the last time. If you got the gene variants you can’t get rid of them.
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@CarlosLuis Thanks for the education on the T2 resistance perspective. I admire your ability to do the pre-bolus thing; I’ve yet to learn to dose effectively early when I cook or when the wife says “Dinner will be ready in…”, I catch myself saying, “well, 5 minutes will have to be enough” way too often. I hate eating cold foods that aren’t supposed to be cold foods.
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Obtaining A1C at 6% and staying in target range 96% is awesome. Keep up the good work!
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