Humalog taking 3 hours to lower BG?


(Marianne) #1

Newly diagnosed and trying to find my patterns! I’m noticing that with Humalog, I am getting highs two hours after eating, but then a precipitous drop in the third hour, with a three hour after meal reading being in the 140’s, but a two hour reading being up over 200. I tried taking the Humalog 15 minutes before eating, and it did not make a difference, has anyone else experienced this? I will talk to my educator about it as well, because I’m wondering if I should wait longer after the injection before eating, but the Humalog site says 20 minutes. (I’m new to this site, and really appreciate everyone, btw. 44 years old and misdiagnosed as Type 2 for four years, I had a long honeymoon, but for the past year I have not been able to control my BG, and was finally diagnosed as T1 about a week ago.)


(Dennis J. Dacey, pwD) #2

Hi Marianne @Mariannapher , first let me Welcome you to TypeOneNation - I hope that over time you will become more comfortable working T1D around your lifestyle and that you will enjoy this site.

What you are experiencing with Humalog is not unusual - I’ve had similar experiences. Your BGL is probably beginning its freefall after about two hours and you just notice it when it hits 140 mg/dl. You didn’t mention what your BG reading was before you took insulin and then ate, so I’ll presume that it may have been 120 to 130 - going up 100 points isn’t unusual. A lot depends on what you ate - not all carbs work the same, some are very fast and others take hours. You are probably doing OK; with over 60 years living on insulin I’ve been through what you are experiencing.

As to patterns - you will see many patterns as time goes on and just because something appears to work today doesn’t mean it will work all the time or even work tomorrow. As my wife will say when I tell her that I’ve had a couple of days in a row where I think I’ve figured this out - “just wait till tomorrow and things will crash”.

Very basically, [good] diabetes management is being able to manage your activities and food with the right amount of insulin - yet that doesn’t take into account the forty-two things that can affect your glucose; some of those 42 bits will push your BG up and others will knock it down.

Hope that my rambling was not too confusing - best advice is to try to relax and don’t pressure yourself to hit the allusive “perfect” - keep asking questions, read trustworthy information and listen to your diabetes educator. You WILL do just fine.


(joe) #3

@Mariannapher hi Marianne, I’ll add to @Dennis, that you can look up Pharmacokinetics here http://care.diabetesjournals.org/content/36/2/273

but our “best” rapid acting insulin takes usually, 20 minutes to start working and will continue to work for 4 hours.

If you eat rapidly absorbing simple sugars, you will get a bigger spike in the +1 to +2 hours after eating. If you eat slow absorbing carbohydrates or mixed (fats or protein and carbs) you can get a low at ~2 hours.

If you take your insulin too early, you can get into real trouble.

If you correct for that spike at +2 hours by taking more insulin (called stacking insulin) you can also get into trouble at +4 to +6 hours.

and then I can add that your body may be still producing insulin (honeymoon, it often starts when you first start taking insulin) and so the next couple weeks to couple months, and this is not really a very good time to be setting rules for insulin to carbohydrate ratios.

when you say “not able to control” I can’t tell if you mean this interim over 200 after a meal or if you mean you go from 400 to 40 all the time.

if you are testing before meals, and are under 140 before you eat and inject (or pump a bolus) and then at 2 hours after, finding you are roughly 50 mg/dl higher than your starting number, you are pretty much doing what you should be doing.with the insulin we have today and can expect a ok number at +4 hours.

“Think like a Pancreas” is a great book, “Using Insulin” and “Pumping Insulin” are 2 others well worth a look. good luck!


(Marianne) #4

Thank you!! My diabetes educator also recommended that book, I will be sure and pick it up today!


(Michael) #5

One of things I’ve used over the years is to mix up the types of carbs with each meal. I generally will have a piece of fruit along with a meal containing some more complex higher fiber carbs. The fruit gets into you more quickly to counteract the drop you speak of while the higher fiber items will tend to have a lower more spread peak later. Doesn’t always work, but for the most part it does. Your sugar will fluctuate after meals, no ifs and or buts. The question is how long does it stay high, or low and how do you feel.


(Charles) #6

I’m real actively new as well. 4 yrs in. But when I was doing similar spikes after eating, I asked the endo. I spiked up as high as 250 or so and then drop back to my normal of around 115. I asked if I should correct for this. His answer was why? I was confused. Simply put yes it goes up but it comes back down. Don’t worry about it. If you try to micro manage the spikes you will only get into trouble. That was his advice to me. All of the others brought great points too. All of these are factors of why it rises so high and then drops. I’ll mention one more. Stress! Worrying about spikes like this can create stress causing your body to react. If your still producing insulin you might release more or you may release sugar into your system. You can see how it’s a catch 22. Darned if you do darned if you don’t.
I personally look at it this way. When I eat if it goes up higher than 200 oh well. As long as it comes down, who cares. I don’t want to create as situation for going low by adding more insulin to the mix.
Bouncing from high to low over and over is no FUN! It’s also not good for your body either. Your gonna have to eat foods and see what it does to you. Everybody has different body chemistry so what works for me may not work for you.
But with that being said, over reacting is potentially bad too!
In this instance adding insulin, other than you get into real trouble by adding insulin. Causing you to drop too low. Too low is worse to me than going kinda high.
You kinda have to pick your battles so to speak. Don’t know if you’ve experienced any real lows yet, but it’s coming in the future. You will need to figure out go to foods that work for you. A CGM ( constant glucose meter) is great for this. You can eat something and see what it does to your sugar levels. Example drinking a soft drink. I use three different times of drinking that soda and kinda mentally take an average of how high or how quickly it makes changes in me. File away for future reference. You can make a food log too and it’s something to reference to.
Best advise I can give you is go slow, think before you react and ask yourself what is the worst case if I do this? What if I do nothing what will happen? Which way is the best for me?
There is no magic number, no magic formula that works every time. It is day by day only. Someone above said it so well. Just wait till tomorrow, it could be different. To me being diabetic is one big puzzle. Sometimes the pieces fit together locket you split other times no matter how hard you try it just doesn’t work. When that happens step back and try to work your way through it. Slowly and thoughtfully. Don’t panic and overreact.
Good luck. Hope I helped. Don’t forget that just cause it works for me or someone else that’s it’s a guarantee for you. Every body is different!!
Charlie