# How long does insulin take to take effect?



## pottersusan (Oct 23, 2015)

With my (2nd hand) CGM I've become very aware of how long it takes from giving myself insulin to it having any effect on my BG. I use Novorapid and it takes at least an hour to have any effect! I think the 'rapid' part of the name is a bit of a misnomer. I'm trying very hard to reduce the spikes in my BG ( the CGM certainly highlights them) but being organised enough to give myself insulin an hour before eating is hard - especially when you are busy, to say nothing of not knowing what and when you might be eating when you are out.
For you other pancreasless folk out there my surgical consultant tells me that more than 10% of people who've had a total pancreatectomy die of hypoglycaemia. This in NHS terms makes it 'common' - another reason why I want a CGM funded by the NHS. I really don't want to become part of that percentage.


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## Northerner (Oct 23, 2015)

If anyone should get one Susan, it's someone in your situation. I find novorapid can take up to an hour to have any noticeable effect on my levels in the morning, a bit quicker at lunchtime, then quicker still by evening - although even then it's 25-35 minutes! Rapid?  I've heard Apidra is quicker to peak.


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## pottersusan (Oct 23, 2015)

My surgical consultant has written to my diabetes consultant telling him very politely to 'remove his finger'! What with that and going to see my MP I've got 'patient from hell' on my record! If I get an NHS one I'll be selling my 2nd hand one (I hope I won't be trampled in the rush!!)


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## Robin (Oct 23, 2015)

I certainly need to do my insulin at least half an hour before eating, and sometimes an hour. As you say, it's difficult to remember/ break off from what you're doing. And when I've been driving up to Scotland to visit my daughter, it's impossible, I daren't do my insulin before we are actually driving into the service station in case we get stuck in a traffic jam on the motorway, and then I want to eat ASAP and get on my way. I only became aware of quite how long it takes because I invested in a Libre.


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## pottersusan (Oct 23, 2015)

I don't know about you, but I don't wake up more than an hour before I have my breakfast . I've decided that as of tomorrow I'm going to have an old fashioned cooked breakfast with as few carbs as poss to eliminate the mid morning spike. The need for these changes became obvious when I had my hba1c done about 3 months into having the cgm. I've all but eliminated hypos  but the result is that my hba1c had gone up significantly which wasn't a great surprise. It's very much sort one problem and create another!
If anyone has any ideas for low carb, high calorie, wheat and lactose free portable snacks I'd love to hear them! Oh, and no fruit with stones...


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## Robin (Oct 23, 2015)

I agree about breakfast! I often have scrambled egg, which I can have straight way, (even Burgen toast I have to wait 30 minutes for, and despite the recommendations, I find porridge gives me a horrendous spike!
My favourite high calorie low GI snack is a chocolate brownie, off the top of my head, I know there are gluten free ones on sale, but I couldn't say whether they're lactose free, because Ive never had to consider that. Home made, possibly?


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## TheClockworkDodo (Oct 23, 2015)

Walnuts are low in carbs and high in calories, if you can tolerate nuts.  I also eat Green & Black's 85% cocoa dark chocolate, but they can't guarantee it's lactose-free (no milk in ingredients, but a "may contain milk" warning) - you can get chocolate which is both gluten and lactose-free, but I don't know if you'd be able to find one which is dark enough to be low in carbs.

If I have my Novorapid more than about 10 minutes before eating, I tend to hypo mid-meal


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## trophywench (Oct 24, 2015)

Apidra does start to work quicker and also finishes quicker.  About 3.5 hours instead of 4, or 4 +.    I think Humalog is much the same as Novorapid, except it does sometimes tend to have a 'sting' in its tail after about 5 hours.

Can you 'do' eggs?  Frittata?


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## pottersusan (Oct 24, 2015)

I don't know what the Diabetes Fairy will make of my diet when she comes to visit.

I wish I liked nuts. I'm in danger of  changing into an egg!


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## HOBIE (Oct 24, 2015)

Hi Pottersusan. If you are pumping have you tried giving your bolus in % ie 20% straight away then 80% later on. Depending what you are eating. "Dual wave". When I was on MDI I used to inject 30min before eating. Good luck


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## pottersusan (Oct 24, 2015)

Hmm. I tend to forget about the various bolus options. Thanks


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## Pumper_Sue (Oct 24, 2015)

pottersusan said:


> I use Novorapid and it takes at least an hour to have any effect! I think the 'rapid' part of the name is a bit of a misnomer. I'm trying very hard to reduce the spikes in my BG ( the CGM certainly highlights them) but being organised enough to give myself insulin an hour before eating is hard - especially when you are busy, to say nothing of not knowing what and when you might be eating when you are out.


Are you 100% sure it's the novo that's slow or is your basal out?


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## HOBIE (Oct 24, 2015)

Pumps are so adaptable & everyone's different.  Is every day the same ?  Like you at work I never know what time I have my dinner or what it is till I see it. Quite often I miss dinner & adjust pump to suit.


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## pottersusan (Oct 25, 2015)

Pumper_Sue said:


> Are you 100% sure it's the novo that's slow or is your basal out?


Ive been working hard on getting my basal right, so I'm pretty sure its the novo that's slow. its probably something to do with my strange physiology!


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## Worcester_Matt (Oct 25, 2015)

It's interesting reading about everyone's injecting times. I find that, for anything other than something quite sugary/pure carbs like bread on its own, I need to inject after eating. If I injected before eating almost all of my meals I can guarantee a hypo quite soon after eating. Lord knows what's happening with my digestive system!


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## TheClockworkDodo (Oct 25, 2015)

Worcester_Matt said:


> It's interesting reading about everyone's injecting times. I find that, for anything other than something quite sugary/pure carbs like bread on its own, I need to inject after eating. If I injected before eating almost all of my meals I can guarantee a hypo quite soon after eating. Lord knows what's happening with my digestive system!


I need to split my dose if I'm having something like a cake or a pudding at the end of my meal, otherwise I'll hypo before I've got to the end of the first course.  I don't know whether it's my digestive system or whether I just eat very slowly!


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## trophywench (Oct 26, 2015)

That's where a pump helps and being able to do extended or multi-wave boluses.  Both are a terrific help.


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## heasandford (Oct 26, 2015)

trophywench said:


> Apidra does start to work quicker and also finishes quicker.  About 3.5 hours instead of 4, or 4 +.



Sadly not for me - I converted to Apidra before I got my pump, but it has honestly made very little difference.

My Libre has shown that pre-bolusing can help to prevent the worst of spikes, but the timing can be variable depending on where my BG is when giving insulin. I can go hypo very quickly if there is no food on board, but as soon as I eat my BG goes up - more with high GI carby food, but even with protein if there's no carbs around.


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## pottersusan (Oct 26, 2015)

heasandford said:


> Sadly not for me - I converted to Apidra before I got my pump, but it has honestly made very little difference.
> 
> My Libre has shown that pre-bolusing can help to prevent the worst of spikes, but the timing can be variable depending on where my BG is when giving insulin. I can go hypo very quickly if there is no food on board, but as soon as I eat my BG goes up - more with high GI carby food, but even with protein if there's no carbs around.


I'm glad it's not just me and being a 'newish' diabetic. It's amazingly comforting that people who've been dealing with diabetes for many years don't know all the answers.It makes me feel a lot less stupid and gives me hope that I'm on the right track. Quite what the Diabetes Fairy is going to make of me, when she comes to stay, I don't know!


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## trophywench (Oct 27, 2015)

None of us knows all the answers!!  Why the heck do you think we joined here in the first place?


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## Annette (Oct 28, 2015)

trophywench said:


> None of us knows all the answers!!  Why the heck do you think we joined here in the first place?


And as soon as we think we know an answer...it all changes anyway.


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## Bloden (Nov 4, 2015)

Annette Anderson said:


> And as soon as we think we know an answer...it all changes anyway.



You're so right, Annette! I'll think I've got the answers, then BAM! the goalposts move. Ho hum...


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## Cofito (Dec 13, 2015)

Question. Having just had my son diagnosed and sitting in parents room typing . At the moment we are injecting then eating. 

Then taking a level 2 hours after eating. 

Should we be doing this differently is there a risk or spiking like this as the insulin isn't taking effect straight away or the reverse depending on what he is eating. 

I have these kinds of questions for the doctors before we leave but thought I would ask here.


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## Northerner (Dec 13, 2015)

Cofito said:


> Question. Having just had my son diagnosed and sitting in parents room typing . At the moment we are injecting then eating.
> 
> Then taking a level 2 hours after eating.
> 
> ...


This is something that can depend on the individual, as to how fast the insulin takes to start working in the system. For some people it can take a while, hence this conversation, and this can lead to the digestion of the food peaking before the insulin, leading to a glucose spike. However, for some people (and especially children, I think) this may not be the case, and the insulin may start working almost immediately - some children need to inject immediately prior to eating, or sometimes even after. I'm afraid it's one of those 'individual' things that is learned through experience. For the time being, I wouldn't worry about this aspect too much until you are more settled. The best thing to do is to try gradually increasing the time prior to eating, and then testing an hour after to ensure that levels are not too high or too low, then adjusting timing the next time - eventually you will arrive at a 'best' time, although this will still outfox you at times!  It sounds complicated, and it can be at first, but eventually you build up experience, so you do need patience.


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## KookyCat (Dec 13, 2015)

Hi Cofito
Sorry to hear about your son, hope he's doing OK and you're managing to get some sleep.  As Northerner has said I wouldn't worry too much at the moment.  It all depends on how sensitive he is to insulin.  I'm constantly told I react to insulin like a child (I'm 42!), because I have a similar level of sensitivity, I'm classed as extremely sensitive for an adult and often have to bolus after food otherwise I'd be hypo before I finished chewing.  You'll get a feel for how sensitive he is when everything settles down.  The amount of insulin I needed when just diagnosed was nearly three times as much as I need now so things change over the first 12 weeks or so.  Let us know how you're getting on, there are some great people here if you need support


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## Cofito (Dec 13, 2015)

Thanks northerner and kookycat

That all makes sense. Having lots of time on my hands at the moment in amongst playing the play station with my son . I'm just reading and googling so all info is a help as I can then ask the doctors or file it away for a later date to explore. 

Kind of what I thought and why important to have the data so can understand how things effect him. 

Anyway breakfast time


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## AN9 (Dec 27, 2015)

I have Humulin I injections, and I have to inject about an hour (or I'm supposed to) before my meal. Of course, sometimes I forget and have to inject afterwards. In my job, it's easy to get side-tracked...


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## trophywench (Dec 27, 2015)

Humuin I is not a fast-acting insulin of the kind that Type 1s have with meals, or all the while when using an insulin pump, as pottersusan does. AN9.

The 'I' stands for 'intermediate' in your case - it works up to a peak after approx. 4 - 5 hours, then declines gradually over the next 18 or 19 hours.


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