# Day 1 - Novorapid & Lantus. Help please



## Lolilou (Mar 23, 2018)

so, first day with my new insulin. 

My waking reading was high then took my Novorapid at breakfast. Was down to 5.1 within 2 hours.... wow!!! However, I started to feel horrible, shaking & dizzy. Tested again an hour later & was 4.8. When I feel like this, should I just go with it (as long as I’m over 4) & monitor or have something to raise my sugars slightly? Or is the 6 units of Novorapid possibly too high? I also have really painful leg & feet cramps. Anything I can do to ease this? I’m not seeing anyone until Wednesday (community) then with the specialist 17.04.


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## Northerner (Mar 23, 2018)

Lolilou said:


> so, first day with my new insulin.
> 
> My waking reading was high then took my Novorapid at breakfast. Was down to 5.1 within 2 hours.... wow!!! However, I started to feel horrible, shaking & dizzy. Tested again an hour later & was 4.8. When I feel like this, should I just go with it (as long as I’m over 4) & monitor or have something to raise my sugars slightly? Or is the 6 units of Novorapid possibly too high? I also have really painful leg & feet cramps. Anything I can do to ease this? I’m not seeing anyone until Wednesday (community) then with the specialist 17.04.


Always test when you feel like this and then you will be able to build up an experience of where your levels are. It's most likely that, because of your misdiagnosis your levels have been pretty high until now, and your brain sends out panic signals when you are suddenly much lower even if you are not actually hypo. In time, once you are able to manage your levels better and you get used to lower levels the symptoms you describe should only appear when you are low/below 4.0, or sometimes you can be above 4.0 but with rapidly falling levels.

Do lots of testing in these early days and weeks


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## Lolilou (Mar 23, 2018)

Northerner said:


> Always test when you feel like this and then you will be able to build up an experience of where your levels are. It's most likely that, because of your misdiagnosis your levels have been pretty high until now, and your brain sends out panic signals when you are suddenly much lower even if you are not actually hypo. In time, once you are able to manage your levels better and you get used to lower levels the symptoms you describe should only appear when you are low/below 4.0, or sometimes you can be above 4.0 but with rapidly falling levels.
> 
> Do lots of testing in these early days and weeks



Thank you. So I’m ok to just go with it & not try to raise them a bit? I felt horrible! It’s so complicated  

At least once they saw my GAD result was over 2000, they stopped telling me I was type 2. You were all spot on when I joined a few weeks ago so I can see I’ll probably get more help & advice from here than anywhere else


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## trophywench (Mar 23, 2018)

Just wondering Lolilou, what are you eating for brekkie, have they asked you to eat the same thing each day and have they asked you to keep a food and BG test diary?


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## Northerner (Mar 23, 2018)

Lolilou said:


> Thank you. So I’m ok to just go with it & not try to raise them a bit? I felt horrible! It’s so complicated
> 
> At least once they saw my GAD result was over 2000, they stopped telling me I was type 2. You were all spot on when I joined a few weeks ago so I can see I’ll probably get more help & advice from here than anywhere else


When you get these symptoms, if you're not actually below 4.0 I'd suggest just having a small biscuit or a jelly baby - this will elevate your levels a little and should remove the symptoms. Try not to have too much though, which can be difficult at times because your brain is telling you to eat! Then I'd suggest testing again after 15 minutes to see where you are  The slight elevation won't harm you, but it will help you gradually reduce your levels rather than going from sky-high to low-ish too quickly  Are you speaking to your nurse about adjustments to your insulin doses? Dropping to 5 a couple of hours after injecting the novorapid might suggest a slightly too-high dose. Novorapid can take between 3-5 hours in bringing your levels down, so this is why it's important to test frequently to try and discover your own personal 'profile'. Are you aware of the Freestyle Libre system? This is sensor that you place on your arm and you can then scan whenever you want to find out what your level is. They are now being made available on the NHS and might be very helpful to you if you can persuade your GP to prescribe


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## Alister (Mar 23, 2018)

I think you need to pay attention to they symptoms more than the actual figure & treat accordingly, especially if you are going to be driving (or operating heavy machinery etc.)
a small snack to boost your levels a little may be in order (without overdoing it )
once you are maintaining more stable levels these sympoms should reduce/disapear unless you are really going hypo


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## Lolilou (Mar 23, 2018)

Urrrr was feeling iffy so tested & was at 3.2 & shaking like mad. Took a fast acting carb (realised I’d not had enough carbs at lunch) & now my sugar is 19.1 aaaarrrrrgh!!!!


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## Lolilou (Mar 23, 2018)

Northerner said:


> When you get these symptoms, if you're not actually below 4.0 I'd suggest just having a small biscuit or a jelly baby - this will elevate your levels a little and should remove the symptoms. Try not to have too much though, which can be difficult at times because your brain is telling you to eat! Then I'd suggest testing again after 15 minutes to see where you are  The slight elevation won't harm you, but it will help you gradually reduce your levels rather than going from sky-high to low-ish too quickly  Are you speaking to your nurse about adjustments to your insulin doses? Dropping to 5 a couple of hours after injecting the novorapid might suggest a slightly too-high dose. Novorapid can take between 3-5 hours in bringing your levels down, so this is why it's important to test frequently to try and discover your own personal 'profile'. Are you aware of the Freestyle Libre system? This is sensor that you place on your arm and you can then scan whenever you want to find out what your level is. They are now being made available on the NHS and might be very helpful to you if you can persuade your GP to prescribe



Yes I was reading up on those earlier, they look amazing!! Hopefully my GP will prescribe it but if not, I’ll find it myself cos my poor fingers are shot to pieces!

Thank you for the help, it means a lot.


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## grovesy (Mar 23, 2018)

Lolilou said:


> Urrrr was feeling iffy so tested & was at 3.2 & shaking like mad. Took a fast acting carb (realised I’d not had enough carbs at lunch) & now my sugar is 19.1 aaaarrrrrgh!!!!


It is easy to over treat a hypo.


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## Lolilou (Mar 23, 2018)

grovesy said:


> It is easy to over treat a hypo.


Well I certainly did that lol I’ve been & bought some dextrose tablets so hopefully I can manage better next time. They’re coming down again now anyway. Talk about learning curve


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## grovesy (Mar 23, 2018)

You will get there.


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## Ljc (Mar 23, 2018)

I agree it’s easy to over treat a hypo especially when you have the hypo hunger, it’s a real battle of wills  then.
It’s possible your doses of insulin need tweaking, the don’t usually like to bring our levels down so quickly, I would contact your team for some advise on reducing your bolus insulin a bit.


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## TheClockworkDodo (Mar 23, 2018)

Hello @Lolilou - sorry I missed your previous thread here, but good to meet someone else whose GAD test was over 2000 - mine was too!

I'd probably have something like a hobnob (under 10g carbs and not too fast-acting ones) if I was shaking and dizzy but my blood sugar was over 4, on the assumption that it was going down too fast.  But if it was under 4 I'd have 15g fast acting carbs (eg fruit juice or glucose gel - dextrose tablets are fine) and then wait 10-15 minutes, test again, and then if over 4 have something like a TUC biscuit (2.7g carbs), but not more than that unless I was doing unexpected exercise or something.  Medical professionals may tell you that you should have more than that - they sometimes advise a futher 15g slow-acting carbs to follow up the 15g fast acting ones, but if you follow that advice you will almost invariably end up at 19 ... 

I agree with Lin about tweaking your doses - it probably would be a good idea to talk to someone about this soon rather than waiting until your appointment.  The doses they put us on to start with are a "best guess" and usually need to be tweaked a bit (or a lot, in my case - they put me on 16 units of Lantus to start with, and after the first week I'd hypo'd so much they dropped the dose to 6 units).  If you have a phone number or email address for a DSN (diabetes specialist nurse) it would be worth contacting them, they should be able to advise you about this.  Don't be afraid to contact them, helping you get your doses right is their job!


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