Delayed Insulin

Earlier today I complained about the effects my grilled cheese sandwich were having on my post-lunch control. Steady at 262 for about three hours — horrible! I also predicted that, once I’d biked home and headed out the door to tutor, my blood sugar would drop dramatically without any more insulin (and that’s not even counting what would happen with my six p.m. kickboxing class).

Well, my friends, I was correct. No sooner had I gotten off my bike than my CGM trend arrow started facing directly downward; by the time I’d met my tutee, I was around 178. That held steady, sans additional insulin, till the kickboxing class, and by the time I got home for dinner, my blood sugar was at 111.

So this is what I find frustrating: I’ve tested my basal rates; they’re fine. I didn’t take any additional insulin between the time of that last post, and the time I ate dinner. And sure enough, five (5!) hours later, my blood sugar had indeed dropped to a normal level — which would suggest that if I’d taken additional correction boluses (boli?) as I was tempted to do, I’d have ended up with hypoglycemia. Do other people have this problem? That is, a severely delayed reaction to “rapid-acting” insulin that only begins working once you start moving around? I’ve spoken with multiple endocrinologists and never gotten a very satisfying answer about this — the best I’ve come up with is that there could be a problem with my insertion site for my pump (in this case, I changed it recently and it was working fine). It’s one of the reasons that I think Symlin works well for me — my body reacts much, much faster to food than it does to insulin. But there are times, like this afternoon, when Symlin doesn’t do shit.

Anyway, end of story is that I came home from the gym and made myself a dinner of cabbage salad and tuna fish. Which, now that I’ve written it down, sounds disgusting. But it was actually pretty tasty. And, conveniently, almost carb-free.

Side note — remember how I asked whether in addition to the San Francisco Ferry Building, the Empire State Building might light up blue this weekend for diabetes? According to JDRF and this site, it is — check it out.

Catherine Price
Catherine Price

Catherine Price was diagnosed with Type 1 diabetes when she was 22 years old. She has written for publications including The Best American Science Catherine Price is a professional journalist who was diagnosed with Type 1 diabetes when she was 22 years old. Her work has been featured in publications including The Best American Science Writing, The New York Times, Popular Science, The Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Health Magazine, The Oprah Magazine, and Outside, among others. A graduate of Yale and UC Berkeley’s Graduate School of Journalism

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Kate
Kate
14 years ago

I just had this happen for the first time yesterday..being pregnant and super-panicky about my control, I called my OB’s office (since at least they’re in on Sundays) and they had the nerve to lecture me on “not taking enough insulin.” I know my dosage, but thanks, guys… even without taking additional insulin or exercise I ended up with a low (I had taken enough so that I could have a snack later, which I was forced to skip), the whole effect was simply delayed by 2 hours, and I’ve been trying to figure out what caused it to no… Read more »

Megan
Megan
14 years ago

Have you tried to take a square wave bolus to lessen the “hit” of the insulin? This works well for me to prevent lows while still giving the proper dose! Let me know if you do!!

Scott Richard
Scott
14 years ago

Happens all the time…especially the day after I change sites!  I can run 300 for hours and not a drop of insulin makes a difference…then I crater…It totally stinks!

Jeff Nobles
Jeff N.
14 years ago

P.S. My body also reacts much faster to food than to insulin.

Jeff Nobles
Jeff N.
14 years ago

I have this problem, too. It seems the worst for me when I’ve changed an infusion site, and I blame it on absorption issues (but don’t really know). I haven’t found the answer. If I notice the problem I’ll have a cup of chili or another low-carb lunch. That isn’t always possible. I’m curious whether anyone has a solution, or if this is just another of the hassles of T1 that we have to muddle through.

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