Cant get my bgs right in the evening,for example last night 2.5 hours post meal 7.7 bg ,ninety mins later 11.5 and all I ate for tea was small meat sandwich 30gms carb and a sugar free jelly with 3 slices of tinned peaches in juice (no juice with my slices) 10gms carb=40gms total and gave 5 units bolus to cover and as my ratio is 9gms carb per unit insulin this should have been slightly more than I needed ,so any solutions come to mind folk???? have phoned for dns advice but wont hear for a while as only ansaphone in d dept at hospital Before evening meal was 5.9 bg
There may be a few contributing factors here, some that spring to mind: Carbohydrate and "of which sugars" values dictate how fast the sugars will respond in your blood stream. For example a slow release carbohydrate will have a value of lets say 100g carbs, but an "of which sugars" value of 27.5g. The greater the difference the slower the release. In contrast Fast acting sugars have for example a carb value of 100g and an "of which sugars" value of 95.9g stipulating that the release of sugars will have a far more imediate effect on your blood sugars. Based on this it all depends on what you choose to eat to detremine the likely effect on your blood glucose readings. In your specific case it may be that the fruit you had was a slow releasing carb and having checked 2 hours after your meal your blood glucose seemed ok but with the release of sugar from the fruit continuing over a long period continued to push your sugar levels up some hours later when you tested again giving a higher reading.
Generally speeking most folks tend to wind down after work, having an evening meal and sitting down watching tv, reading a book or similar. This change in your daily activity may also contribute to your blood sugars responding differently to that during the day i.e 9-5. Sometimes it has proven effective to take a short walk after an evening meal to create a bit of excelerated blood flow around your body and expel a little energy. Often this walk could be very breif indeed - over exercising could lead to a hypo- be careful.
If you use a pen to inject your basal insulin (background insulin) consider what time frame it is effective over if your background insulin is taken early in the morning it could be running low in its active state towards the evening hours- for example i used to take two shots of levemir background insulin in a day approximately 12 hours apart this was to create two small curves in its potensy as opposed to one long curve over twenty four hours this was done by halving the dosage. only ever change insulin dosages after consulting your diabetic specialist or gp never makes changes alone as the results could cause severe problems and nobody else is aware of why you may suddenly go hypo or hyper.
If you use a pump consider dispersing the dosage over a longer period of time - for example i now use a pump and have the option to do three types of bolus dose "standard" meaning continuous injection, "Extended" meaning the dose is broken into smaller injections over a longer period of time often 15 mins or 30 mins, and finally a "multiwave" i use this when both long acting and fast acting carbs are consumed in the same meal this is because a multiwave will give a 30% dose up front and the remainder over a longer period i.e 15mins or 30 mins. Having these options to prolong the dosage allows the body to absorb the insulin more steadily instead of all at once. The extended and multiwave doses are often taken when the dosage is higher than 6.0 units. It helps also to prevent insulin backlog (slow absorbtion) and scaring in injection sites allowing absorbtion at the location to remain stable and not painful.
Please take note I am no doctor but have had Diabetes type 1 now for five years and have attended many courses on how to gain better control of my blood sugars. Having said this even I make mistakes and have to learn the hard way. Please discuss these points with your specialist before undertaking any of them - these are ideas not recomendations as everybody is different and may respond differently. Remember only change one variable at a time as doing all of them may also cause unexpected changes and you'll never identify which one caused the unexpected change in blood sugar levels.