Bg hour after meals

[K8tie_x]

I've experimented with injecting well in advance of meals and find it does help most if the time but can depend what I'm eating and how much insulin I need. Are you on a pump or not?
I'm now on a pump so find things are slightly different now as I'm more sensitive to insulin than when I was injecting. I benefitted though when I was injecting definitely by injecting in advance but have found with the pump I've gone low before my food has fully worked due to being more sensitive to the insulin. I often try to have a good percentage pre meal and then the rest during it after but I know this is just a nightmare with the needles. It may be abit if trial and error for you but just try and be aware of the low and high gi foods when deciding how to administer the dosages, also pre meal readings if I was 4.0 I would leave it till immediately before eating to give any insulin to avoid hypos but 5+ I know would be safe for me to start administering it.

5 years ago when I was pregnant they used to advise 1 hour post meals, but I was told 2 hours post meals in this pregnancy but my DSN doesn't ask me to provide these readings ever she just focuses on pre meals only but the obs team can be abit funnier and like those 2 hr post meals to be below 7.8.

 

[jhinkson1]

Im on novorapid injections so i was worried i might go too low but ive tried it half an hour before and its been ok. I just dont think im injecting early enough, an hour before would probably be better.
It would be good if they made an insulin that peaks quicker but has a shorter duration.

They've asked me to test an hour after meals because that's when your sugars peak. If i was testing 2 hours after id be in range most of the time. Testing 1 hour after my sugars can be in double figures so they want to stop this because it will still be getting to the baby.
Its so hard though and very stressful.
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[Nannyspice]

I am type 2 only on metformin 500g once a day, and my average reading before and after meals is an average of 6.3, I will try one hour after main meal on Sunday as my nurse said I only need to check my sugars twice a week. Thanks for replies.

 

[K8tie_x]

I was on novo rapid with my first baby and if I'm honest I never checked bloods one hour after meals as unless I had no carbs at all it was always out of range as I found my insulin hasn't finished working till 2 and a half hours so if I corrected like they'd said I'd be hypo constantly, this with trying to work full time was a nightmare. My DSN though wasn't too fussy as she knew the 1 hour bloods were so difficult it was the consultants but this time they said new research has shown its not the 1 hour but 2 hour bloods that are important. I think all diabetic teams give very slightly different information, try not together yourself too down about it as it really got to me with my first pregnancy. I'm now on a pump though and have found my control to be so much better, up until now (29 weeks) I've been brilliant with all readings but I'm finding I may need to cut out some carbs now as my readings have shot up all of a sudden.
Have you considered a pump? I was really adamant I didn't want one with my first but after researching them this time I can honestly say it's been the best decision I have ever made, my quality of life and diabetes control has improved dramatically.

 

[jhinkson1]

I'm not sure about the pump, but i don't really know much about it. I've heard it takes a lot of fine tuning?

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[K8tie_x]

I was very sceptical until I started really researching it properly and hearing all the stories from people who have one. The first week is the toughest as they estimate your novo rapid levels, I was on a 20% reduction from what I was having manually and still constantly hypo so reduced levels further.
Basically to sum it up simply your novo rapid is delivered every 3 minutes throughout the day which replaces your background insulin then you still have your bolus doses with your meals. You can set the basal rates hourly so you can have fluctuating amounts through the day, I need much more during the early hours than in the afternoon so my insulin is tailored around my needs even if I don't eat it stays constant.
I'm much more sensitive to the insulin through the pump than what I was when I was having big doses through injection which I think can only be a good thing as its more like a non diabetic individuals insulin is administered.

 

[jhinkson1]

But when you're pregnant don't your insulin requirements change all the time? Does that mean you'll have to keep changing it?
I'm just a bit cautious if i keep getting constant hypo's or hypers and its pumping insulin automatically when i dont want it too, or not giving me enough. Im probably being really silly though and it doesnt work like that.

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[K8tie_x]

Yeh it changes at various stages throughout your pregnancy I found about 24 weeks and now again at 29. You just set it to what your ratios are then put it in how many carbs and it works out how much insulin you need. You can administer tiny amounts too like 0.1 of a unit. My explanation may not have been great but speak to your team if your interested and see whether you qualify to get one through the NHs luckily I did but different areas I think it all works differently and may be harder or easier to get one than other areas

 

[nigelho]

Is anyone actually able to reach the below 7.8 target an hour post meals? I'm finding it so difficult. Even if i eat the same thing everyday, one day i'll reach the target and the next day they'll be well off. So frustrating!

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Hi, If you're not on a pump you should only be testing between 4-5 hours AFTER a meal. This time allows your quick acting insulin to work. My daughter now on a pump has been told to do 1 hour test and she should target 7.8mmols. I don't know how the pump works but she has a lot of hassle with the software and getting the correct settings for the novorapid. Too much hassle for me so I'm sticking to injecting and adjusting my ratios to suit MYSELF and not what the BOOK says. I've done DAFNE and they've given me the info to better manage myself. I test 4 hours after my meal but I do any corrections, if required, before I work out my carbs/ratios.

 

[nigelho]

I agree that carb counting is essential, unfortunately this isn't good enough for me. Despite having exactly right insulin:carb ratio and counting correctly my bm still spikes and then crashes and my consultant hasn't been able to sort it out so low carbs whilst miserable at times is the only thing I can get to work but my diabetes is particularly brittle. I guess everyone is different and it's trial and error that we all must try.


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Carb counting will only work if you are using the correct ratios. DAFNE is an excellent course to go on as they EXPLAIN everything and even look at the insulins you're on. However, 4-5 hour testing should be followed as the insulin need this time to work. If you test BEFORE the insulin has done its job and you correct you can be stacking up insulin then later on HYPO. I did this for almost 4 years with the DSN knowledge but it was only after doing DAFNE I realised how incorrect the previous info had been. My HBA1C in 6 months has gone from 8.95 to 7.2% and I'm feeling so much better. I now know how my system reacts to my insulins and I set my ratios to what I'm doing during the next few hours.

 

[jhinkson1]

I know novorapid has a duration of four hours so 4 hourly testing would make sense, but they usually say test 2 hours after a meal because that when novorapid reaches its peak. As i am pregnant i have been set the target of below 7.8 1 hour after a meal because 1 hour after a meal is usually the highest your sugar level goes and they don't want it too high for the baby regardless if the insulin has reached its peak or not.

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[LemonTree]

Hiya

the post-meal 7.8 requirement is a pregnancy thing. This was really hard for me to achieve until someone mention low GI!

I was increasing my insulin doses and all sorts to try to get my 1 hour post meal readings under 9 but then I was majorly hypoing 2 hours after eating. Now if I stick to lower GI foods such as porridge in the morning I tend not to get the spikes. I do sometimes have to have up to 10g of carbs 2-3 hours after eating though or I will go low. You just have to find out what works for you. My insulin ratio is lower in the middle of the day so I suppose I am more active then and need less of it but I will have to have a snack in the afternoon too. My diabetes team decided that I was just one of those people who would have to eat my way through my pregnancy because I am prone to hypos (I was told off for having too many).

Everyone is different and people react differently to different foods but I would recommend trying low GI foods for a couple of meals - that way you don't have to cut out carbs completely which can mess with your head - we need carbs as energy for brain power!

Did you know that spaghetti is low GI compared to other pastas? I don't know why this is but it has less of an effect on my sugar level than other white pastas. Perhaps you could try a spaghetti based meal as a trial run.

Good luck

 

[jhinkson1]

Hi
Most of my meals are low G.I. unfortunately. I've stopped eating porridge because i have to take more insulin to get within the target! Spaghetti is quite successful with me too but anything i eat and i manage to reach that target i will get a hypo so i've started eating more too to try and get rid of the hypos! I'm finding chocolate digestives are quite good (only one or two) they don't make my sugars spike.

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[LemonTree]

Hobnobs are good too. I find the oats are slower release. Nice to have a good excuse to eat biscuits

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[K8tie_x]

I find its best to avoid breakfast at all other than something small like an apple but some days I really feel like I need something more carby if I'm feeling light headed and sickly. Take note of the boxes though too they told me to completely avoid done cereals like rice crispies so I was but I've been shopping at aldi lately and noticed their own brand of rice crispies only has 2.9 grams of sugar per 30g bowl (make sure your aware of what 30g is before I started measuring I was having a 70g bowl ). Whereas bran flakes which you'd think would be less than rice crispies actually are alot more.

 

[jhinkson1]

So this morning i decided to go lower carb. 2 boiled eggs and 1 slice of toast. 1 hour after i was just out of range and i only took 2 units. I also didnt take my 2 units of levemir as it hasnt been doing anything. So far so good. No hypos and sugars in range.

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[K8tie_x]

The burgen type seeded breads are supposed to be better to avoid the spikes too so maybe you could switch to that bread, even 50/50 is better than white my dietician says x

 

[jhinkson1]

Yeah i have brown and seedy bread. I'll check the carb contents though or just have a smaller slice!

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[Moaney]

I've been told 2 hours too. 1 hour is unrealistic I feel. I was wondering with the pump....are u put on it due to poor control?! I was told if I cldnt get my hba1c down myself I wld go on pump, but that was years ago?! Is it quite discrete & does it work out itself what insulin to give u or do u set it to dispense as and when?! I wld love to know as I'm thinking a pump might come into play as I get more heavily pregnant?! :O


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[K8tie_x]

It's smaller than an iPhone but slightly fatter, it's much more discreet than I'd imagined I have a little pouch for it and the only time you really see it is if you have really slim fitting clothes on and I tend to put it round the back then so you can't see it, then you have the tubing from the pump which goes to the cannula that you can't see through your clothing.
The pump I have is Bluetooth from my blood machine so it's all programmed with my ratios for different times in the day and I just put the carbs I'm having and it delivers the insulin and works out if I need a correction as well. The basal is the same insulin that is delivered with meals (novorapid for me) but its set at the rate you need which can be set at different levels as you need it which they work out for you but may need tweaking as I was more sensitive to the insulin being delivered through the cannula compared to one big injection of insulin.
It's delivered every 3 minutes which is more like how a normal pancreas would work and it's tailored to your needs so I'm on a much higher basal rate in the morning than in the afternoon, obviously if you have your long term insulin in one big go you can't do this so for me it's been great as I can get rid of those afternoon hypos but still maintain a high basal rate when I need it in the morning.
I was offered s pump with my first pregnancy and wasn't sure so declined, then after problems with hypos they offered me it again so I researched it and it sounded amazing, it's been the best move I've ever made my quality of life is do much better, I'm not click watching waiting to have my background insulin in the morning or at night and I'm not fading about running off to the loo when I'm out doing my insulin I can just use my blood machine like a remote and tell it to give me my insulin. A big thing for me too was being able to split my insulin dose so I can have half pre meal and depending what I eat have the rest after or if I want a pudding I can just program an extra few units.