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Confusing reactions to insulin

Adam.froud

Adam.froud

Active Member
Messages
42
Location
Suffolk
Type of diabetes
Type 1
Treatment type
Insulin
Okay, so I am very new to this and my understanding and experience is limited.

But...

This morning when I woke up my BG was 6.7. I had 100g Greek yogurt (4g carb) and 5 units of novorapid. 2 hours later my BG was 6.0, and three hours later it was 6.1.

At lunchtime my BG was 7.1. I had chicken breast and cabbage (2g carbs) and another 5 units of novorapid. 2 hours later my BG was 6.3, and three hours later it was 6.6.

At dinner time my BG was 6.7. I had chicken breast, green beans and 75g sweet potato (20g carbs) and another 5 units novorapid. This time my BG dropped down to 4.2 two hours after eating.

So why such different reactions to insulin? I'm aware that insulin resistance is usually lower in the evening, but is it to such an extent?

This condition is so confusing sometimes!
 
You aren't just reacting to the insulin, but the food too. What you are up to will also have an impact. If you walked home, if you are just more relaxed at home.

You do seem to be on quite high ratios so newly diagnosed. You might want to consider basal testing to check to see if youre bolusing to compensate for lack of basal.
 
Adam.froud said:
Okay, so I am very new to this and my understanding and experience is limited.

But...

This morning when I woke up my BG was 6.7. I had 100g Greek yogurt (4g carb) and 5 units of novorapid. 2 hours later my BG was 6.0, and three hours later it was 6.1.

At lunchtime my BG was 7.1. I had chicken breast and cabbage (2g carbs) and another 5 units of novorapid. 2 hours later my BG was 6.3, and three hours later it was 6.6.

At dinner time my BG was 6.7. I had chicken breast, green beans and 75g sweet potato (20g carbs) and another 5 units novorapid. This time my BG dropped down to 4.2 two hours after eating.

So why such different reactions to insulin? I'm aware that insulin resistance is usually lower in the evening, but is it to such an extent?

This condition is so confusing sometimes!
Click to expand...
Did you take your bs at 3 hours after dinner ?
When a meal is low carb some of have to bolus for protein. I SURE DO. I bolus for half my protein. So if I'm eating 3'oz (21g) I bolus as if it were 10 carbs. The amount of fat and fiber in the meal will also effect insulin action. The other components of the meal need to be considered as well, not just carbs. If the meal is vlc protein can turn to glucose via gluconeogenisis.

I was never able to ' random' eat. Too many variables. Over time I found my macros for each meal and my bolus to keep me steady. I eat 80% fat, 15% protein and 5% carbs all from above ground veggies. So same size meals at different time of day but loads of variations of protein and veggies. Without enough fat I am starving and I spike. Therefore avocado at every meal for me.
I do this because it caused me too much anxiety and surprises on my meter. This way I take small doses of insulin and stay very steady. Most people would find it too restricting and boring but I love my food.

Your numbers seem steadier !! Fasting still a tad high for my liking but finding your correct basal dose to bring it down a bit will help. You're doing great so quickly!! If you keep a food journal with your meals opand proportions you will find which meals work and which don't. Carbs and protein in the morning don't work for me but they ramp up during the day.

Best wishes. Keep testing to figure out YOUR plan.
 
I wouldn't worrry @Adam.froud Your body isn't a machine and so it will sometimes react differently. So many things can affect blood sugar.

I agree with @catapillar regarding the basal test. For the small amounts of food you're eating, your doses seem higher than I'd have guessed. So perhaps you actually need a little more basal. Worth testing and asking your DSN, I think.

Once you're sure your basal is ok, you can then adjust your meal time insulin more confidently and expand your meal choices.
 
Kristin251 said:
Did you take your bs at 3 hours after dinner ?
When a meal is low carb some of have to bolus for protein. I SURE DO. I bolus for half my protein. If the meal is vlc protein can turn to glucose via gluconeogenisis.
Click to expand...

This could explain why my BG dropped so much more with the only meal where I had a significant amount of carbohydrate. Perhaps I'll try introducing slightly smaller amounts of carbs at breakfast and lunch!

BG 3 hours after dinner (now) was 5.1.
 
Adam.froud said:
This could explain why my BG dropped so much more with the only meal where I had a significant amount of carbohydrate. Perhaps I'll try introducing slightly smaller amounts of carbs at breakfast and lunch!

BG 3 hours after dinner (now) was 5.1.
Click to expand...

Moderate carbs make it easier to,control blood sugar, I've found. I eat 180g per day approx but we all have our own level that works for us.
 
catapillar said:
You aren't just reacting to the insulin, but the food too. What you are up to will also have an impact. If you walked home, if you are just more relaxed at home.

You do seem to be on quite high ratios so newly diagnosed. You might want to consider basal testing to check to see if youre bolusing to compensate for lack of basal.
Click to expand...
I haven't been able to work out my ratios yet. My DN suggested 2 units/10 g of carbs since I'm a bit fat. I've been working on that basis although it seems to be excessive in the evening. I've also asked 2 units/1 mmol but this doesn't seem to work for my evening meal dose!
 
azure said:
I wouldn't worrry @Adam.froud Your body isn't a machine and so it will sometimes react differently. So many things can affect blood sugar.

I agree with @catapillar regarding the basal test. For the small amounts of food you're eating, your doses seem higher than I'd have guessed. So perhaps you actually need a little more basal. Worth testing and asking your DSN, I think.

Once you're sure your basal is ok, you can then adjust your meal time insulin more confidently and expand your meal choices.
Click to expand...
My DSN told me not to be afraid to experiment (within reason). So I have been! Sometimes things work and sometimes not. But I gather from this forum that this can often be the case with t1d regardless of experience and knowledge!
 
Adam.froud said:
My DSN told me not to be afraid to experiment (within reason). So I have been! Sometimes things work and sometimes not. But I gather from this forum that this can often be the case with t1d regardless of experience and knowledge!
Click to expand...

Too true - no one gets perfect blood sugars all the time!

Once you know your meal time ratios, you can eat more confidently. Things will still go off track a bit, but each day you'll get the experience and knowledge that you need. You've made a great start :)
 
5 units insulin for 4gm CHO (breakfast) and 2gm CHO (dinner) does seem a lot however it kept you BGL stable so it works for you. However you had a lot more CHO for dinner (20gm) but the same insulin dose and your BGL dropped a bit too much so I'd recommend backing off the evening dose by 0.5 (if possible) or 1 unit to see how that goes. My ratios are different for each meal of the day so it's quite normal.
 
@Adam.froud Thinking about this more, I wonder if your sweet potato carb count is slightly out? That would explain you going slightly lower than you expected.

I wouldn't have counted you evening meal as 20g carbs there. My count is a bit lower.
 
HI @Adam.froud I may be being a bit thick here but if you're on 2u per 10g of carbs and had 4g carbs for breakfast wouldn't that mean 1u? (similarly lunch would work out at next to nothing insulin wise about 0.4u) tea looks about right based on the ratio, other meals look out by a factor of 10? Unless you're having a healthy correction dose or I'm having a major math failure (quite possible!)

If it's working for you (which apart from tea it looks like it is) don't change it but it doesn't seem like you're on the ratio you think you are?
 
Adam.froud said:
I haven't been able to work out my ratios yet. My DN suggested 2 units/10 g of carbs since I'm a bit fat. I've been working on that basis although it seems to be excessive in the evening. I've also asked 2 units/1 mmol but this doesn't seem to work for my evening meal dose!
Click to expand...

You're not doing 2:10 though are you? That would mean a meal with 4g of carbs would get 1 unit of insulin but you took 5 units for your 4g of carb breakfast, which be a 1.2:1 ratio, more than one unit for every gram of carb. 2:10 would mean half a unit or less for a meal with 2g of carbs, but you had 5 units, which would be 2.5:1.

Those ratios seem to have worked for you at breakfast and lunch but as they are unusually high I just question whether the bolus dose might be making up for a lack of basal rather than just covering food.

Maybe have a look at the Bertie online course for carb counting and working out insulin to carb ratios.
 
staffsmatt said:
HI @Adam.froud I may be being a bit thick here but if you're on 2u per 10g of carbs and had 4g carbs for breakfast wouldn't that mean 1u? (similarly lunch would work out at next to nothing insulin wise about 0.4u) tea looks about right based on the ratio, other meals look out by a factor of 10? Unless you're having a healthy correction dose or I'm having a major math failure (quite possible!)

If it's working for you (which apart from tea it looks like it is) don't change it but it doesn't seem like you're on the ratio you think you are?
Click to expand...
Hi, yes I'm aware that I'm not doing the 2:10 ratio all of the time, as been increasing my breakfast/lunch bolus to try and bring my levels down.

Today I had 10g CHO for breakfast, injected 5u and my levels went from 7.0 upon waking to 6.8 3h after eating.
 
catapillar said:
You're not doing 2:10 though are you? That would mean a meal with 4g of carbs would get 1 unit of insulin but you took 5 units for your 4g of carb breakfast, which be a 1.2:1 ratio, more than one unit for every gram of carb. 2:10 would mean half a unit or less for a meal with 2g of carbs, but you had 5 units, which would be 2.5:1.

Those ratios seem to have worked for you at breakfast and lunch but as they are unusually high I just question whether the bolus dose might be making up for a lack of basal rather than just covering food.

Maybe have a look at the Bertie online course for carb counting and working out insulin to carb ratios.
Click to expand...
Yes I think I may need to adjust my basal further.

I'm doing a lot playing around with things at the moment trying see what works.

I'm going to try basal testing over the night couple of nights (hopefully my alarm won't wake the baby!) and see what's happening there.
 
@Adam.froud,

Going by your profile picture (I don't know how old it is) - but you don't appear to be very fat at all... Unless you have what's called "double diabetes" - T1D combined with insulin resistance (a common trait of T2D) - then I'd imagine that your overcompensating with bolus insulin because of a lack of basal.

You may want to have a read through the following link which outlines how to do a basal rate test:

https://mysugr.com/basal-rate-testing/

Note - when I did my most recent basal rate test, I cheated and used the Freestyle Libre, it proved invaluable for me, especially with the overnight BG readings. It may be something you might want to consider.

You're a very recent T1D, so getting ratios and doses of both basal and bolus insulin takes time, patience and a bit of trial and error too! Further to that, as your more than likely honeymooning, you'll find that things may be up and down for as little as a few weeks to over a year! Try not to be too hard on yourself and not get worked up about yo-yo BG results, especially in the early days as it's all a big learning curve.

From what I've read in your prior posts and the numbers you've given in this thread - you seem to be doing very well indeed:)
 
Last edited:
Adam.froud said:
I'm doing a lot playing around with things at the moment trying see what works.
Click to expand...

One other thing to watch out for is to not change too many thing at once and once you do change something give it a day or two before deciding whether or not it's worked (various other things can affect your levels even if your doses are spot on...)
 
azure said:
@Adam.froud Thinking about this more, I wonder if your sweet potato carb count is slightly out? That would explain you going slightly lower than you expected.

I wouldn't have counted you evening meal as 20g carbs there. My count is a bit lower.
Click to expand...
I tried having a lidl protein roll for lunch today, which is 8.5 g CHO per roll, I believe.

I was 7.4 before lunch and had my roll with 5u novorapid. Three hours later my BG is 5.2.

So maybe I am over-calculating a bit?
 
GrantGam said:
@Adam.froud,

Going by your profile picture (I don't know how old it is) - but you don't appear to be very fat at all... Unless you have what's called "double diabetes" - T1D combined with insulin resistance (a common trait of T2D) - then I'd imagine that your overcompensating with bolus insulin because of a lack of basal.

You may want to have a read through the following link which outlines how to do a basal rate test:

https://mysugr.com/basal-rate-testing/

Note - when I did my most recent basal rate test, I cheated and used the Freestyle Libre, it proved invaluable for me, especially with the overnight BG readings. It may be something you might want to consider.

You're a very recent T1D, so getting ratios and doses of both basal and bolus insulin takes time, patience and a bit of trial and error too! Further to that, as your more than likely honeymooning, you'll find that things may be up and down for as little as a few weeks to over a year! Try not to be too hard on yourself and not get worked up about yo-yo BG results, especially in the early days as it's all a big learning curve.

From what I've read in your prior posts and the numbers you've given in this thread - you seem to be doing very well indeed:)
Click to expand...

My DSN did say I might be a bit insulin resistant because I'm about 92 kg, so I am a bit overweight!
 
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