Food BG peaks

[MushyPeaBrain]

How much do people find their BG rises 2 hours after eating and how much is too much?

I am interested in this because it feels like my BG rises too high sometimes and I feel high symptoms, even though my carb ratio brings it back down correctly later.

For example today I was BG 6.6 and I ate a 30g sandwich for lunch. 2.5 hours later I was 9.9 and feeling slightly high.

This big rise can also make it hard to tell if my set changes are working and I often have to wait 3.5-4 hours to tell if they are.

 

[jopar]

What sort of bolus are you setting for it?

It looks like you may need to start your bolus earlier to prevent the spike...

one one hand the spike is just within limits of your starting BG.. So pehaps you should as look at lowering this starting point as well..

Personally I wouldn't like to be in the 6's before eating and for a spilke mid 6 is my limit, a 9.9 wouldn't make me feel slightly high it would make me feel quite ****.. But their again it's rare for me to see a BG in the 7's can't remember the last 9 I had

 

[iHs]

Hello Mushy

I think you are using Humalog so that should start to work fairly quickly so dont think really that there is any need to bolus early although of course you can do just to see if it makes a difference

Not sure how the Animas pump delivers insulin but what I would do, is adjust my carb ratio so that my bg levels were a bit lower 2.5hrs after the meal. I try to get my bg levels to be somewhere around the 6mmol mark before I eat and then try to aim to be 7- 8mmol 2.5hrs later. Using the Accu chek Combo I am also able to adjust my basal rates hour by hour to achieve that level but you might not be able to. Do you leave yourself go for another 2hrs if your levels are higher to see if your bg level drops back or do you do a correction mid morning or mid afternoon?

 

[MushyPeaBrain]

Hello

Thanks for the replies! I am pumping on Novorapid and I bolus literally just before I eat. Does everyone else do it sooner then?

I did wonder about reaching 9 ish 2 hours after but wasn't sure what to alter - the carb ratio or the basal. When I mentioned this to my DSN she just said not to worry as some people's BG rises by 5 2 hours after and it's what it ends up at that counts :shock:

My BG target is 6. As a brittle diabetic I have gradually reduced my target (started at 8) to allow my body to adjust. I can swing to a hypo quite easily, especially with my active baby son, so I am cautious about setting my target lower at the moment.

Also I don't eat at the same time each day always so surely my basal wouldn't solve this?

I am using normal Animas bolus which delivers the whole insulin 1u every 4 seconds. I could adjust a basal using a temp setting for 1 hour or more to take effect mid peak?

All tips are very helpful as I want to fine tune this!!!

 

[jopar]

It really depends on what I am eating to how long I will start my bolus off before eating... In general I start a bolus off 10 minutes before I eat, unless I'm at the bottom of 4mmol/l then I do it as I eat... But sometimes such if I going to have a burger while out, I will start my bouls of 20 minutes before I eat using a multiwave bolus, but extend the second wave a bit longer than normal to prevent too much insulin stacking up before I eat sending me two low before the carbs kick in..

 

[donnellysdogs]

Hi Mushy

TBH, besides the factors such as bolus and basal, there are other factors that my consultant told me about:-

1) Try to spread your meals so that they are 5 hours apart. I belive that you are doing this. You will also have an acting time of your insulin set on your machine,,,you need to check what this has been set up to.....Keeping your meals 5 hours apart will minimise the stacking of insulin if you eat (as I was initially doing at 9.30am and again at 11.30amish for my lunch). I no longer do this, and it has helped for breakfast and lunchtime readings.

2) If you are peaking at2-3 hours after a meal, then it is your bolus that is the main priority to be concerned about.

3) There is a setting on the combo machine called : Meal Rise....and this has to be set at a level to which the machine will allow you to rise to WITHOUT offering an extra correction bolus AFTER you have put in a post meal BG. Mine is set at the lowest configuration on this which is that it will only allow me to rise 2.8mmol without offering me a correction bolus.......so excluding what your starting BG is, no matter what your reading is, my machine also calculates to only ever allow me to rise 2.8mmol, and then also counteracts it. This, if you have this facility on your machine-check what it is has been set at....and definitely no, you should not be allowed to rise 5mmol after eating-unless of course you were 2 to start off with-and even then your machine is set to calculate to get you back to 6!!!!!

 

[donnellysdogs]

I also bolus directly before I eat. Only once I bolus'd earlier by 15-20 minutes and landed myself in deep s**t going hypo whilst I was eating.

 

[richieh]

1st thing... don't worry... 1 or 2 hours at nine is hardly that bad... most non-diabetics have a similar pattern, there's just doesn't last that long as there body reacts more quickly.

What are your fasting reading like?
It could be your carb ratio is compensating for a short fall in you background insulin.

One thing I've suffered from with my insulin is the 1hr daylight shift... I've found that it completely messed up various segments of background insulin.

My be worth doing a fasting check just to make sure.

Obviously you need to be aware of the release rates of certain foods... white bread releases carbs much faster than wholemeal, so could cause a spike...also you may just have a high metabolism so you digest the food faster.
Can you adjust the delivery pattern?

 

[Snodger]

Obviously you need to be aware of the release rates of certain foods... white bread releases carbs much faster than wholemeal, so could cause a spike...also you may just have a high metabolism so you digest the food faster.

also, fat in a meal can slow down carb release by a significant amount for some people. Eg a slice of white bread with melted cheese on top will be quite a bit slower to get into your blood than that same slice by itself.

Melted cheese. mmm. Lunchtime.

 

[MushyPeaBrain]

Thanks guys! Have been bolusing about 10-15 mins before food and have found this has much improved a lot of my spikes, although I know there will be times doing that isn't possible.

I need to do fasting tests to check my basal but am having to wait until the weekend when hubby can look after our son. I'm pretty sure my overnight is almost spot on but suspect the rest of the day may need tweaking :roll:

I've also had my correction ratio altered due to losing so much weight and being on much less insulin so will see how that goes.

 

[adele]

My basal rate ratio is 12g carb to 1 unit insulin, with a correction dose ratio of 2.5 so i find that for every 12g of carbohydrate I eat, my BG goes up by 2.5mmol.