Type 1 Highs up to 4 hrs after eating

[JimMcM]

High all. Kinda new here, M, 47, type 1 diagnosed almost 2 yrs ago. I'm doing quite well apparently, from what my consultant has been telling me at our regular appts, HbA1c has gone from 107 to 72, and all other tests are coming back very good also, but I've a question for others living with type1...

Say I was roughly, 7 or 7.5 before eating my dinner, and I injected 5 units for the 50g of carbs, and say 3 units to cover the protein, that's a total of 8 units... Maybe 4 hours later, I could still be abt 14 or 15!!! I'm only kinda noticing it now, because of my Libre, and when I test myself, it's fairly close to the mark!! I'm carb counting btw, and everything is weighed, and properly counted for.

The only time it doesn't do this, is when I train after dinner, which is abt 3 evenings a week. I first started on a 20 - 1 ratio and now that the pancreas has completely stopped, I'm on a ratio of 10 - 1...

Should I inject far more for my normal evenings, or will it make me drop like a stone later on?? Does anyone else have the same issue?? Any help would be greatly appreciated.

Jim

 

[JimMcM]

Yeah, it looks like I'm gonna be on a constant learning curve alright lol... Thanks for that, I'll have a lookout for this person. Cheers

 

[kaylz91]

So highs after exercise?

I don't quite see where you got this from? OP states the only time it DOESNT happen is when he trains in the evening

 

[kaylz91]

First thing first, have you conducted a basal test to make sure your basal dose is correct? Nothing else will work as it should if your basal dose is off

Are you 100% sure you need to cover the protein? sometimes too much insulin can actually cause highs as well, I know most that need to cover protein do so due to the absence of substantial carbs as with substantial carbs your body shouldn't use much of the protein at all as glucose

Are you including a lot of fat in your meals? Fat slows the absorption and can cause a delayed spike which can be worked around by splitting your bolus, I don't do it often but I do adopt the splitting bolus regime for Christmas and New Year Dinner

If your basal dose is correct then perhaps look at your bolus ratio's, they can change significantly and while your using a 1:10 it may be 1:7 or even 1:5 or lower still
xx

 

[urbanracer]

Hello.

Sounds like your slowly getting the hang if things, but trouble with T1 is that your always learning.

So highs after exercise?

Could be that because if the energy you expend during training your liver is dumping glycogen into you to make up the deficit.

You might find that you have to do a small correction dose after your training, should be easy to track with a Libre on, just to bring you down to more normal levels.

There is a person on here that goes in the gym @Kim Possible I think, who might be able to shed some light.

It would be interesting to know what you actually ate?

Carbs like pasta do raise my blood sugars after the insulin has peaked.

 

[The Pirate Twins]

Ok keep your hair on it was a miss read so deleted the post.

 

[JimMcM]

First thing first, have you conducted a basal test to make sure your basal dose is correct? Nothing else will work as it should if your basal dose is off

Are you 100% sure you need to cover the protein? sometimes too much insulin can actually cause highs as well, I know most that need to cover protein do so due to the absence of substantial carbs as with substantial carbs your body shouldn't use much of the protein at all as glucose

Are you including a lot of fat in your meals? Fat slows the absorption and can cause a delayed spike which can be worked around by splitting your bolus, I don't do it often but I do adopt the splitting bolus regime for Christmas and New Year Dinner

If your basal dose is correct then perhaps look at your bolus ratio's, they can change significantly and while your using a 1:10 it may be 1:7 or even 1:5 or lower still
xx

First thing first, have you conducted a basal test to make sure your basal dose is correct? Nothing else will work as it should if your basal dose is off

Are you 100% sure you need to cover the protein? sometimes too much insulin can actually cause highs as well, I know most that need to cover protein do so due to the absence of substantial carbs as with substantial carbs your body shouldn't use much of the protein at all as glucose

Are you including a lot of fat in your meals? Fat slows the absorption and can cause a delayed spike which can be worked around by splitting your bolus, I don't do it often but I do adopt the splitting bolus regime for Christmas and New Year Dinner

If your basal dose is correct then perhaps look at your bolus ratio's, they can change significantly and while your using a 1:10 it may be 1:7 or even 1:5 or lower still
xx

Hiya, thanks for the reply... When first diagnosed in Jan '17 they set my basal to 20 units, and my bolus to 20 units, 3 times per day. I started carb counting within about 6 weeks, and all my dosages changed obviously. My basal went down to 14 and my bolus went to 20:1... I'm currently on 10:1 and a basal of 17 which is what I was told to use by the hospital. The reason I dose for the protein was that I was noticing that my highs were lasting quite a while, so after some reading (maybe slightly ill-informed reading), I thought I needed to take the protein into consideration.

All my meals are home prepared by my wife and daughter, and the fat is kept to a minimum because of the fact that I do a lot of cycling & training etc, so I'm lucky enough on that front. Going back to the topic of protein, maybe you could be right... maybe I don't need to inject for it, maybe I just need to inject a little more for the carb intake.. Like, I eat a really high, clean carb breakfast on a Sunday morning, then cycle maybe 60 odd miles, and at the halfway coffee stop, I'm still a tad high, but perfect when I get home.

Thanks again for the reply, I'll maybe do a few tweaks and see how I go.

Jim

 

[JimMcM]

I would be interesting to know what you actually ate?

Carbs like pasta do raise my blood sugars after the insulin has peaked.

Hiya.. On a normal evening, say I had maybe 200 grams of mashed potato which is 31 grams of carbs, some boiled carrots and peas, or processed peas, which are around 16 grams of carbs, and then about 60 grams of lean meat or chicken, which, when i read up on, should be halved in weight and bolused for, so that is roughly 30 grams...

It only beats me on a day that I'm not evening training, once I train, I'm sound.

 

[kaylz91]

I would highly suggest you do a basal test, the hospital cant tell you how much your body needs so the only way to get it pinpointed is to see how you react with that dose throughout different fasting periods of the day, I agree basal tests aren't a pleasure but they really are useful and gives us the information to see where we need to make tweaks, what basal are you on and when do you take it?
xx

 

[JimMcM]

I've just been reading up on the basal tests now since you mentioned it. I'm on Abasaglar, and I take it at around 7 or 8 pm... The test seems like a bit of a chore, but also sounds like its really worthwhile. As soon as I get my head around it, I'm gonna get one done for definite...

Thanks again for your help. Talking with someone who's actually living with it, really makes things clearer..

 

[kaylz91]

No problem at all

Do let us know how you get on, also I believe your insulin is most similar to Lantus, may I ask what time these higher levels are happening at? Some find that although they claim it has a 24 hour coverage period that some basals do in fact fall short lasting 20 hours or sometimes less, some work around it by splitting their dose, often not 50/50 either or have to change their insulin, is that a possibility for you? I don't know much about your basal as I've only ever used Tresiba
xx

 

[ert]

Your diabetes nurse should be able to help you with this if you record your data waking, bedtime, before meals and 4 hours after. On my DAFNE course, they aimed for blood sugars the same as before eating and four hours later. As mentioned in the posts above, this may not happen if there is a higher fat content in the meal, like for pizza. For tweaks, always start by eating a carb-free meal to test your basal insulin before changing your quick-acting insulin. On training nights, I have to halve my morning basal and meal quick-acting insulin doses, so leave your training night doses as they are.

 

[urbanracer]

Hiya.. On a normal evening, say I had maybe 200 grams of mashed potato which is 31 grams of carbs, some boiled carrots and peas, or processed peas, which are around 16 grams of carbs, and then about 60 grams of lean meat or chicken, which, when i read up on, should be halved in weight and bolused for, so that is roughly 30 grams...

It only beats me on a day that I'm not evening training, once I train, I'm sound.

So on the nights you are training you're using up the glucose, and on the nights you don't train you eat the same amount but there's no activity to use up the glucose?

For myself, activity makes a massive difference to the amount of insulin I need.

I've just been reading up on the basal tests now since you mentioned it. I'm on Abasaglar, and I take it at around 7 or 8 pm... The test seems like a bit of a chore, but also sounds like its really worthwhile. As soon as I get my head around it, I'm gonna get one done for definite...

Thanks again for your help. Talking with someone who's actually living with it, really makes things clearer..

As @kaylz91 has suggested, some people split their basal dose because the insulin does not last for 24hrs in the body. I myself never really got on with Abasaglar and I'm having much better control with Levemir which I believe is now the NICE recommended basal insulin for T1's so maybe worth a chat with your doc if you've done the basal test and it doesn't lead to a resolution.

 

[JimMcM]

@urbanracer @kaylz91 @ert @The Pirate Twins Thanks for all the advice... Yeah, I have spoken to someone at work who's also type1, and they have mentioned splitting doses. I've decided to wait until I speak to a particular diabetic nurse, locally, as she is type1, and she's easier talked to... Kaylz91, most of the real highs, from what I can see, seem to from after my 2 pm lunch break.

Again folks, thanks for all the help...