Type 1 MASSIVE bg spike after meals

[Snazeh]

Hopefully someone can help, I’m just at my wits end now, have no idea what to do or to try and understand what’s going on, this morning, my BG was 5.6, ate 3 pieces of toast and it’s not 2 hours after I ate and my BG is !!!17!!!, I posted the other day and people suggested that I change my pens, which I have done, I’ve counted carbs properly as per the info on the loaf of bread, this has been going on for almost a week now, I know this is more of a rant but I really hope someone can advise, if it makes any difference I’m taking levemir twice daily and novorapid with my meals, thanks in advance

 

[Jaylee]

Hello @Snazeh ,

How long prior to your breakfast did you inject the Novo?

It could be a timing issue with the basal regarding its working profile?
How long after you wake up do you eat? Another thought could be foot on the floor liver dump catching up with you too..

 

[Snazeh]

Hello @Snazeh ,

How long prior to your breakfast did you inject the Novo?

It could be a timing issue with the basal regarding its working profile?
How long after you wake up do you eat? Another thought could be foot on the floor liver dump catching up with you too..

I won’t lie I injected literally 20 seconds before I ate my toast... I don’t tend to have a set routine, sometimes I won’t even eat breakfast, sometimes il wake up and go straight to eat, it might be worth pointing out that this isn’t specific to breakfast, this has happened for every meal I’ve had for almost a week now bar the exception of a few carb free/minimal carb meals I’ve had... thanks

 

[Jaylee]

I won’t lie I injected literally 20 seconds before I ate my toast... I don’t tend to have a set routine, sometimes I won’t even eat breakfast, sometimes il wake up and go straight to eat, it might be worth pointing out that this isn’t specific to breakfast, this has happened for every meal I’ve had for almost a week now bar the exception of a few carb free/minimal carb meals I’ve had... thanks

Fully understood, my routine can get shot sometimes..

Insulin use is like good comedy....
It's in the.
..... Timing.

Hope this helps a little.

 

[Hertfordshiremum]

Hopefully someone can help, I’m just at my wits end now, have no idea what to do or to try and understand what’s going on, this morning, my BG was 5.6, ate 3 pieces of toast and it’s not 2 hours after I ate and my BG is !!!17!!!, I posted the other day and people suggested that I change my pens, which I have done, I’ve counted carbs properly as per the info on the loaf of bread, this has been going on for almost a week now, I know this is more of a rant but I really hope someone can advise, if it makes any difference I’m taking levemir twice daily and novorapid with my meals, thanks in advance

Hi I am Type 1 LADA I had the same problem last summer. I have improved my situation so happy to share what has worked for me. Firstly my nurse tried longer needles, I was using 5mm and switched to 6mm, a big improvement straight away. Apparently there are also 8mm.
Second my nurse tells me Novorapid takes 1 - 1.5 hrs before really kicking in so I am not surprised you are at 17 after eating toast. I personally ate one piece of toast when having a hypo and at 3 and then 30 mins later was at 15! I know the frustration! I don't normally eat bread though as I always have terrible spikes with it.
I also was perscribed Fiasp (quicker acting than Novorapid) as I was having to wait at least an hour before having any reaction to Novorapid, I know this as I got the Libre as I was having so much trouble which was invaluable in proving Novorapid was just too slow for me. I only really use Novorapid now if I am going to eat very low carb or carb free eg omelette for breakfast or low carb salad for lunch.
I now have Fiasp which has really improved things together with the longer needles. I still wait 20 mins after injecting Fiasp before eating, this is not the case for everyone as it is fast so you need to experiment with the effect it has on you, but as I can see what's going on with the Libre this is the time I need. I am not overweight nor insulin resistant but over 100 GAD antibodies.

I would try asking for longer needles and to try Fiasp. Hope this helps you.

 

[Muneeb]

Hopefully someone can help, I’m just at my wits end now, have no idea what to do or to try and understand what’s going on, this morning, my BG was 5.6, ate 3 pieces of toast and it’s not 2 hours after I ate and my BG is !!!17!!!, I posted the other day and people suggested that I change my pens, which I have done, I’ve counted carbs properly as per the info on the loaf of bread, this has been going on for almost a week now, I know this is more of a rant but I really hope someone can advise, if it makes any difference I’m taking levemir twice daily and novorapid with my meals, thanks in advance

This can be for many reasons, but I'd suggest a few things:
Change insulin pens for new ones - you said you have already done this.
Check your basal dosage, this could be incorrect
You many be ill even though you don't feel it and this will require more insulin (basal & bolus)
No matter how fast any of the modern insulins are they do not act fast enough for fast release carbs, so you will need to prebolus (15-30 minutes before).
If you eat food spontaneously I would suggest to try and stick to lower carb so insulin can 'catch up' or eat low carb foods before eater higher carb to allow time for the insulin to act.
Make note of where you are injecting, injection sites have significant impact on the absorption rate - also check for lipohypertyrophy (fat deposits) which also affects absorption.

 

[deszcznocity]

Please google: "Prof. Ram Weiss - Low Carb in Type 1 Diabetes" - the video is about 30mins long. Summary:
1) Under EU regulations the macros on the food packaging can be up to 30% off
2) glucometer can be 15% off / CGM same or even more
3) Fresh unopened insulin can be up to 60-70% off (not mentioning opened/used insulin)
4) Patients lypohypertrophy (insulin absorption blunting) - 25-50% difference
and this is obviously just the tip of the iceberg - there are more factors. Our body is a symphony of organs and hormones, we are not walking pancreases. A lot of what you have heard on Dafne course is actually wrong. Take a look at Dr Bernstein's diabetes solution book or find his videos on youtube.

 

[AlanaPerrin]

I had a similar experience to another person who has replied. Novorapid was taking too long to kick in for me, and with two young boys I was struggling to get the timing right as I’d forget to inject long enough before meals. I was getting high apikes that came down fairly quickly, but went up way higher than I’d have liked.
I’ve been on Fiasp for a few months now and I’m not getting as many spikes - only if I’ve miscounted carbs or had to guess.
I do need to pre bolus for breakfast longer than other meals, and if it’s particularly carby (porridge for example) I need an extra half unit to my ratio. Feet to the floor phenomenon is a pain!
Hope that helps!

 

[JayF]

Hello @Snazeh
I was (am) in a similar situation. I take NR before meals and Lantus at bedtime, plus 1000 mg SR metformin morning and evening. My insulin-carb ratio has always been 1 unit to 10 g carbs. However, in the morning I was finding this was insufficient and was experiencing not the "dawn syndrome" but "feet on the floor" syndrome. As soon as I got up, my blood sugars would rise. Eating, like you, wholemeal toast for breakfast would spike my blood sugars even taking my NR dose 15 to 60 minutes before food. However, after speaking to my DSN it seems my body is more insulin resistant in the morning and I should try increasing my morning NR dose, e.g. 1.5:10, 2:10, 2.5:10 etc for 3 days, review each increase and, if there is little change, then increase again to the next level (hope that makes sense). I have been on the 2.5:10 ratio now for 3 days and my highest spike this morning was 10. Yay! I'm happy with that but it's early days yet and I don't suspect I'm out of the woods by a long run.

My other meals are fine @ a ratio of 1:10 and the NR works well here - just the mornings .

I am self-funding the Freestyle Libre Sensor which has been a great eye opener for me as well and what my blood sugars do during the day and night; my diabetes diagnosis was made in 1994. Whilst I appreciate it is quite costly, it has increased my quality of life significantly. Might be worth a try as well so you can understand what your body is doing