huge spikes after eating - help!

[Tom-stick]

Hi all!

I’ve been struggling recently with massive spikes after eating and wondered if anyone else has encountered this before? I’ve included my Libre readings from yesterday and as you can see, it seems that there is a massive delay in the insulin taking effect but I’m having it 30 minutes before eating. I’ve currently waiting to get a pump but just wondered if anyone had any advice.

Thank you

 

[ert]

What you're seeing is just that unlike a normal person's insulin, injected insulin doesn't match the food you're eating. On the DAFNE course, we learnt as long as your blood sugars come down 4 to 5 hours after eating normally, the dose will be correct and to ignore the spike.
I don't spike because I eat keto, rather than eating normally.

 

[TashT1]

A couple of things I check when I start going higher are:

1. Is the sensor working correctly. Do a finger prick test, set an alarm for 15 mins & scan the sensor. If it’s off by 2mmol I repeat this every time I test for 24hrs. If it’s still out of whack call Abbot & get a replacement.

2. Ask myself am I sick? If I’m a bit run down spikes will happen. Is it stress, maybe?

3. Check that I’m not being lazy about carb counting & guestimating. Eat a few things I know shouldn’t cause a spike & see what happens.

4. Do a basal test & consider increasing the basal dose by 2 units (in consultation with my DN) for a few days.

5. Consider adjusting my carb ratios (in consultation with my DN). I’ve been running high lately & it turned out I’m better low carbing for breakfast & increasing to a 1:5 for lunch.

Looking at your graph you not only spiking but dropping quite dramatically. Can you pinpoint the cause of that? Exercise or correction doses?

It’s frustrating to see spikes & sometimes demoralising but just do what you can to bring things back under control without too much stress.

 

[In Response]

Libre is renowned to exaggerate when high.
I would recommend testing with a finger prick a couple of hours after eating to check how high you are really going.
Given the inaccuracies when high, there is little point testing when in normal range to work out how far out your sensor is at that time. It may be 1 mol/l out when at 5 but 3 or more out when high.
Given the valleys in your graphs I would be surprised if your sensor is consistently very high.

 

[Tom-stick]

A couple of things I check when I start going higher are:

1. Is the sensor working correctly. Do a finger prick test, set an alarm for 15 mins & scan the sensor. If it’s off by 2mmol I repeat this every time I test for 24hrs. If it’s still out of whack call Abbot & get a replacement.

2. Ask myself am I sick? If I’m a bit run down spikes will happen. Is it stress, maybe?

3. Check that I’m not being lazy about carb counting & guestimating. Eat a few things I know shouldn’t cause a spike & see what happens.

4. Do a basal test & consider increasing the basal dose by 2 units (in consultation with my DN) for a few days.

5. Consider adjusting my carb ratios (in consultation with my DN). I’ve been running high lately & it turned out I’m better low carbing for breakfast & increasing to a 1:5 for lunch.

Looking at your graph you not only spiking but dropping quite dramatically. Can you pinpoint the cause of that? Exercise or correction doses?

It’s frustrating to see spikes & sometimes demoralising but just do what you can to bring things back under control without too much stress.

Thanks for the advise, very helpful!

The drops have no relation to exercise or correction. It seems that there is just a massive delay for the insulin to start working. I change injection sites regularly so is a bit odd in my opinion.

 

[Tom-stick]

Libre is renowned to exaggerate when high.
I would recommend testing with a finger prick a couple of hours after eating to check how high you are really going.
Given the inaccuracies when high, there is little point testing when in normal range to work out how far out your sensor is at that time. It may be 1 mol/l out when at 5 but 3 or more out when high.
Given the valleys in your graphs I would be surprised if your sensor is consistently very high.

I know the sensors can be in accurate at times and I have been lazy with my finger pricking so I should try that again. Thank you

 

[Tom-stick]

What you're seeing is just that unlike a normal person's insulin, injected insulin doesn't match the food you're eating. On the DAFNE course, we learnt as long as your blood sugars come down 4 to 5 hours after eating normally, the dose will be correct and to ignore the spike.
I don't spike because I eat keto, rather than eating normally.

Thank you that is what I was told by the doctor but it seemed really odd to me! Maybe I should try adjusting my diet and see if that helps.

 

[TypeZero.]

Hi all!

I’ve been struggling recently with massive spikes after eating and wondered if anyone else has encountered this before? I’ve included my Libre readings from yesterday and as you can see, it seems that there is a massive delay in the insulin taking effect but I’m having it 30 minutes before eating. I’ve currently waiting to get a pump but just wondered if anyone had any advice.

Thank you

View attachment 46401

Here are a few things that I think that may be going on:

1) I remember having similar peaks when my basal was too low and I had to over-bolus to bring BS down. Have a carb-free lunch and see if your BS levels stay the same throughout the day.

2) If your bolus is taking long to work then you could switch to a faster insulin (if you don’t already use one) e.g. Lyumjev or Fiasp, you may alternatively want to pre-bolus x minutes before eating