High blood sugars after a meal.

bobandpat

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103
Type of diabetes
Type 1
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Insulin
Hi all.

Suddenly I'm struggling with my blood sugars after a meal, any meal. It goes up to 12/13mmol/L 2hrs after a meal but gradually comes down to around 5mmol/L before my next meal so I don't want to be taking any extra insulin..

We're not getting out much because of the weather so I've taken to using the exercise bike to try to bring it down which sometimes works and sometimes doesn't.

Don't know when my next annual checkup will be as our GP seems to be working from home on the phone. The receptionists are working but they don't seem able to give me an appointment even for bloods taking :banghead::banghead::banghead:. I've tried making a phone appointment with the doc but they say he's only 'seeing' emergency cases.

Any advise, please, on what I can do to bring it down? TIA
 

Technician87

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Not a great deal really...I'm easy!!
It sounds like your insulin isn't acting as fast as you would like it too. What do you take? Are you on a pre set injection dose or do you calculate?? I would try injecting somewhere different for a while. Try alternating between the backs of your arms, I have found (and been told by my nurse) that this is a quick absorption site. Worth a go, see what happens. Hope you're well and stay safe.
 

Rokaab

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You may also need to take it a bit earlier to counteract the spike, I know I need to take my breakfast dose earlier before my meal than lunch or dinner.
 
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ert

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Unlike a normal person's insulin, injected insulin follows a fixed curve and doesn't match the food you are eating, hence the spike. On DAFNE we learned that as long as our blood sugars are returning to where they are five hours afterwards, to ignore the spike. There are things you can do which help somewhat, such as timing injections mentioned by @Rokaab, and also walking for 20 minutes straight after eating, and for me personally, eating lower carb.
 
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bobandpat

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103
Type of diabetes
Type 1
Treatment type
Insulin
It sounds like your insulin isn't acting as fast as you would like it too. What do you take? Are you on a pre set injection dose or do you calculate?? I would try injecting somewhere different for a while. Try alternating between the backs of your arms, I have found (and been told by my nurse) that this is a quick absorption site. Worth a go, see what happens. Hope you're well and stay safe.

Basal is 8 units of Lantus, bolus is Novorapid and I calculate for that. I alternate between stomach and legs.

Thought that the type of exercise I take, walking and cycling, would have helped the Novorapid to work fairly quickly. Sorry just don't like using my arms, tried years ago and couldn't come to terms with it.

Thanks stay safe.
 

bobandpat

Well-Known Member
Messages
103
Type of diabetes
Type 1
Treatment type
Insulin
You may also need to take it a bit earlier to counteract the spike, I know I need to take my breakfast dose earlier before my meal than lunch or dinner.

Thanks but I take morning dose 10 minutes prior to meal and add another 5 minutes to each shot as I go through the day so that I'm taking it 20 minutes before the meal.

Actually.that's made me realize that dinner is the only meal where I don't get a big spike. I'll try taking all my injections 20 minutes before each meal.

Thanks stay safe.
 

Rokaab

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Thanks but I take morning dose 10 minutes prior to meal and add another 5 minutes to each shot as I go through the day so that I'm taking it 20 minutes before the meal.

Try it and see what works, I know when I was using Novorapid, I needed to have it about 30 mins before breakfast (didnt need nearly that long for the other meals)
Watch out for hypos though before eating in case you didn't need it quite that early
 
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bobandpat

Well-Known Member
Messages
103
Type of diabetes
Type 1
Treatment type
Insulin
Unlike a normal person's insulin, injected insulin follows a fixed curve and doesn't match the food you are eating, hence the spike. On DAFNE we learned that as long as our blood sugars are returning to where they are five hours afterwards, to ignore the spike. There are things you can do which help somewhat, such as timing injections mentioned by @Rokaab, and also walking for 20 minutes straight after eating, and for me personally, eating lower carb.

I've been diabetic since 1974 so my diabetes team tell me that I've lived with it too long for DAFNE to be any use to me!!!!

The problem with ignoring the spikes is that they're so high it's bound to make a difference to my next Hba1c which I now have an appointment for the blood letting next week. I usually have a reading of about 6.5 but I'm sure it's going to be well up on that.

I've always taken 100gm or less of carbs per day, I'm not a very big lady and put on weight too easily if I'm not careful. Have wondered about doing ultra low carbs but my hubby panics and since it looks like he may have started with Alzheimer's I'm not happy to put him through more stress.

Thanks stay safe.
 

ROE100

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73
I do hope you come up with a solution. I have had a similar experience. I also was told do not adjust this spike until 5 hours as the insulin could still be working when I brought this up on the DAFNE course and said I spike more than the 2 recommended and then start to drop on the 5 hour 6 hour mark I was told we don't have time for this and no offer to see them after the course. This dramtic drop was always after lunch never for Breakfast and never for dinner. So left to myself as all they could see my HBA1c was good so why worry.

Since then I have changed both insulin Humalog to FiAsp and Lantus to Tresiba - reduce carbs for lunch only and also if on the high side 7's or 8's before lunch then do injection and wait to see when I start to come down which could be an hour later. I know FiAsp is meant to be quicker than Humalog but to be honest sometimes it is not - each day can be different - oh the joys of D.

All the best
 

Dave P

Well-Known Member
Messages
100
Type of diabetes
Type 1
Treatment type
Insulin
Unlike a normal person's insulin, injected insulin follows a fixed curve and doesn't match the food you are eating, hence the spike. On DAFNE we learned that as long as our blood sugars are returning to where they are five hours afterwards, to ignore the spike.
They are giving out bad advice then, in my opinion. It is all well and good for them to say ignore such spikes which last hours regularly, but it isn't them who will have to live with the consequences of ignoring it.

I do hope you come up with a solution. I have had a similar experience. I also was told do not adjust this spike until 5 hours as the insulin could still be working when I brought this up on the DAFNE course and said I spike more than the 2 recommended and then start to drop on the 5 hour 6 hour mark I was told we don't have time for this and no offer to see them after the course.
No surprise that they don't want to hear that their advice isn't adequate or accurate. They offer simplistic, one size fits all advice which sets a very low bar and lets people have a false sense of security that their high numbers are fine and can be ignored, which you can do right up until the point where you get a letter telling you you're slowly going blind, brilliant.
 
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UK T1

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Messages
334
Type of diabetes
Type 1
Treatment type
Insulin
Hi all, as has been suggested, I notice a huge difference in the presence of post meal spikes when I haven't done much exercise/movement that day.

I raised this with my consultant during the first lockdown and he said it made complete sense. If you're less active and your circulation is therefore a little slower that day, then your insulin won't be broken down and absorbed as quickly. On those days I sometimes need to pre bolus up to 45 mins before a meal, depending on the meal. Other days I can inject as I start eating and get no spike. It is a bit of trial and error for me, depending on the meal and what exercise I have already done that day.

I wouldn't be happy regularly having spikes which take 5 hours to come to normal. It shows you you have the right insulin dose, and don't need to correct. But perhaps injection site rotation or injection timing need amending. It could be that lockdown has changed routine and so injection sites aren't being rotated as before, so this is explaining delayed insulin action? Hope some of this helps a little!
 
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