Higher glucose readings after 4 hrs of taking novorapid

inked62

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Hi pre meal I took 9 units of novorapid readings were 7 MMOL/ 2 hrs later they were 15 MMOL/L then 4 hrs later readings were 21.3 MMOL/L
I had no food in between
Why is this happening
 

EllieM

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Ouch, what was the meal?
Other immediate possibilities I can think of
1) gone off insulin, broken pen or bad injection site
2) illness
 

Antje77

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Hi pre meal I took 9 units of novorapid readings were 7 MMOL/ 2 hrs later they were 15 MMOL/L then 4 hrs later readings were 21.3 MMOL/L
I had no food in between
Why is this happening
Can it be the meal had more carbs than the insulin could deal with?
 

inked62

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Meal was 2 tortilla wraps and crispy chicken with salad tolling 86 grams of carbs I took 9 units of novorapid .
I’m perplexed .
I’ve washed hands etc injected in stomach no insulin loss .
Maybe I have my insulin to carb ratios wrong .
Clinician told me to up to 1.5 per 10g of carbs .
 

Antje77

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Maybe I have my insulin to carb ratios wrong .
Clinician told me to up to 1.5 per 10g of carbs .
It takes time to find the right ratios, it's a trial and error process, for your clinician as well as for you.

The more notes you take on insulin doses, carbs eaten and glucose level, the easier it becomes to get the ratios right!
 

Rokaab

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Meal was 2 tortilla wraps and crispy chicken with salad tolling 86 grams of carbs I took 9 units of novorapid .
I’m perplexed .
I’ve washed hands etc injected in stomach no insulin loss .
Maybe I have my insulin to carb ratios wrong .
Clinician told me to up to 1.5 per 10g of carbs .

At 1.5units per 10carbs, for 86 carbs that would be 12.9 (13 if you round up) units, not 9 :)

But yes as @Antje77 says its all very much trial and error finding out your ratios, and said ratios can vary dependent what time of day it is (I need more in the morning for instance for the amount of carbs)
 
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Trevor vP

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Meal was 2 tortilla wraps and crispy chicken with salad tolling 86 grams of carbs I took 9 units of novorapid .
I’m perplexed .
I’ve washed hands etc injected in stomach no insulin loss .
Maybe I have my insulin to carb ratios wrong .
Clinician told me to up to 1.5 per 10g of carbs .

How much Protein in the Chicken. I find I need to delay Bolus for higher protein animal protein.

I have a method I use somewhere between these two methods

Warsaw FPU Method nicely explain( personally I find too much Bolus but I use the logics to know when to catch the Spike)

https://waltzingthedragon.ca/diabet...e-post-meal-spikes-caused-by-fat-and-protein/


Another method is the KISS NHS method. This method is easy to use

https://cdn.website-editor.net/f420...How-to-bolus-fir-fat-and-protein-KISS-MDI.pdf
 
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Trevor vP

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How much Protein in the Chicken. I find I need to delay Bolus for higher protein animal protein.

I have a method I use somewhere between these two methods

Warsaw FPU Method nicely explain( personally I find too much Bolus but I use the logics to know when to catch the Spike)

https://waltzingthedragon.ca/diabet...e-post-meal-spikes-caused-by-fat-and-protein/


Another method is the KISS NHS method. This method is easy to use

https://cdn.website-editor.net/f420...How-to-bolus-fir-fat-and-protein-KISS-MDI.pdf

Sometimes if I am doing a big multi hour endurance event I actually use the Delay on set protein spike to fuel(obviously) with a corrected Bolus for exercise .
 

In Response

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How much Protein in the Chicken. I find I need to delay Bolus for higher protein animal protein.
The body will convert protein to glucose only in the absence of carbs.
With two tortillas, the protein will have little or no affect on blood sugar levels.
 
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ert

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The body will convert protein to glucose only in the absence of carbs.
With two tortillas, the protein will have little or no affect on blood sugar levels.
Protein always ends up as glucose. But it's the law of big numbers, mathematically speaking. There is a high number of carbs in tortillas it makes the glucose from protein insignificant in terms of dosing.
 
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ert

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Hi pre meal I took 9 units of novorapid readings were 7 MMOL/ 2 hrs later they were 15 MMOL/L then 4 hrs later readings were 21.3 MMOL/L
I had no food in between
Why is this happening
I agree with the posts about learning to calculate your carb ratio involves a lot of experimentation and number checking.
Even then there is a lot of variability in these calculations depending on the time of day, injection sites, insulin age, temperature etc, etc, so a lot of us have to give correction doses (or eat some fruit to stop our blood sugars from falling below where they are starting). The safest time to give a correction dose is with your next meal, 5 hours after your last dose to stop your insulin from stacking. You need to as your DN for a starting point for a correction dose.
 
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KK123

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How much Protein in the Chicken. I find I need to delay Bolus for higher protein animal protein.

I have a method I use somewhere between these two methods

Warsaw FPU Method nicely explain( personally I find too much Bolus but I use the logics to know when to catch the Spike)

https://waltzingthedragon.ca/diabet...e-post-meal-spikes-caused-by-fat-and-protein/


Another method is the KISS NHS method. This method is easy to use

https://cdn.website-editor.net/f420...How-to-bolus-fir-fat-and-protein-KISS-MDI.pdf

Thanks for posting these articles, both good reads and it really emphasises that it's not simply a question of 'count carbs, inject insulin, eat meal' and everything will be hunky dory, as so many people including medics seem to believe. After much experimenting, it's nice to know that I actually adopt both methods anyway having worked it out for myself and who knew I was following such a mathematical, intricate approach! I like the bit about 'balanced meals' at each meal time makes it 'easier' to bolus just for the carbs but to me that means the same meals day after day at the same times, great for some but not my lifestyle, (incidentally those balanced meals showed a pic of porridge/baked potato/pasta across the 3 meals with little to no fat).

It is a riskier approach I suppose and not for everyone but I know (at the moment) that if I eat a meal combining carbs and a lot of fats, after 3/4 hours my insulin works fine as in it rises and is then back to normal at around hour 4, but dead on hour 5 my levels will start to rise again. That's when I take the additional unit (or 2) of insulin and it works a treat, stops any second rise in its tracks. You do have to know yourself and watch it like a hawk of course as the dangers of a low increase, also when you add in what you have done that day, exercise, work and a myriad of other things, that too has to be calculated into it.

The libre/cgm are good to help with this of course but it still takes a fair amount of self management and work. I don't know how the parents of little diabetics cope, reading about the formula to combat the lad eating a protein bar would almost make me shout 'No, you're not having it'!!! I also was interested in the bit about if you are a person who normally eats a combination of carbs and high fat at meals you probably don't need to do this second phase as you're already adapted as it were, but if you have it as a one off, you probably do. I tend to stick to lowish carb these days, more because at work it's easier to manage by not having to think about it all too much but when I do fancy a carby, fatty old meal I can have one and still manage the prolonged after effects. Thank you!
 
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jape

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My guesses are: Firstly, it would seem that the 9 units of Novorapid is not sufficient for an intake of 86 g of carbs. You will need to experiment with higher doses of Novorapid, but be careful not to send yourself into a hypo - it is very easy to overdose. Secondly, I would guess that the initial rise in your BG (after 2 hours) can be ascribed to the tortillas, and the subsequent rise to the crispy chicken. I would assume the crispiness is the result of breading and being fried in oil. Fats slow down the absorption of carbs into the bloodstream.

Anyway, these are my guesses. Talk to you clinician about it.
 
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sgm14

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From your question, you may be making the same assumption that I made when I was first diagnosed. I was told to test 2 hours after a meal to see if the blood sugars had "come back down enough" and from that I assumed this meant that the peak was always less than 2 hours after the meal.

When I got my freestyle libre and could see exactly what was happening, I could see that that was mostly, but not always true. One of the meals that I took occasionally would cause a small spike within an hour and had fallen back after two hours, but then I had another much large spike after 3 or sometimes even 4 hours later.

> Maybe I have my insulin to carb ratios wrong .
> Clinician told me to up to 1.5 per 10g of carbs

Talk to them. I suspect they may tell you this is just a starting recommendation or a suggestion and you need to see if it works out for you.

Not everyone has a simple and consistent ratio. If you were to ask me what my insulin to carb ratio was, I would say I don't really have one. More accurately, the ratio varies either depending on the meal or the time of the meal and it has changed over time.
 
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Trevor vP

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Thanks for posting these articles, both good reads and it really emphasises that it's not simply a question of 'count carbs, inject insulin, eat meal' and everything will be hunky dory, as so many people including medics seem to believe. After much experimenting, it's nice to know that I actually adopt both methods anyway having worked it out for myself and who knew I was following such a mathematical, intricate approach! I like the bit about 'balanced meals' at each meal time makes it 'easier' to bolus just for the carbs but to me that means the same meals day after day at the same times, great for some but not my lifestyle, (incidentally those balanced meals showed a pic of porridge/baked potato/pasta across the 3 meals with little to no fat).

It is a riskier approach I suppose and not for everyone but I know (at the moment) that if I eat a meal combining carbs and a lot of fats, after 3/4 hours my insulin works fine as in it rises and is then back to normal at around hour 4, but dead on hour 5 my levels will start to rise again. That's when I take the additional unit (or 2) of insulin and it works a treat, stops any second rise in its tracks. You do have to know yourself and watch it like a hawk of course as the dangers of a low increase, also when you add in what you have done that day, exercise, work and a myriad of other things, that too has to be calculated into it.

The libre/cgm are good to help with this of course but it still takes a fair amount of self management and work. I don't know how the parents of little diabetics cope, reading about the formula to combat the lad eating a protein bar would almost make me shout 'No, you're not having it'!!! I also was interested in the bit about if you are a person who normally eats a combination of carbs and high fat at meals you probably don't need to do this second phase as you're already adapted as it were, but if you have it as a one off, you probably do. I tend to stick to lowish carb these days, more because at work it's easier to manage by not having to think about it all too much but when I do fancy a carby, fatty old meal I can have one and still manage the prolonged after effects. Thank you!

I think we all amazing that we can Calc Carbs by eye site and guess protein and fat by some miracle and time it all perfectly with a little bit of insulin so a blood glucose number hits the right amount at the right time. Just makes us remember how clever the pancreas actually is.
 
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