Blood Glucose Spikes after evening meal no explanation?!

[JackPurvis]

I’ve been type 1 diabetic for around 4 months now and considering its early days and everything still be so new, I have had really good control of my levels and I am able to achieve very predictable results every day with the help of carb counting ect. However, for around the last 1-2weeks, around 2hours after finishing dinner (2hours into the novo rapid) my blood levels will go form an expected 4-5mmol and suddenly shoot up to around 10-115mmol in the course of 10mins. For example today I checked my levels just before I got the bus home from work and I was 4.4mmol , around 14mins later after just walking through the door I checked again since I felt a slight headache and I was 11mmol. As far as I understand this can’t be a novorapid issue since I know I’m 100% taking the correct amount of insulin for my evening meal (anymore and I would have a hypo) since the novorapid keeps my levels stable and all around great for 2-3hours.

I try and drink as much water as possible, I do not snack at all, therefore I’m struggling to understand why. Don’t get me wrong I understand Type 1 Diabetes can be an uncontrollable beast and just because you do something right one day, doesn’t mean every day is going to be completely plain sailing, however this is starting to bother me as its now became almost totally predicable that I will heavily spike 2-3hours after my meal. Plus, it brings along the migraines and headaches with it.

The only thing that I have been doing different recently is the time I’m which I take my Long-acting insulin Tresiba. I used to take it right before I ate my evening meal around 6:00PM, whereas now, since unlike novorapid you specifically take it when you eat, it tends to slip my mind, so I tend to take it on the evening as soon as I remember to do so around 10:30PM - 1:00AM. It has going from taking it religiously around 6:00PM to now anytime at all between 10:30PM - 1:00AM. I have also recently been going to bed slightly later but not sure if that would really change much.

With this being the only change in my routine, I’m not sure if the change in tresiba injecting times is what’s causing my levels to spike so predicably on the evening or if it may be something else (especially since I thought you were able to be relatively flexible with Tresiba).

Any ideas on why this is happening would be appreciated, as I have called my doctor asking what could be causing the significant changes and after explaining everything, she also just seemed confused and said there is no reason for that to be happening.

I wouldn’t be so bothered about it but just with my having such good control over the last 3months to suddenly spike almost around the same time every night around 11-12mmol making me feel a bit ill is just really demoralising and makes me feel like I’m doing something wrong.

Thanks for the help in advance!!!

 

[dancer]

Does your blood glucose reduce again, without correcting with Novorapid? If not, you most likely need to increase your Novorapid dose for your meal. You say you are 100% sure you take the correct dose of Novorapid. Is this because you have tried increasing and gone hypo, or is this from your previous diabetes training? Our carb ratios can change from time to time, so it could be you need to change your ratio for that particular meal.
Another possibility is stress. Are you stressed travelling on public transport, now we have the problem of the new covid variant? If so, this can cause a rise in blood glucose.

It is also possible you are coming out of the honeymoon period which can cause various increases in both basal and bolus doses.

I have never used Tresiba, so can't comment on that.

You say you asked your doctor about what's happening. Was this your GP or hospital clinic doctor?

 

[becca59]

Tresiba is pretty forgiving and it’s 48-72 overlap makes making quick changes difficult. It is not one that needs rigidly taking at the same time either. However, there is quite a lot of difference between 10:30 and 1:30. I would go back to picking a time and been more rigid.
As for rises in connection to your meal. 4.4 was quite low for the stresses of catching a bus and walking. It could be your body is preparing for it by releasing extra glucose from your liver. Yes it hasn’t done this before, but diabetes likes to throw curve balls to keep you on your toes.
Plus a rise to 11mmol a short time after eating is ok as long as it comes down later.
As you mentioned diabetes evolves and is inconsistent we have to change with it. At 2 months in your insulin ratios maybe changing. Perhaps touch base with your DN.

 

[JackPurvis]

Does your blood glucose reduce again, without correcting with Novorapid? If not, you most likely need to increase your Novorapid dose for your meal. You say you are 100% sure you take the correct dose of Novorapid. Is this because you have tried increasing and gone hypo, or is this from your previous diabetes training? Our carb ratios can change from time to time, so it could be you need to change your ratio for that particular meal.
Another possibility is stress. Are you stressed travelling on public transport, now we have the problem of the new covid variant? If so, this can cause a rise in blood glucose.

It is also possible you are coming out of the honeymoon period which can cause various increases in both basal and bolus doses.

I have never used Tresiba, so can't comment on that.

You say you asked your doctor about what's happening. Was this your GP or hospital clinic doctor?

My glucose will correct itself without taking anymore insulin however will take around 3-4 hours sometimes longer, and may only drop a small amount, therefore I’ve been taking small correction does the lasts couple of days and it still takes it’s time to come down but is quicker at around 1-2hours

The reason I feel confident in the amount of novorapid I’m taking is mainly because there’s very little difference between my lunches and dinners in terms of food and it always is pretty much the same amount of carbs around 60g, and it just seems odd that it would be the insulin if it works for every other meal then for dinner seemly work fine then heavily spike at the sameish time most nights.

I have tried the last few days increasing the novorapid a couple of times and I just go into a hypo quite quickly and then by the time I’ve snacked I’m back to being high anyways so can’t tell if that’s the snack or my BS following the same patter as it has done the last few nights.

I daily covid test and I haven’t had covid as far as I’m aware .

I don’t think I would say I’m stressed or anything like that and if anything I enjoy using public transport. I could be coming out of my honeymoon period but if that were the case wouldn’t my Bloodsugars and ratios across the whole day change not just at one very specific time and be almost perfect the rest of the Time?
I was in contact with my hospital diabetic nurse who is linked with myself

 

[dancer]

@JackPurvis we don't all have the same carb ratio for every meal. Mine are all different, so it is possible that you need a little more for that meal. Did you try raising your dose by just half a unit? My brother tells me that his disposable pens only give whole units, so you would need a reusable pen if you don't have one.
You are in a strange situation, I hope you are able to solve this problem.

 

[Yaya10_10]

one thing is that
sometimes the food enter ur blood stream after the insulin became less effective.

I mean the insulin effective time is ended. this happens when you have protein or pizzas and these sort of food.

it gets digested slowly.