Why does blood sugar sometimes rise 3-4hrs after dinner?

[littlevoice359]

Hello. I was diagnosed with Type 1 diabetes in Dec 2018 and I am still getting to grips with the condition. Mostly, I find it infuriating and exhausting because of the almost constant need to make decisions based on partial information. I wear a Libre sensor, along with a Bubble Mini sensor that sends data to xDrip on an Android phone. This lets me keep track of my blood sugar trends between meals and when I am asleep. My doctors say my blood sugar control is excellent ( A1C has been consistent at 50 for the past 3 clinics and my time-in-range is 97% ), though personally would like it to be better.

I still struggle with one issue in particular, which is that my blood sugar will sometimes start to rise 3-4 hours after I have eaten dinner. If I do not notice the gradual rise, I find that my blood sugar going to bed could be at or over 10. This forces me to take a corrective dose of NovoRapid, but in doing this, I run the risk of sending my blood sugar too low while I am asleep. But, if I do not take a corrective dose, my blood sugar could quite easily remain elevated all night, which is not a good thing. A bit of a Catch-22 situation…

I think the problem is somehow related to the amount of protein and/or fat in my evening meal? I have seen hints to this effect in various pieces of literature I have read, but I have not yet seen the issue explained in any kind of concise way.

Currently, as a stop-gap containment, I have configured xDrip to alarm if blood sugar rises above 8 during the evening and, if it does, I then confirm with a finger-prick test and take 1-2 units of NovoRapid, depending on how steeply blood sugar is rising. Rather too much guesswork involved here, though, for my liking. I would like to understand the mechanism involved so that I could better anticipate when the rise is likely to happen. This would let me feel more comfortable about taking a corrective dose of insulin before blood sugar rises too high.

I hope I have explained my dilemma sufficiently well?

Many thanks in advance for any advice or insight you can offer!

 

[xshtiek]

Hello. I was diagnosed with Type 1 diabetes in Dec 2018 and I am still getting to grips with the condition. Mostly, I find it infuriating and exhausting because of the almost constant need to make decisions based on partial information. I wear a Libre sensor, along with a Bubble Mini sensor that sends data to xDrip on an Android phone. This lets me keep track of my blood sugar trends between meals and when I am asleep. My doctors say my blood sugar control is excellent ( A1C has been consistent at 50 for the past 3 clinics and my time-in-range is 97% ), though personally would like it to be better.

I still struggle with one issue in particular, which is that my blood sugar will sometimes start to rise 3-4 hours after I have eaten dinner. If I do not notice the gradual rise, I find that my blood sugar going to bed could be at or over 10. This forces me to take a corrective dose of NovoRapid, but in doing this, I run the risk of sending my blood sugar too low while I am asleep. But, if I do not take a corrective dose, my blood sugar could quite easily remain elevated all night, which is not a good thing. A bit of a Catch-22 situation…

I think the problem is somehow related to the amount of protein and/or fat in my evening meal? I have seen hints to this effect in various pieces of literature I have read, but I have not yet seen the issue explained in any kind of concise way.

Currently, as a stop-gap containment, I have configured xDrip to alarm if blood sugar rises above 8 during the evening and, if it does, I then confirm with a finger-prick test and take 1-2 units of NovoRapid, depending on how steeply blood sugar is rising. Rather too much guesswork involved here, though, for my liking. I would like to understand the mechanism involved so that I could better anticipate when the rise is likely to happen. This would let me feel more comfortable about taking a corrective dose of insulin before blood sugar rises too high.

I hope I have explained my dilemma sufficiently well?

Many thanks in advance for any advice or insight you can offer!

Hi, I have noticed the exact same phenomenon, and come to the same conclusions, Pizza is especially bad for this.
It will certainly be interesting to hear what the others have to say

 

[Japes]

For me, it's a combination of a higher carb/higher fat meal with an inactive time following that meal. I try only to have those kinds of meals when I know I am going to be active after them or do a split dose of my Novorapid. 60% to start with then the remaining 40% a couple of hours later when I see a rise.

I think it's because it takes longer to digest that kind of meal, and the carbs get released properly later. (Not very technical but it makes sense to me.)

 

[Zhnyaka]

Yes, you are right, most likely your food is saturated with fats and proteins. I usually inject an extra dose after 3 hours only if I eat something like pizza, but here's how it's calculated:look at the number of calories in the dish, then calculate from them the amount of carbohydrates multiplied by 4 and divide the result by 100, inject the same amount of insulin as if you would inject carbohydrates

I'll try to write down the calculation formula

(calories - 4*carbohydrates)/100
Or
(4*proteins +9*fats)/100
as a result, inject insulin after 2-3 hours as if it were crabs
I hope I explained it clearly

 

[StewM]

Yes, you are right, most likely your food is saturated with fats and proteins. I usually inject an extra dose after 3 hours only if I eat something like pizza, but here's how it's calculated:look at the number of calories in the dish, then calculate from them the amount of carbohydrates multiplied by 4 and divide the result by 100, inject the same amount of insulin as if you would inject carbohydrates

I'll try to write down the calculation formula

(calories - 4*carbohydrates)/100
Or
(4*proteins +9*fats)/100
as a result, inject insulin after 2-3 hours as if it were crabs
I hope I explained it clearly

I do this, and it’s completely eliminated late spikes.

Though I found dosing at 2 hours exactly after I finished eating worked best for me*, but that’s very much down to “we’re all different”.

*My approach with a pump has been different, but is neither here nor there to this conversation.

 

[littlevoice359]

Yes, you are right, most likely your food is saturated with fats and proteins. I usually inject an extra dose after 3 hours only if I eat something like pizza, but here's how it's calculated:look at the number of calories in the dish, then calculate from them the amount of carbohydrates multiplied by 4 and divide the result by 100, inject the same amount of insulin as if you would inject carbohydrates

I'll try to write down the calculation formula

(calories - 4*carbohydrates)/100
Or
(4*proteins +9*fats)/100
as a result, inject insulin after 2-3 hours as if it were crabs
I hope I explained it clearly

Interesting. I will look back at my recent past meals and see what this number gives me. But, just looking at it, it seems to me that both calculations will yield a number greater than zero, regardless of the meal contents. Should extra insulin only be taken if either/both calculations yield a number greater than some specific limit? Or, is there a third calculation involved?

 

[Zhnyaka]

Interesting. I will look back at my recent past meals and see what this number gives me. But, just looking at it, it seems to me that both calculations will yield a number greater than zero, regardless of the meal contents. Should extra insulin only be taken if either/both calculations yield a number greater than some specific limit? Or, is there a third calculation involved?

My doctor gave me this formula when she taught me how to eat fast food, so I only give an extra shot if I'm going to eat something like pizza or burgers, but I don't do it when I eat something like buckwheat porridge. But we are all different. I think it is necessary to give another injection for food that raises your bg so much that it begins to bother you.

 

[Ushthetaff]

Ach the old what I call long term carbs for me it’s Pizza and even worse pasta , I sometimes take my insulin 3\4 hrs after to stop rises , it’s all about trial and error but eventually you will find what works for you , it’s definitely a marathon of learning and experience but sucess will happen

 

[littlevoice359]

Yes, you are right, most likely your food is saturated with fats and proteins. I usually inject an extra dose after 3 hours only if I eat something like pizza, but here's how it's calculated:look at the number of calories in the dish, then calculate from them the amount of carbohydrates multiplied by 4 and divide the result by 100, inject the same amount of insulin as if you would inject carbohydrates

I'll try to write down the calculation formula

(calories - 4*carbohydrates)/100
Or
(4*proteins +9*fats)/100
as a result, inject insulin after 2-3 hours as if it were crabs
I hope I explained it clearly

Thanks again for this. I was able to update my tracking software to include a calculation of FPU (apparently this is the preferred term for amount of fat and protein in a meal). This will help me decide on what to eat in the first instance and, just as importantly, know when to expect a rise in blood sugar 3-4hrs after eating. Much appreciated!

 

[StewM]

Thanks again for this. I was able to update my tracking software to include a calculation of FPU (apparently this is the preferred term for amount of fat and protein in a meal). This will help me decide on what to eat in the first instance and, just as importantly, know when to expect a rise in blood sugar 3-4hrs after eating. Much appreciated!

I have a wee note on my phone with all my FPU calculations for quick reference later. Makes things less time consuming in the long-run.

One thing to watch is the overall dose needed for meals may drop as a result of using this supplemental dose. I had to drop my carb ratio to accommodate dosing for FPUs to.