High Two Hours After Meal

[dtennant9]

Hi

This morning I had a reading of 6.3 which is very good or me. Two hours after breakfast and I am 15.9.

Quite often by the next meal I am back down to normal levels. Does this mean that my Bolus insulin is incorrect for this meal time? I'm more concerned that although its high after two hours its back to near normal at the next mealtime so surely if I take more Bolus it will go really low? I don't like getting these spikes in the middle though.

I have just started taking a lot more background insulin yesterday so maybe that will have an effect soon as I'm aware that it can take a few days to settle.

Any help you can give would be great.


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[SamJB]

The two hour post-meal level is a key indicator that your bolus is incorrect. If there are any significant differences, then you will need to adjust your bolus accordingly. For me, 1 unit of Novorapid will lower my levels by 2mmol/l.

If there are significant differences between the two hour post meal and your next pre-meal reading then it usually means that your basal is too high. Although it depends on if you were exercising, or especially busy during that period.

The key to figuring out your basal dose is by looking at your pre-bed and pre-breakfast readings. Make sure you don't eat or inject bolus insulin about 4-5 hours before bed, so that this doesn't interfere with your readings. If your pre-bed and pre-breakfast readings differ by more that 1.6 mmol/l, then adjust your basal by 10% accordingly.

From what you've said, it sounds like you need to increase your bolus and decrease your basal, depending on your overnight readings.

 

[Hellbunny]

Good advice from Sam there,also can I just ask what you had for breakfast? Only because since I ditched cereals (or high carb in general) my high/low swings have gone, for example if I had 2 shredded wheat, my 2hour post reading could be 12mmol, with a rapid drop to 2-3mmol a hour later, it's only since Ive gone lowGI and reduced carbs my 2hour reading is similar to ny next pre meal. Sorry if I've rambled but as Sam said it could be your basal which needs adjusting also

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[dtennant9]

Thank you both for the advice.

My basal levels have just been put up as I was getting highs pre meal as well and running out of Lantus towards the end of the 24 hours.

I think it could be what I ate. I had 60g of carbs for breakfast which consisted of 2 x weetabix, and a slice of white toast with a banana. Might try and modify my diet slightly.


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[dtennant9]

Two hours after lunch and the reading is better this time, do I guess it must be something to do with my morning doses or what I'm eating. Thanks again for helping out.


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[mrman]

Good advice already but as you adjust one insilin expect to have to change the other. As you were previously high pre~meal this might of been not having enough qa for the meal previous. So you may need to increase your bolus for your breakfast, but, your basal may need reducing and not increasing. Another thing to consider is timing of insulin. For high gi meals such as cereals with milk I inject 1 hour before breakfast as the food converts to sugar quicker than the insulin acts. other meals I only have to inject 10~15 mins prior.

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[noblehead]

It goes without saying that the timing of insulin doses is important in relation to the food you eat and pre-prandial bg readings, if your already high before food then it's understandable that your postprandial bg will be higher than if you were within range, If you Google Strike the Spike by Gary Scheiner you will get a better understanding of how to control postprandial bg rises.

I do much like what Brett says and inject ahead of my food to give the insulin time to work, for myself it's no more than 15 mins but some type 1's do inject up to 30 mins before, the notion that insulin's such as Novorapid and Apidra are fast acting is deceiving, yes they are faster at working than human and animal insulin's but to say you can inject before or after food is not totally correct, the only time I now inject before food is if my bg is in the low 4's, the meal is low-gi or has a high-fat content.

 

[SAH154]

Two hours after lunch and the reading is better this time, do I guess it must be something to do with my morning doses or what I'm eating. Thanks again for helping out.


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I used to have this quite often it's hard to get to the bottom of it. I thought it could be linked to wake up hormones etc?
Some days I did hypos instead?

From my DAFNE course I learnt that you can have variable ratios for insulin depending on what time of day it is when you eat my ration was 1 unit to 10g of carb regardless of when I ate

 

[SAH154]

It goes without saying that the timing of insulin doses is important in relation to the food you eat and pre-prandial bg readings, if your already high before food then it's understandable that your postprandial bg will be higher than if you were within range, If you Google Strike the Spike by Gary Scheiner you will get a better understanding of how to control postprandial bg rises.

.

What an excellent article and also it linked to http://www.diabetesselfmanagement.com/A ... in/amylin/

Blocking glucagon secretion. Glucagon is a pancreatic hormone that raises the blood glucose level by stimulating the liver to release stored glucose. It is usually secreted in response to stress or hypoglycemia (low blood glucose). Without amylin, most people with diabetes produce extra glucagon when they eat; this can contribute to after-meal blood glucose spikes. When taken with meals, Symlin suppresses the inappropriate release of glucagon by the pancreas.

 

[dtennant9]

It goes without saying that the timing of insulin doses is important in relation to the food you eat and pre-prandial bg readings, if your already high before food then it's understandable that your postprandial bg will be higher than if you were within range, If you Google Strike the Spike by Gary Scheiner you will get a better understanding of how to control postprandial bg rises.

I do much like what Brett says and inject ahead of my food to give the insulin time to work, for myself it's no more than 15 mins but some type 1's do inject up to 30 mins before, the notion that insulin's such as Novorapid and Apidra are fast acting is deceiving, yes they are faster at working than human and animal insulin's but to say you can inject before or after food is not totally correct, the only time I now inject before food is if my bg is in the low 4's, the meal is low-gi or has a high-fat content.

My timing of my injections is not always brilliant, I have a toddler so I'm often taking my insulin after I've eaten just incase I'm delayed with my meal. My breakfast insulin is usually taken before my meal at breakfast on work days but my significantly so.

Interestingly I did take it before I ate at lunchtime today. I started at 8.1, 10.1 two hours after and 7.6 in the evening. Not brilliant but not bad either. I don't usually test in between meals so I'm not usually aware of these readings.


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[mrman]

Not bad readings at all only a meal rose of 2 and only slightly under pre meal reading. if you could get your pre meal lunch reading to 5~6, you'll get amazing results based on that rise and fall of levels.

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[sarah1282]

Im exactly the same im high 2 hours after eating but 4 hours after eating my levels are between 5 and 6. My morning readings are also between 5 and 6 so I think my long acting insulin must be correct. These spikes drive me mad

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[noblehead]

What an excellent article and also it linked to http://www.diabetesselfmanagement.com/A ... in/amylin/

Yes I've read that article before SAH154 :thumbup: