Spikes

[PG1759]

I think I mentioned this before... Anyway, I seem to be struggling with post meal spikes (I'm sure a lot of us do) I did find injecting 15 - 20 minutes helped but today the spikes are back with a vengeance. I stared dinner at 5.3 and I put my usual ratio in. There was nothing with high sugar or high gi etc and it was the same dinner I eat every day. I injected 20 minutes before I ate and within 2 hours they had shot up to 14.6 ! They then stayed high before sloping back down to 5.something before tea some 5 hours later.

Any ideas ? I think my ratio was right as I was the same before each meal

 

[PG1759]

I use Apidra by the way.... I'm wondering if I would be better (with caution) injecting a bit earlier to allow it to get in to my system ?

 

[tim2000s]

Someone else using apidra found from their libre that they needed to inject earlier than they expected as it was terribly quick acting. If you are going to do that, make sure you have the appropriate safeguards in place in case of unexpected hypos.

 

[Wurst]

What are you eating exactly ? Reduce the amount of carbs or something that always catches me out is forgetting to change injection sites regularly.

 

[toby64]

HELLO JUST A BIT OF TRIVIA I FOUND OUT LAST WEEK FROM MY DIETITIAN, SHE HAS SAID THAT THEY NOW KNOW THAT FATTY FOODS INTERFERE WITH HOW MY INSULIN REACTS AND THE TIME FOOD TALES TO BE DIGESTED, SHE HAS SUGGESTED THAT I SHOULD WAIT UP TO A HOUR AFTER EATING FATTY FOODS BEFORE INJECTING, I had never been told this before, i feel this could explain a lot of times when things have not gone as expected. She had also told me that the same things happen when you use chocolate for HYPOS as the fat content inhibits the break down of the sugars. Not knowing what you have been eating, is it possible that this could be part of the reason as you still seem to come back down given enough time, i think perhaps that you need to be very careful having insulin to far in advance of eating?.
Just a thought
Best Regards
Toby.

 

[noblehead]

@PG1759, your ratio looks spot on if you were 5mmol five hours after injecting, I would say the spike is more to do with the timing of your dose or it may well be due to poor insulin absorption ( due to injection site problems).

I find injecting 15 mins before works well, but others such as @Novorapidboi say that they administer insulin 30-40mins before food, if you have a read of the following article Gary Scheiner talks about getting the timing right:

http://www.diabetesselfmanagement.com/articles/high-blood-glucose/strike-the-spike-ii/all/

 

[AndyOD]

I must be a bit different to most I inject almost on top of my food like 2-3 mins before (Humalog) and it seems to be ok when I check after two hours.
I used to leave it 10-15 mins then found I was getting hypo before eating.

 

[PG1759]

I must be a bit different to most I inject almost on top of my food like 2-3 mins before (Humalog) and it seems to be ok when I check after two hours.
I used to leave it 10-15 mins then found I was getting hypo before eating.

Yeah I used to that (in my case it was ignorance) and it seemed to work but all changed recently.

 

[PG1759]

@PG1759, your ratio looks spot on if you were 5mmol five hours after injecting, I would say the spike is more to do with the timing of your dose or it may well be due to poor insulin absorption ( due to injection site problems).

I find injecting 15 mins before works well, but others such as @Novorapidboi say that they administer insulin 30-40mins before food, if you have a read of the following article Gary Scheiner talks about getting the timing right:

http://www.diabetesselfmanagement.com/articles/high-blood-glucose/strike-the-spike-ii/all/

I think my ratio is spot on most of the time. Today I injected 25-30 minutes before I ate in the hope that it might help.... I was 5.4 before I ate and they still spiked up to 11.9 after eating ( 2 and a half hrs after) which was better than yesterday's 14 something.

I eat pretty much the same thing every dinner Monday to Friday ( that's how it has taken over my life ! Lol)
Today was a cheese and cucumber sarnie on granary bread(low gi) standard crisps and a low fat yoghurt. ... 67 carbs Hardly a wild dinner !

I pretty much stayed high for the rest of there afternoon and came back down into normal range around 5pm

Any advice always welcome

 

[AndyOD]

Yeah I used to that (in my case it was ignorance) and it seemed to work but all changed recently.

Why what changed ?

 

[Diamattic]

When was the last time you checked your basal ratio ? if you inject before a meal, and test at 2 hours after eating, 4 hours after eating, and 6 hours after eating would you have kept going down or stayed at the 5mmol/l before the tea?

If you have your basal set high it will help pull down your sugars after a spike so it looks like your rapid acting did it when really it was a high basal rate helping to normalize it.

 

[PG1759]

Why what changed ?

I don't know really I started spiking.. Having said that I have made basal adjustments since as I was dropping all the time

 

[PG1759]

When was the last time you checked your basal ratio ? if you inject before a meal, and test at 2 hours after eating, 4 hours after eating, and 6 hours after eating would you have kept going down or stayed at the 5mmol/l before the tea?

If you have your basal set high it will help pull down your sugars after a spike so it looks like your rapid acting did it when really it was a high basal rate helping to normalize it.

I don't fully understand what your saying ( probably me not you!) the concept of what I think your saying is something that has crossed my mind though... Is my basal too low ?

In answer to your question surrounding my post meal checks. I would be high after 2 hours, lower after 4 and back to where I started after 6

 

[AndyOD]

I think I mentioned this before... Anyway, I seem to be struggling with post meal spikes (I'm sure a lot of us do) I did find injecting 15 - 20 minutes helped but today the spikes are back with a vengeance. I stared dinner at 5.3 and I put my usual ratio in. There was nothing with high sugar or high gi etc and it was the same dinner I eat every day. I injected 20 minutes before I ate and within 2 hours they had shot up to 14.6 ! They then stayed high before sloping back down to 5.something before tea some 5 hours later.

Any ideas ? I think my ratio was right as I was the same before each meal

So I would say (as I always do) this is a hypo.
Rational:-
Whenever (almost without fail) I inject and eat my blood sugar rises if I test 1 hour after eating lets say I am 7mmol/li before my meal then I am 9 mmol/li after 1 hour then the insulin works for a second hour and 1 am 7.2 or less.
When I get a hypo I start at say 7 then after a couple of hours (bearing in mind normally 7.2.
I am almost always over 14 if I have been hypo your body reacts to hypos releases glycogen and gives you a high.
This is how you would (if you didn't have more than 1 hypo) wake up after a hypo if you passed out, and if you've even been to hospital with a hypo you'll know that the next 12-24 hour period is very difficult to get the BG back to normal.

A lesson from the JIGSAW course:-
Avoid the lows, thus Avoid the highs

 

[PG1759]

So I would say (as I always do) this is a hypo.
Rational:-
Whenever (almost without fail) I inject and eat my blood sugar rises if I test 1 hour after eating lets say I am 7mmol/li before my meal then I am 9 mmol/li after 1 hour then the insulin works for a second hour and 1 am 7.2 or less.
When I get a hypo I start at say 7 then after a couple of hours (bearing in mind normally 7.2.
I am almost always over 14 if I have been hypo your body reacts to hypos releases glycogen and gives you a high.
This is how you would (if you didn't have more than 1 hypo) wake up after a hypo if you passed out, and if you've even been to hospital with a hypo you'll know that the next 12-24 hour period is very difficult to get the BG back to normal.

I know what you are referring to but it's not happening to me on these occasions. I've got a libre for starters so I'm constantly scanning myself and I'm no where near hypo

 

[AndyOD]

So is it must be absorption then ?

http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7503

 

[PG1759]

Possible I suppose... What do I do inject in different sites ? I always go for the stomach and rotate from left middle right etc

 

[noblehead]

I think my ratio is spot on most of the time. Today I injected 25-30 minutes before I ate in the hope that it might help.... I was 5.4 before I ate and they still spiked up to 11.9 after eating ( 2 and a half hrs after) which was better than yesterday's 14 something.

I eat pretty much the same thing every dinner Monday to Friday ( that's how it has taken over my life ! Lol)
Today was a cheese and cucumber sarnie on granary bread(low gi) standard crisps and a low fat yoghurt. ... 67 carbs Hardly a wild dinner !

I pretty much stayed high for the rest of there afternoon and came back down into normal range around 5pm

Any advice always welcome

Again, as your bg levels came down to normal levels it would appear you have some issues with insulin absorption, just reading your reply above (post 17) I would suggest you use your arms for your bolus dose and see how you get on, still bolus ahead of your food and test.

The following shows where you can inject insulin, as a rule QA insulin is best injected in the stomach and arms and long acting in the legs or buttocks:

http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7261

 

[PG1759]

Brill thanks for that I will give it a try tomorrow. Just a secondary thought... Tonight I decided to eat a zero carb tea and not inject. I cheated slightly and ate a tiny yoghurt afterwards for 6 carbs. Bearing in mind my basal should cover 15 carbs as a snack I would of thought I would be ok. I've been the same since eating or thereabouts. I ate at half seven ish and now 2-3 hours later my bloods have rose from 6.0 to 7.8 I am wondering if there could be a lack of basal In me ?

 

[noblehead]

Brill thanks for that I will give it a try tomorrow. Just a secondary thought... Tonight I decided to eat a zero carb tea and not inject. I cheated slightly and ate a tiny yoghurt afterwards for 6 carbs. Bearing in mind my basal should cover 15 carbs as a snack I would of thought I would be ok. I've been the same since eating or thereabouts. I ate at half seven ish and now 2-3 hours later my bloods have rose from 6.0 to 7.8 I am wondering if there could be a lack of basal In me ?

Basal doesn't cover snacks, that's why you bolus. The small rise would be the yogurt, with those readings you should try a low-carb meal more often.