Spiking

[Charlie Tudgay]

Every time I eat my blood spikes but if I ever give more insulin I then have a hypo.
Like today my blood was at 6.5 so I gave myself 2u humalog an hour before lunch as I know it spikes, I was 5.4 before eating where I gave myself another 2u (as was eating 55g and I'm on 1:15/1:12.5 ratio) and my blood shot up to 12.6 I mean that's more than doubling. But now three and a half hours later I'm down to 4.2.

Is there anyway to stop the spiking and keep the sugars more level than going too high and then dropping? This happens with every meal.

 

[pinewood]

I'm struggling with this too at the moment so hope someone will be along with some advice! Yesterday I shot up to 10mmol after eating but then I was down to 4.0mmol an hour later! What I'm trying is to inject my NovoRapid 15 mins before eating. I used to inject literally right before eating, but will try 15 mins before and see if that can help drop the peak without leading to a big drop afterwards.

 

[himtoo]

it would be interesting to know what the 55 grams of carb actually were.
different carbs have different glycaemic indexes and are absorbed by the body differently.
also would be interesting to know the fat content of the food as that can slow down absorption if high fat.
as you spiked and fell within 3+ hours high fat would not be indicated.

 

[Charlie Tudgay]

it would be interesting to know what the 55 grams of carb actually were.
different carbs have different glycaemic indexes and are absorbed by the body differently.
also would be interesting to know the fat content of the food as that can slow down absorption if high fat.

It was a wholewheat marmite sandwich with an apple. I know brown bread has a bit more sugar than white bread but I still feel it's better but not 100% sure anymore! I even peak when I have a small bowl of porridge for breakfast (which is 25g of carbs in total but take 3-4u for as ratio 1:7.5g in the morning due to dawn effect) I still split this dose having 1-2u 45 mins before.

 

[noblehead]

Injecting 2 units an hour ahead of your food when your bg was 6.5 may have meant you went low and your liver compensated, do you have good hypo awareness symptoms?

Most of us find by injecting 10-20 mins before food helps to reduce postprandial spikes, as QA insulins take around 15 mins to work.

 

[Charlie Tudgay]

I find that it takes that long for insulin to work for me. Yeah always get warnings around 4.5mmol/L

 

[LucySW]

I find that it takes that long for insulin to work for me. Yeah always get warnings around 4.5mmol/L

I find nothing really happens (from Libre) for 30 mins. I know it's supposed to be 15 mins, but in my experience it's slower.

 

[jack412]

I find nothing really happens (from Libre) for 30 mins. I know it's supposed to be 15 mins, but in my experience it's slower.

I was thinking it might help if it was taken earlier, so the insulin was peaking more when the sugar hit.

 

[himtoo]

It was a wholewheat marmite sandwich with an apple. I know brown bread has a bit more sugar than white bread but I still feel it's better but not 100% sure anymore! I even peak when I have a small bowl of porridge for breakfast (which is 25g of carbs in total but take 3-4u for as ratio 1:7.5g in the morning due to dawn effect) I still split this dose having 1-2u 45 mins before.

this is a tough one @Charlie Tudgay
have double checked your carbs first - 2 slices wholemeal bread approx 30 cho , 25 gr marmite 4.8 cho , and 200gr apple 22.8 cho
so i get approx 58 cho -- so your dose looks spot on for the carbs based on the ratio.

if we use 1 unit lowers bg by 2mmol that would indicate no fast acting and you should have tested at approx 14.5 at 2 hours post meal.
so with the 2 units 1 hour pre meal and 2 more at meal you have still tested 12.6 ( how long after meal ??) and 4.2 3.5 hours post meal

so my next question would be how long have you had D ? i have noted your age and am wondering if honeymoon period part of the answer , also wondering about hormone involvement.
how long have you been getting these spikes and drops every meal ? days , weeks ? or longer ?

 

[Charlie Tudgay]

this is a tough one @Charlie Tudgay
have double checked your carbs first - 2 slices wholemeal bread approx 30 cho , 25 gr marmite 4.8 cho , and 200gr apple 22.8 cho
so i get approx 58 cho -- so your dose looks spot on for the carbs based on the ratio.

if we use 1 unit lowers bg by 2mmol that would indicate no fast acting and you should have tested at approx 14.5 at 2 hours post meal.
so with the 2 units 1 hour pre meal and 2 more at meal you have still tested 12.6 ( how long after meal ??) and 4.2 3.5 hours post meal

so my next question would be how long have you had D ? i have noted your age and am wondering if honeymoon period part of the answer , also wondering about hormone involvement.
how long have you been getting these spikes and drops every meal ? days , weeks ? or longer ?

Hi Himtoo. Ive had diabetes almost a year. I know I could still technically be in the honeymoon period but doesn't that mean lower bloods not higher?

The 12.6 was about 1.5 hours after lunch (so a bit early to test but was the only time I could because I was at work) I've been having spkies for quite a while but it's not all the time like one day it will so the next I try to compensate giving myself split doses starting earlier but then I won't spike. It has a life of its own!!

 

[himtoo]

i have had many times at work where my bg's do what yours are doing -- and sometimes stress at work can be a factor as well.

i think the honeymoon period can cause variability as well as lowering as the pancreas might take a while to engage.

i always eat pretty much the same lunch every day and most days are not exactly the same test wise but no day at work was either.

i thought perhaps splitting your lunch and eating the apple as long after your sandwich as lunch allows( 20 -30 min ? ) and see if that makes any difference.

have you tried a lower carb lunch with less insulin as well ? if you are willing and spend the time varying your lunch you may get more hints as to cause of spike.

 

[noblehead]

The 12.6 was about 1.5 hours after lunch (so a bit early to test but was the only time I could because I was at work) I've been having spkies for quite a while but it's not all the time like one day it will so the next I try to compensate giving myself split doses starting earlier but then I won't spike. It has a life of its own!!

Have a word with your DSN or diabetes consultant about it as they may suggest something completely different, but sometimes poor insulin absorption can be to blame for postprandial spikes but as you've only been diagnosed a year this is highly unlikely, but just the same make sure to rotate your injection sites (and use a new needle every-time) to prevent problems further down the road.

 

[nigelho]

Every time I eat my blood spikes but if I ever give more insulin I then have a hypo.
Like today my blood was at 6.5 so I gave myself 2u humalog an hour before lunch as I know it spikes, I was 5.4 before eating where I gave myself another 2u (as was eating 55g and I'm on 1:15/1:12.5 ratio) and my blood shot up to 12.6 I mean that's more than doubling. But now three and a half hours later I'm down to 4.2.

Is there anyway to stop the spiking and keep the sugars more level than going too high and then dropping? This happens with every meal.

Hi Charlie, When do you test after eating your meal? I did DAFNE in 2013 and was told to test AFTER 4 HOURS because most quick acting insulins are still working during 2-4 hours. If you test after 2 hours, it all depends on how quickly YOUR BODY reacts to insulin, forget about the 2 mmols higher than before you start eating. You're basically having 4 units of Humulog. By injecting 2 units 1 hour before your meal it's began to work on lowering you by approx 1 mmol with no carbs yet eaten. You may only need a ratio of 1:15 grams carbs. I'd love that as I use 1:4 grams carbs Apidra.plus metformin SR as I very resistant to insulin. Try not doing a 2 hour test and just inject your Humulin using the 1:15 ratio and see what happens by testing 4 hours later. The 4.2 mmols 31/2 hrs later is not a problem....I'd happy with high 4's -5's. The hypos are caused by you doing more insulin at your spike possibly after 2 hours...don't correct if necessary..until after 4 hurs otherwise you are 'STACKING' your insulin and when it finally works your BSs then drop like a stone.....This happened to me for approx 3 years by doing 2 hours tests and correcting then. I found out when I did DAFNE.

 

[Richard F]

Mine spikes sometime as high as 16-17mmol an hour after breakfast (fruit and toast). If I adjust it chances are I'll go hypo later in the morning.

At the carbs 4 one course the diabetic nurse said not to worry too much about spikes, as long as the sugars were right before meals.

 

[himtoo]

Mine spikes sometime as high as 16-17mmol an hour after breakfast (fruit and toast). If I adjust it chances are I'll go hypo later in the morning.

At the carbs 4 one course the diabetic nurse said not to worry too much about spikes, as long as the sugars were right before meals.

can't agree with your nurse on that one richard. spikes are an indicator that the process is not in control and yo-yoing will become an issue.

 

[Richard F]

can't agree with your nurse on that one richard. spikes are an indicator that the process is not in control and yo-yoing will become an issue.

I thought this too, but despite everything (inc the Carbs 4 one course) I haven't managed to improve it. Mornings worst though. My AM blood sugar is between 4-7mmol I will have breakfast and take 1 unit per 10 carbs (fruit and toast) + a correction if required.

Usually high BS mid morning but down to 4-6 before lunch. The other day I was 17mmol and was tempted to take a correction, I'm pleased I didn't 45 mins later I was back down to 6.5 with only moderate exercise.

I'm fairly active so very conscious of avoiding hypos whist out and about.

 

[himtoo]

I thought this too, but despite everything (inc the Carbs 4 one course) I haven't managed to improve it. Mornings worst though. My AM blood sugar is between 4-7mmol I will have breakfast and take 1 unit per 10 carbs (fruit and toast) + a correction if required.

Usually high BS mid morning but down to 4-6 before lunch. The other day I was 17mmol and was tempted to take a correction, I'm pleased I didn't 45 mins later I was back down to 6.5 with only moderate exercise.

I'm fairly active so very conscious of avoiding hypos whist out and about.

don't want to hijack trixy's thread but perhaps @Richard F you could look at some breakfast alternatives- i usually have scrambled eggs ( 3 ) and 1 piece toast ( 18 carbs total )

 

[noblehead]

don't want to hijack trixy's thread but perhaps @Richard F you could look at some breakfast alternatives- i usually have scrambled eggs ( 3 ) and 1 piece toast ( 18 carbs total )

A good suggestion, also try injecting your insulin ahead of your food to see if that reduces your postprandial spikes @Richard F.

 

[Richard F]

Yes I here what you're saying, I used to avoid fruit because of this. Since having fruit for breakfast other aspects of my health have improved, and the diabetic professionals I speak to think it's healthy.

If I check (as recommended) before meal times I'm okay. The other in-between checks are because of driving or exercise.

An earlier injection could work, but if I'm 4-5mmol when I get up I don't want to have it too early or I'm hypo before breakfast.

 

[noblehead]

An earlier injection could work, but if I'm 4-5mmol when I get up I don't want to have it too early or I'm hypo before breakfast.

QA insulins take around 15 mins to work, so you could try injecting 10-15 mins before food to see if that makes a difference (being mindful to watch out for hypo's when experimenting).

There's some really good advice in the following about preventing postprandial spikes:

http://www.diabetesselfmanagement.c...blood-glucose-management/strike-the-spike-ii/