Afternoon rise in bg

[lilibet]

Lo all

Just moved to b/b few weeks ago after being on premixed. Control was due to robust carb management but due to spikes and lack of flexibility, wanted to change over, which I only did when I got to TDD 20.

On levemir and novorapid - 6u and 5u. Still working out novo ratios
Things were fairly stable first few weeks, and then went to pot this week (no discernible reason!). Trying to get on top of it, still fairly low carbing so havent went all dose adjustment mad!

However, am finding that every day from about 3 or 4 pm onwards am getting steep rises in bg for no reason, Have been testing like mad anyway (you should see my fingers.....). So, any suggestions. Was taking basal at 8am and moved it to 10am to see if any help. Also upped dose from initial 5 to 6 but still rising.
Eg todays example with is fairly typical - pre lunch 5 at 1pm two hours post lunch 6.8 (so ratios seem ok, if not needing upped as novo pretty much starts diminishing about 2hrs 30 mins for me).

Testing at 5pm ish (so novo should be out of system) 8.9. THis has been pattern all week and didnt eat anything that would cause delayed rise in bg.

Any thoughts? I know Levemir isnt as potent as Lantus and lower doses even less so apparently
I already split it, and it seems as if basal is spot on all day, until later.

Will call DNS to ask but her parameters and mine are VERY different and she tells me 'not to worry' i my pre dinner is in the 8's. My A1cs have been 5.1 5.7 5.3 and I REALLY expect that to rise, but dont mind whilst im titrating a new regime as long as I can get it to work for me

 

[jopar]

Lilbet

If you split your levimer and you sure that your basal profile is steady (might be worth checking this)

I ponder whether your problems lay in the low carb diet and the protien... The increase protien would mean that you need to cover with insulin... Problem being that injecting quick acting in one shot, means that the insulin is acting quicker than the protien is being adsorbed into glucose!!

You might need to do a small correction Jab later to handle the rise if this is the case.. Or you could try one of the older soluable Insulins that take longer to kick in (30 minutes) and peak at around 2-4 hours and can effect blood glucose for upto hours...

 

[lilibet]

Hi jopar

Been skipping meals to test the basal and when ill last weekend with tummy thing, had no food for three days and basal seemed ok overnight and most of the day. However there is a definite 'something' happening at that time of day and given my bg keeps going up well after Novo should be out of system I can only assume its basal? Suppose I was just wondering if Levemir running out, given its less potent but that would meant that the morning dose is running out 7 hours after injecting or thereabouts, though night time is fine. Literature suggests levemir can last mean 5.7 to 24 hours as otherwise I cant think for the life of me why its going up

I split Levemir am and pm and changing timings and dose hasnt helped. I am carb counting and have a half pen but just tend to round up, as I do appreciate that if my body is used to lower carb then it gluconeogenesis from protein will be maybe more pronounced than someone who doesnt lower carb. I am taking correction doses but still working on ratios for that. Sometimes it barely drops me and am wary of stacking the insulin. Reason I chucked premix was to get BETTER control but its all gone to hell. :evil: