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BG suddenly jumping late afternoon/early evening??

V

victry77

Well-Known Member
Messages
260
Hi, wonder if anyone had any ideas. I take Novorapid and Levemir and carb count.

My control is quite tight and for the past month ranges have been about 4-7. Due to my hypo tendencies my DSN wanted me to ease up on my control a little, which I have done this past week. Levels have been fine when testing pre and post food.

However, these past three days, for whatever reason, around about early evening (6pm-onwards when I test, but not sure when the increase starts to happen, possibly late afternoon) my levels have been jumping into the 15's.

I have no idea what is causing this. When it happened for the second time yesterday, I increased my basal again and return to my usual ratios (when my levels were a bit too hypo skimming) and yet just tested and I'm back in the 15's again.

I was 7.5 before lunch and forgot to test after 2hrs, so not certain when this increase started to happen. Same applies the last couple of days, too. Levels this high are very, very unusual for me.

Does it sound more like it could be basal issue? I take my does before bed.
 
I take Lantus so it's probably pretty different, but I had a similar situation and was told to push my basal back to 9pm rather than 11pm when I was taking it, and this does seem to have helped
 
Thanks becky, I'll try bringing my Levemir forward a bit.

I've just test 2hrs post lunch and they've jumped 6mmols into the 14's!! So, the problem definitely around this time.

I've previously been on a 1:8 ratio for lunch with only up to a 3mmol spike at 2hrs. Wonder why the sudden huge leap?

Although, I was also a little higher than normal pre-lunch, too.
 
post meal levels don't really mean anything dose wise is out necessarily............

if your still high by the time the meal time insulin is gone then it will be a dose issue......

at 6pm are you getting ready for dinner?
 
Are you taking levemir once or twice a day? If only once then it could well be running out
 
Usually when adjusting the basal downwards, it can sometimes mean adjusting the bolus upwards a bit to get the right balance on how the background and bolus control bg levels. Also, unless using an insulin pump, its best to only test bg about 3hrs after using the bolus and not worry too much about the high 2hrs post meal. I can climb upto 12mmol in the first hour if my pre meal bg is on 6-7mmol and I have eaten carbohydrate in moderate quantity. Eating lower carb meals, its a different story.

Unless bg levels remain at over 8mmol 3hrs post meal, then dont worry. If they are at 10mmol, then correct back to a sensible target (8mmol) again and adjust the carb ratio on the bolus so that the next day, the bg test will be lower.

Try if you can, to control your bg levels using bg targets and work out from your new overal daily insulin amount what your correction factor should be (the 100 rule is good). You can still have reasonably good bg levels without the risk of complications by aiming for good pre meal and post meal targets.
 
I had the same with levemir. I took it once a day in the evening with no trouble. Then one day out of the blue it just stopped lasting the full 24 hours and my sugars would go up early evening. You could try splitting the levemir dose if you currently only take it once.


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Are you taking levemir once or twice a day? If only once then it could well be running out
Click to expand...


Thank you, this is EXACTLY what I'm thinking. I think the levemir is suddenly not lasting. I do understand people saying not to worry much about the 2hr readings, but this is awfully high for me and all of a sudden. It's seems something other than general post-meal spikes or a bolus problem.

I'm going to split my does starting tonight, to see if it helps.

I normally take 6 units about 11-11.30pm and this BG raise appears to be happening approx 2-3pm. Any recommendations regarding what times to take the split doses?

Thank you.
 

I ended up swapping my basal as I couldn't get to grips with splitting the levemir as I always ended up high or low depending on the overlap. I was only taking 3 units so it was hard to balance. I now take tresiba once a day so if it doesn't work splitting then you could ask to swap.
Tresiba has a much flatter profile and it has also helped with DP I used to get with levemir.
Good luck


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I would suggest starting off with a 50/50 split 12 hours apart and see how it goes, the good thing about levemir is that you can see how the changes affect you quickly unlike lantus which you have to wait a few days. You may well have to do some basal testing too. You are on a very low dose don't be surprised if you find you end up needing more!
 
Hi Ruth, no, not especially. Plus it happened three days running. But I know what you mean regarding high flat delaying the spike.

Interestingly, though, the past couple of days it hasn't (haven't split levemir does as yet). I'll monitor for the next couple of days and see how it goes.
 
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