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Blood sugar levels rising 4 hours after evening meal

J

Jane!

Well-Known Member
Messages
50
Type of diabetes
Type 1
Treatment type
Insulin
Hello, am still quite new to this ( diagnosed Type 1 in August aged 54 - huge shock! but managing levels fairly well through low carb eating & exercise). With help from Dr Bernstein and this website my blood sugar levels pretty much sit within the 5-7 range before meals and under 9 ( usually around 7.5 - 8.0) after meals). I inject 8 units of Lantus first thing in the morning and as I'm carb counting, usually 2 or sometimes 3 units of Novorapid with breakfast and dinner ( nothing with lunch which is usually under 5 grams of carbs). My problem is in the evening: I eat around 18.00, two hours later my blood sugar is always 9 or under ( often around 7.5) but then two hours after that ( and just as I'm getting ready for bed!) it starts creeping up and if I don't get on my exercise bike for 20 mins ( which brings it back down to between 6.0 - 7.5) it will reach 10. Am getting a bit tired of having to run round the house in my pyjamas when I'm tired and need to sleep! My diabetes nurse ( who was unhappy with my recent HbA1c of 43 / 6.1% as she things I'm at risk of hypos, despite never going below 4.6 and that's rare) told me it was fine to go to bed with a BS level of 10 and that it would 'come down by the morning' which yes , it does, but tends to be a bit higher than usual when this happens but I;d be much happier if it were lower. While I'm happy to exercise 3 hours after dinner to prevent this, it's not always convenient. Can anyone advise please?
 
If you figure out why id br happy to know my 4year old suffers with this but her blood sugar rises to14/18 3/4hours after her tea although she would of been in range 2/3hours after x
 
Have you done a basal test to check that's ok? That'd be my first starting place.

What kind of thing do you have for dinner? Does the rise always happen or only after certain foods?
 
The most likely answer is that given by the two previous posters. Your Lantus is probably not lasting 24 hours and as a result you see the overnight rise. In your position, I would give myself an extra unit of Lantus and see what happened. I'd be aware that I might get a hypo at around lunchtime in doing that though, as the lantus peaked.
 
@Jane!

If your meal contains protein and fat, the glucose from protein and fat takes longer than four hours to be released by which time the quick acting insulin is no longer working. Some of us take a small correction dose of quick acting insulin to deal with glucose from the protein and fat.
 
Ambersilva said:
@Jane!

If your meal contains protein and fat, the glucose from protein and fat takes longer than four hours to be released by which time the quick acting insulin is no longer working. Some of us take a small correction dose of quick acting insulin to deal with glucose from the protein and fat.
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Ah... I wondered about that.. looking back through my diaries, it mostly seems to happen when I've had half a LIDL protein roll with my meal ( usually lots of stir fry veggies and avocado with chicken or fish). My waking numbers and pre meal numbers are always in the 5.0 - 7.0 (approx) range unless I've eaten a bit later and the rise has taken me higher ( 9.0 - 10.0) closer to bed time ( and I'm too tired to exercise enough to bring it down below 8.0) and then my waking numbers are more likely to be 7.5 - 8.0 ( rather than the usual 6.2 approx). I'm been eating the protein rolls to try and gain some weight without adding carbs or too much of certain types of fat ( just got my cholesterol down from 7.5 to 4.9 - it went up when I added lots of cheese and cream). Thank you for the advice.
 
You may want to consider adding some carbs if you're trying to put on weight. I'm very slim myself and struggle to keep weight on. I eat approx 150 to 180g per day. Obviously you may need to adjust your bolus insulin if you choose to try that. My blood sugar numbers are similar to yours with that amount of carbs.

I identify with the exercising : D That's what I used to do when I was first diagnosed and had a high (like you, they were usually after my evening meal). Do you know about correction doses? That's another option to get highs down. You coukd ask your team to help you work out your correction ratio.
 
Do still look at your basal though. If that's right, it's easier to get the rest right too :)
 
azure said:
You may want to consider adding some carbs if you're trying to put on weight. I'm very slim myself and struggle to keep weight on. I eat approx 150 to 180g per day. Obviously you may need to adjust your bolus insulin if you choose to try that. My blood sugar numbers are similar to yours with that amount of carbs.

I identify with the exercising : D That's what I used to do when I was first diagnosed and had a high (like you, they were usually after my evening meal). Do you know about correction doses? That's another option to get highs down. You coukd ask your team to help you work out your correction ratio.
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Thank you. I did ask the nurse how to work out my correction ratio and she said it's too early for me to be doing that....I have tried using just one unit of novorapid when I went up to 12 once and it took two hours to bring me down to 10 ( and then I got on my exercise bike!)
 
2 hours is a pretty normal time for a correction to work. Mine starts working somewhere between 90 and 120 mins. It can then carry in going down, so be wary of having an extra correction too early as you may not need it.

If you hadn't exercised that time, it would have been interesting to see how much more your blood sugar went down. I have a pump now and when I got it I was told my correction ratio. But when I was on injections I carefully experimented and got a system for myself. Always err on the side of caution if you decide to correct. I'm always extra careful in the evenings too, and sometimes set an alarm to get up and test during the night.

Hopefully, you'll be able to discuss corrections with your nurse soon :)

Edited to add that a half unit pen allows more accurate corrections.
 
azure said:
2 hours is a pretty normal time for a correction to work. Mine starts working somewhere between 90 and 120 mins. It can then carry in going down, so be wary of having an extra correction too early as you may not need it.

If you hadn't exercised that time, it would have been interesting to see how much more your blood sugar went down. I have a pump now and when I got it I was told my correction ratio. But when I was on injections I carefully experimented and got a system for myself. Always err on the side of caution if you decide to correct. I'm always extra careful in the evenings too, and sometimes set an alarm to get up and test during the night.

Hopefully, you'll be able to discuss corrections with your nurse soon :)

Edited to add that a half unit pen allows more accurate corrections.
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Nothing like the rage bolus/correction :)
 
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