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BS levels inbetween readings?

jessie

jessie

Well-Known Member
Messages
275
Location
Gloucestershire
Type of diabetes
Type 1
Treatment type
Insulin
Hello,
I'm newly diagnosed and keeping my BS readings at the right levels (most of the time - thanks for all the advice on hypos btw). My concern is, what about the readings 'between readings' if you know what I mean? I test my blood sugar 4 times a day - before breakfast, lunch, dinner and bed time - and they are normally between the recommended 4-7. But if for example an hour or so after eating a meal my BS was going up to 9 or 10 would this be dangerous and cause complications long term? I did ask my nurse and she said that it's only the 4 readings that count. Do a regular persons levels shoot up after eating or just people with diabetes, or should they not go up at all after eating? Sorry, loads of questions!
 
The nurse is right ,Jessie.Even a non diabetics sugars will go up after a meal.The difference ,of course is that they can cope with it and bring it down quickly.diabetics can't .That's why we need to be careful what we eat.You are doing well if you are keeping your readings between 4-7.Good for you.
 
Hi Jessie,
You don't need to worry about the after-meal BS levels. There is carbohydrate in much that we eat so it is perfectly natural that your blood sugar should rise after eating, and a level of 10 at an hour after a meal is ok provided that by the next meal (or next test) your level has come back down to the 4-7 range. The fact that this is happening shows that your medication, in your case insulin, is working exactly as it should be.
 
Hello jessie,

Even non-diabetics will sometimes rise to 9 or 10 after a big, carb-laden meal.
Ultimately, you need to look at your long term hba1c to get a fuller picture of how your control
is doing.

Regards,
timo.
 
Yes they do matter. Normal people's BS levels do indeed rise after a meal but not to diabetic heights and they return to normal very quickly afterwards. My doctor says you should aim for a rise of not more than 50mg/dl ( 2.7mmol). (2 hours post prandial reading) If your readings are returning to under 7mmol by the next meal then they are most probably OK post prandially. I must admit I do check but I'm under a different system to you ( and get prescribed the strips to do it)

I did a bit of researching and this is what I also found.
The post prandial glucose has an important influence on the average blood glucose which obviously influences the development of all diabetic complications. It may also be that high post prandial spikes are an independent factor for macrovascular complications and an increased mortality risk.
There is some recent evidence that even quite moderate postprandial hyperglycemia (148–199 mg/dl 8.2-11.05 mmol) is a better indicator of potential artherosclerosis than is fasting glucose.
For these reasons the International Diabetes Federation has a goal of 135 mg/dl (7.5mmol) and the American Society for Endocrinologists has one of 140mg/dl (7.7mmol) for blood glucose 2 hours after a meal.
incidently the ASE also has an HbA1c target of ≤ 6.5%
 
Great advice - thanks all. I have been testing my friends levels to see how we compare, but I don't think they are particularly enjoying my stabbing them at every opportunity :wink: But it's all a learning curve I guess - like being back at school!
 
Jessie

I have replied in your other post about hypo's. I am currently testing 8 times a day so that we can see if there is any pattern to my hypo's while honeymooning and also to ensure that if my BS has gone low I can eat, on the other hand its to make sure that the injections I am having are having the desired effect. This has been requested by my nurse.
 
I got really bad advice from my hospital consultant at North Mid in London. When I was having probs with Lantus I made an appt with her a couple of years ago. She told me not to worry about highs of 15 after meals! She also ignored everything else I said to her about other symptoms I was suffering, suchas erratic BS control,hyper and hypo days with no pattern, exhaustion, feeling hypo when I wasnt, other weird sypmtoms and generally feeling like death. She prescribed me anti-depressants and only recently when I had a look at my notes, I found out she made no record of the things I had reported to her! My husband came with me and he was very worried about my deteriorating condition-he was disgusted.
With no help from this consultant, I decided came off Lantus and switched to Pork Isophane almost 2 months ago, and have the best BS control I have had in 19 years. The other symptoms have gone too and i have so much energy now. I have been in this consultant's care for over 15 years and I feel really let down.. How do these people get away with it??
I would never let my blood sugar run to 15 but she assured me it wasnt a problem! After what I've read on this forum I feel stupid that I ever trusted this quack. I am quite sure other patients on lantus have reported similar probs to this clinic and been ignored- I'll do some digging at my next appt. I wanted to post this message because my quality of life was so ****, I felt like ending it all, and I still have flashbacks about the awful days when I felt like I was being poisoned and thought I was dying. I lost all confidence, and was scared to go out on my own in case the tiredness hit me, it was so overwhelming and dabilitating. I had such lousy quality of life and had no idea that changing insulin would be the answer. It was never suggested no matter what doc, consultant, nurse, etc I reported my probs to.
It's scary,and I do worry about what long term damage it's done to me.
Jus
 
Keep hearing bad things about Lantus, sorry if I sound ignorant but this is still new to me, what it is made from? Is it human, animal or man made? Willogs I think I'll start doing readings 2 hours after eating to make sure everything is working how it should!

Thx.
 
Hi Jessie, Lantus is an analogue insulin, it mimics the action of insulin by lowering the blood sugar. It's man=made, and in my opinion not enough long term testing has been done to prove it is safe.
I was on it a while before I experienced problems. It puzzles me why Lantus is being pushed so forcefully on newly and already diagnosed patients. In my case it did not work as it claimed, and did not control my blood sugars. I have read that a lot of the Lantus remains at the injection site even 36 hours after injecting. This explains why I was having days when it didn't seem to work at all, and days when I was dangerously hypo all day, sometimes two-there was no pattern to it.
While some people claim to get on alright on Lantus I have read more stories of people having horrible side-effects, and in my opinion it is a faulty product. I'm sure it will all come out in the wash-when GPs and medics start acknowledging the problems patients are reporting to them.
I told them till I was blue in the face about the erratic control I was having, and I thought it was something wrong with me for nearly 4 years! Now my control is almost effortless, and I feel better than I've felt in years. I had a shXX quality of life while on Lantus, I can't express how bad it was, and I couldn't see an end to it. It was my husband's suggestion that the Lantus could be the problem that made me investigate further and thank God I did, I could not have carried on much longer like I was.
Sorry I've reallly wavered from the original thread! I should post a "down with lantus" thread next time!!. I hope u get your after meal bloods sorted.
Jus :)
Justine
 
Hi, i have been on a course for Type 1 Diabetes and all the advice states that there is no gain whatsoever in testing 8 times a day. You will quickly get sick of it and will feel that the Diabetes is controlling you rather than you controlling the Diabetes. It will not be good for your mental state either!

Just test before breakfast for your baseline reading, and then before every meal you eat. Finally, test just before you go to bed and get it between 6.5mmol to 8.0mmol.

If it is below 6.5mmol eat about 10g carbs for every 1mmol below 6.5. A rich tea biscuit has 6g so 2 has 12g, etc.

If it is over 8.0mmol but under 11.0mmol, leave it alone. If it is higher than 11mmol, you should inject a correction dose of insulin, normally either 1 or 2 units.
 
Did the course tell you the importance of checking before driving? Did the course also say that the newer Human and Analogue insulins also cause Hypo-unawareness? Being diabetic, especially if the insulin you are on causes erratic Blood Sugar contol, despite sticking to a regime, is a very dangerous situation. I had many times when I felt hyp an wasn't, and had no hypo-awareness. Sometimes I just felt a bit tired and checked and found my BS was under 3! I considered not checking on these occasions because my GP had tried to cut my test-strip prescription, and said I should not check more than 4 times a day.
I have been on insulin for 19 years, and I despair when I hear that these courses can say checking your blood sugar can cause anxiety and depression. What a load of garbage-it is far more beneficial to get control of your condition,and know what is going on than to stick to these "rules". Peace of mind is brought about by doing the best to manage your condition, and reduce long-term effects. In my situation my healthcare "professionals" were wll aware of the problems I was having, but offered me no solution but were quite happy to try and cut the amount of strips I was prescribed!
Don't forget that the PCTs that often run these courses have an alterior motive-to cut costs. Unfortunately with the poor information(if any) that seems to be given by some health care providers these days, patients are at their mercy.
My advice to anyone on insulin, if you feel you have to test,do-cause it aint worth the risk, especially before bed! And if that means checking 10 times some days then so be it :x
Jus
 
Jessie, I meant to say I don't think that bloods of 9 or 10 between meals will really cause you a prob, most "normal" non diabetic people can go up to at least 8.
I was going up to 15, as i said and my consultant said it wasn't a prob, I now believe she was talking nonsense-even when it went that high I would correct it with a couple of units of humalog. Her information was given despite there being a poster in her clinic that said going up to 9 or 10 is dangerous! I think if you get it down quick enough, which yours seems to be before meals, it shouldn't give you cause for anxiety. Sounds like your control is quite good. If you keep it too tight, you'll end up hypo before meals and that's not great either.
Sorry if I sounded a bit aggressive in my last posting- Just get very frustrated and worried by any restrictions or daft advice on testing.
Jus
 
I have worked out that I CANNOT achieve blood sugar levels much below 10 at 2 hours after eating without going low later.

My latest HbA1c is 5.8%. I regularly have 2 hour readings of 10.

If I have a meal of 40g carbs in the evening, I need 4 units to cover this. 1 unit of insulin lowers me by 3 mmols. Apidra takes about 4 hours to get out of my system.

If at 2 hours, my blood sugar level is less than 10, then two hours later my blood sugar will be less than 4.

40g carbs isn't a lot. Typically it's something like a quorn escalope + veg plus a portion of fruit. I don't eat anything carb dense like potatoes, pasta, rice etc. I eat lots of veg and nothing high gi.
 
Moggie10, I am testing 8 times a day because I am newly diagnosed and I was suffering from headaches between meals. when I did random tests at this time I was having BS of about 19-20 but when I get to my meal I am back to about 4-6. The after meal tests are done about 3-4 hours after a meal to see if there is any pattern in my control. I am currently in the honeymoon period with completely erratic results I only do 2 fast acting injections a day, one at lunch of 2 units and 4 at tea. I don't carb count and feel that for now the 8 times a day testing is giving us a better understanding my own insulin production for now. I don't think this is the right think to do if you don't need to but I think as a newly diagnosed type 1 it gives you a better insight into how your body works, I know from previous posts from jessie that she is also honeymooning and thought this advice could help her, it is hard to know what is the best thing to do when you are first diagnosed and there is so much confusing info out there.
 
Just test before breakfast for your baseline reading, and then before every meal you eat. Finally, test just before you go to bed and get it between 6.5mmol to 8.0mmol.

If it is below 6.5mmol eat about 10g carbs for every 1mmol below 6.5. A rich tea biscuit has 6g so 2 has 12g, etc.
Click to expand...
This is one where people vary. Some people drop low during the night, others BS rises. I can see it is to avoid hypos at night but for me it would also result in higher fasting BS and consequently higher HbA1c. My doctor originally said to eat if below 90mg/dl (5mmol).This was after initial basal testing in hospital.
However,experience has shown me that if my basal is right, and it is over 4 hours since my last rapid insulin and I haven't exercised in the evening, then whatever BS I go to bed with I wake up with. (and I've done night time checks to verify it)
If my BS is at 80(4.4) or below then (regretfully, because I hate eating for medicinal reasons ) I might eat 8-10 gms but those 10 grams will be reflected in the morning reading. I prefer to go to bed in the low 80s and wake in the low 80s.
 
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