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Correcting between meals

Adam.froud

Active Member
Messages
42
Location
Suffolk
Type of diabetes
Type 1
Treatment type
Insulin
Hi all

I was diagnosed a couple of weeks ago and I am very much still getting the hang of things.

I was told by my nurse only to take my bolus 3 times a day with meals, however I've been reading Think Like A Pancreas he mentions taking correction doses if high between meals.

What do you guys think? What do you do?

Cheers
Adam
 
I correct between meals if necessary, but as its early days for you, I'd give yourself a chance to get your head round the whole thing first and to get experience with carb counting and insulin.

I don't remember exactly when I started correcting between meals, but I guess it was a few months after diagnosis and then I proceeded cautiously.
 
I correct between meals using carb counting and the advice in think like a pancreas. I think it's important to be confident about ratios and understanding insulin on board and the like though. Could you maybe discuss with your dsn? The online Bertie course is an excellent source of info. Good luck with it
 
I wouldn't adjust between meals just yet. I think you need to establish a carb:insulin ratio that works for you. Correction dosages may very well confuse the analysis of carbs ratios.

You are right, correction dosages are needed but perhaps take it one step at a time.

Good luck!!!
 
@Adam.froud . Correction doses are common practice BUT you must understand what you're doing. As already mentioned you maybe better just concentrating on the basics for the present time.
A correction dose is not just about hitting a high BS reading, you have to go back in time and account for insulin on board, understand how different foods digest and release carbs into your system and plan into the future regarding next meal and how correction dose could affect you there. It can be done but experience is key to getting it correct and even then it can go wrong.
 
We corrected between meals from diagnosis with my daughter. We were given the Aviva expert metre, which calculates insulin on board and correction doses, so that helped to begin with. Ask your team for the expert metre if you want guidance with correction doses maybe.
 
I correct between meals if need be. I have found 1/2 unit of insulindrops me about 20 if taken 2 or more hours after food and away from food. However your insulin sensitivity/resistance plays a big roll. How many carbs you arteries, how much fat and how much protein. I think the first thing you should do is make sure your basal is right and how your boluses are workin gwith your meals. If you're always high, without hypos you might up your meal bolus a bit until you find how much insulin will cover your meals. A lot of us are more insulin resistant in the morning and become more sensitive as the day progresses. I need more insulin in the morning but you might be different.

Can you tell us what your pre and post meal numbers are and how much insulin you are taking. What a normal day of food looks like? If your spiking after a car you meal taking your insulin a little while before your meal might help.

@azure taught me this and it makes a big difference even though I hardly eat carbs. I would think it would make a much bigger difference for a carbs meal.
 
I think its important that you have a good blood testing meter like the aviva expert as the biggest priority.

To correct between meals is ok but you need to have your acting time worked out and your target range set ok..

You want to also be aware that the aim initially is to come back to normal levels at 5 hours after a meal.. without correcting...watch what your peak levels are and when they are....


More importantly have you done basal checking first?
 
Your diabetes nurse will no doubt get around to establishing a correct insulin unit to carb ratio for you once they have a clearer idea of it.

I was in your position 14 months ago having been newly diagnosed in November 2015. It takes time as there's rather a lot to take on board, and it's too much to do in one go. Expect that ratio to be adjusted potentially several times yet over the next few months.
 

This is yesterday, which was a pretty good day!

Woke up:
BG 7.1, had yogurt and walnuts for breakfast (5g carbs) and 5u novorapid.

Lunch time:
BG 7.6, had chicken salad (5g carbs) and 4u novorapid.

Tested before I drove home from work and BG was 7.1.

Dinner: walked the dog and BG was 6.7. Had chicken breast, cauliflower, leeks and broccoli (5g carbs) and 3u novorapid.

Bedtime: bg 5.5, took 16u abasaglar and had an apple. Was 6.9 when I went to sleep and 8.5 this morning.
 
Firstly, your meal-time bolus may take 2-3 hours to bring BS back to normal so if you correct inside that time you will overdose. Secondly, if you have a snack of more than about 15g carbs you will need to bolus for it.
 
I'm thinking the apple was not a good snack especially without a bolus and at night if you were less active. Try something fatty like nuts or nut butters. Even a slice of apple with a little peanut butter COULD be better. The fat will slow the carbs down but be careful, pb is fairy high carb.

Looks like you're staying pretty steady, you just need to bring down your set point a bit. Having more of a fat snack before bed should help you have a better fasting and the rest of the day should stay lower.
If I wake up higher than I like I stay higher all day. I can counter this with a small correction about an hour after I finish eating. Do you have a half unit pen? Great for small corrrections and little fear of hypo.

I would talk to your team about allowing you take a small bolus for snacks. Especially carbs ones. I don't need to bolus for a few nuts or olives but I would go sky high with an apple and certainly would need insulin.
 
You need a night of waking up at 3am and two hours before you wake and immediately you wake and doing blood tests to find out what time you drop or rise.

Just going all night with an apple doesnt to me, show a lot.. it doesnt show whether the apple threw your levels up and then they lowered or whether the apple was actually needed.

To me you need to do a few nights without a snack before bed and with testing during the night... to establish an exact timing of your rises and the timings of when you could be going low.

Yourbllods with the eating were very stagnant... it would be good to see what your levels were 2-3 hours after those meals...otherwise its not giving a complete picture...
 

The apple idea came from my DN: I was told not to go to bed with a BG below 6.5, and to have an apple or banana if below. I guess this doesn't work so well for me!

I'm still adjusting my basal to bring down my baseline, although I don't seem to be increasing too much overnight, for the most part!

I don't have a half-unit pen unfortunately.

Thanks for the advice
 
The waking up at night is kind of impractical at the moment, as my baby son is still in our room and if I wake him up no one will be going back to sleep. I'll try testing a coupe of hours after meals tomorrow. When I've had hypos they've been around 2 hours dosing, so I assume this is when my novorapid peaks!
 
Then follow your DSN's advice @Adam.froud

Your blood sugars are probably erratic because of the honeymoon period so don't put pressure on yourself to be perfect too quickly. Not that any of us are perfect!

I find it easier to control my blood sugar with a moderate carb intake and it's helped maintain my insulin sensitivity.
 
Some blood testing machines you can see in the dark.... No need to get up, just turn the machine on and test..

You need a 1/2 unit pen. Get these from your DSN. Goodness knows why they still give out 1 unit pens. People on smaller doses need smaller increments of insulin and 1/2 unit changes are needed.

Also does your meter work out your doses in 1/2 units or full units? The aviva expert does it in 1/2 units, not sure what meter you have.

Your DSN isn't wanting you to go low over night, so she is being careful. Perhaps do like suggested with less than a full Apple.... .?

I've tested and tested at night without switching on lights, it is possible. Or see if your DSN can give you a freestyle Libre for a try for a fortnight...
 
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