Fasting Bg Levels Vs Postprandial Bg Levels

[Colin of Kent]

Scenario 1: I eat lunch at work at about 12.30pm, bolus appropriately, BG remains stable throughout lunchtime and most of the afternoon, but then rises steadily from about 4pm until I get home and eat about 5.30 or 6pm. So, suspecting my basal was maybe to blame, I thought, okay, I'll do a fasting test. I've done at least three now, and each time, I didn't get the same rise in BG around 4pm. In fact, sometimes, I'm having to take a glucose tab to nudge myself back over 5 mmol/l to drive home.

Scenario 2: I'm finding that, if my BG is a little high before a meal, I give myself a correction bolus plus the usual mealtime bolus. Invariably, this results in my BG remaining steady, and requiring a further correction bolus later. The correction dose is calculated via my pump's insulin sensitivity factor (1.5 mmol/l per U). However, I'm finding that when I need a correction away from a mealtime, it usually works okay, and sometimes takes me too low.

I'm thinking that these two phenomena are related. Does anyone else have experiences like this? Can anyone enlighten me as to what's going on?

 

[kitedoc]

Scenario 1: Could the protein from the lunch meal be causing the BSL rise around 4 pm?
Scenario 2: I have noticed that correction doses in the pump algorithms (at least in the Animas pump) tend to be conservative so that 2 correction doses are often required - as opposed to a more aggressive regime which risks over-correction and hypos.
With regard to the correction dose with a meal, the calculation is still only about units per mmol/l and not about units per gram of carbohydrate. I suggest the meal mucks up the usefulness of the correction dose calculation.
I hope that sheds some light and is clearer than mud !!

 

[Colin of Kent]

Scenario 1: Could the protein from the lunch meal be causing the BSL rise around 4 pm?
Scenario 2: I have noticed that correction doses in the pump algorithms (at least in the Animas pump) tend to be conservative so that 2 correction doses are often required - as opposed to a more aggressive regime which risks over-correction and hypos.
With regard to the correction dose with a meal, the calculation is still only about units per mmol/l and not about units per gram of carbohydrate. I suggest the meal mucks up the usefulness of the correction dose calculation.
I hope that sheds some light and is clearer than mud !!

Thanks. I posted this question on another forum and someone there said that the protein can cause the liver to dump glucose at around the three-hour mark, so I think that's likely the culprit. As for the correction calculation, I've adjusted the ratio myself, so it is now more on the aggressive side, but since I last changed it, I think things seem to be a little different in my keto-adapted body.