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From 2.8 to 15.6 in just over an hour

stevethehalibut

Member
Messages
6
Location
Shepherds Bush, London
Type of diabetes
Type 1
Treatment type
Pump
This seems to be a recurring thing and I know it's all to do with getting all my adjustments right but even after 43 years of diabetes I still struggle to get my head around it. I am on the pump using Novorapid.

I'll explain the scenario, bear with with me:

Last night after wolfing down my favourite Thai takeaway (pad krapow so no coconut milk - he I was feeling down need a pickup) my sugs rushed up from 7.2 to 16.8 inspite of combo bolussing 20 minutes with a 1.5hour tail) before so I decided to go out for a cycle ride (the quickest way of bringing sugars down I believe). That brought it down and when I went to bed it was 8.2.
Woke up this morning at it was 2.2 (poss after late-night exercise) so I clambered out of bed and took half a bottle of lucozade and 5 jelly babies. Got back in to be and woke up at 9 to discover it was 15.6 and rising. So i took an adjustment bolus, then had porridge breakfast and bolused for that too. At 12.30 it was still 15.4 so I cycled a bit more and now it's low.

The main problem I encounter is I do tend to wake up with lowish sugar <4.5 but the second I eat anything it shoots up. My I:C ratio is set pretty high in the mornings anyway because my response is sluggish when I wake up. So what can I do to avoid the lows when I wake up and the invariable spikes shortly after I've had mi porridge and blueberries for breccie? It sets me off balance for the rest of the day and so the catching up of the pendulum continues...

PS yes I have read strike spike etc but it's hard putting it in to practice!

Thanks in advance for your thoughts.
 
Hi @stevethehalibut Have you fully basal tested and are you confident it is right. and are you confident you carb factor is accurate? Once you are happy with them, for me, I would class your 1/2 bottle of lucozade and 5 jelly babies as an over correction. For an hypo, I take only 20 g of carbs (equivalent of 4 jelly babies) and wait. The body reacts to a hypo by firstly dumping glucogon from the liver, and then subsequently reclaiming the spent glucogon, resulting in a post hypo high, and then a drop. These will be compounded by the sugar you took, and then the correction dose. This process can take up to 24 hrs.
Personally, when hypo, I take 1 x 200ml carton of orange juice (20g carbs) and wait. It works in 5 mins or less. I then, for the rest of the day, monitor BGs and always consider halving any correction doses suggested by my pump because I have learnt to expect the rebounds, and so accept the risk that I may well run slightly higher than normal for the rest of the day.
 
I used to eat half or 3/4 of a bag of haribo when I felt hypo ... because I didn't test, and simply because I liked them and it was my "treat". I would basically continue to eat them until I felt better .... It took me getting a CGM to actually be able to see how few carbs I actually needed in reality, and as you say ... that patience is key.
 

Agree with @paulliljeros, start with some basal testing and work from there.

Personally 4.5mmol/l on waking is a little too low for me and I prefer to be 5 or above, but like you I like my porridge for breakfast and find that bolusing 20mins ahead of meal reduces the postprandial spike, but to reduce the spike further I add natural yogurt and assorted seeds as the fat helps to slow down the digestion, but pre-bolusing (provided you have your I:C ratio spot-on) should help somewhat.
 
The problem I find now is with my Freestyle libre having lived in blissful ignorance I now know what my sugars are doing and I'm all over the place. I feel like I'm a new diabetic again. Maybe I'll get it right this time.
 
stevethehalibut said:
The problem I find now is with my Freestyle libre having lived in blissful ignorance I now know what my sugars are doing and I'm all over the place. I feel like I'm a new diabetic again. Maybe I'll get it right this time.
Click to expand...
Yup, that's kind of the issue with CGM - you learn there's so much you didn't know. I agree with the others about Basal testing then I:C ratio checking. You do sound out of line. And half a bottle of Lucozade! Wow. That would spike me massively. 100ml has a pretty stratospheric effect...
 
stevethehalibut said:
The problem I find now is with my Freestyle libre having lived in blissful ignorance I now know what my sugars are doing and I'm all over the place. I feel like I'm a new diabetic again. Maybe I'll get it right this time.
Click to expand...
If you have the libre, then break the 24 hours into 3, and target them one at a time, starting with overnight basal. Dont aim for perfectuon, set a wide boundary and just try to keep within say 5 and 11 with a rough target of 7mmol. That way you arr not always skating on the edge of hypos. if you try to keep it within a tight range, you will tear your hair out! Worry about perfection next year lol
 

I recently had the same problem with the morning lows and then spikes after my morning porridge. To sort it out I started eating dinner earlier (around half 6) so that I could sort out my post dinner levels before bed. That seemed to get rid of the morning lows.
To stop the spikes I've switched to a low carb breakfast (under 20g). It seems to stabilise them in the mornings and avoid the massive rise up to 16 that I used to be having.

Hope that helps


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