High blood sugar Spikes

aigo said:

Hi there, I am finding that if I go a long time between eating that once I eat my blood sugar spikes to a really high level. For example I have my breakfast at about 7.15. I will then go to around 12.45 before lunch. I won't usually eat anything or very little in this time. As soon as I eat I spike to a really high level before eventually it comes down. Usually around 3-4 hours after. I am on novorapid and levermer which I am doing twice a day.

If I eat within 3 - 4 hours after my breakfast I will find that I do not spike to a high level.

Does anyone have any idea why this is happening?

Thanks

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Hello, welcome.

It's quite tricky, do you carb count? Sometimes your insulin dose for breakfast may not be enough. Have you considered a basal test to see if your levemir is the right amount or too little or too much? Levemir is in the background to keep us stable in between meals and when we're asleep. Novorapid is suppose to help the meal times but sometimes it's not enough so you'll run high and levemir will drag that high. However your food, doesn't matter how little, we still need to calculate the carbs and inject according to the carbs.

Also depending on your carbs, sometimes we need to prebolus our fast acting in advance before eating. When we eat, our fast acting plays catch up with food so you'll run high then settle back down to normal range when insulin kicks in.

aigo said:

Hi there, thanks for your reply. Yes I do try and carb count, if I went 3 - 4 hours between between breakfast and lunch then I would need between 10 - 11 units of insulin. But if I go 5 hours + then it would not be enough. For example today my blood sugar was 6.7. I had 14 units and it rose to 15 within an hour.

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That's pretty normal because carbs spike our blood sugar and depending on the type of carb, some break down sooner than others and insulin hasn't quite kicked in yet. If you could contact your team to learn about your insulin profile and prebolusing, it should help with meal spikes to some extent.

aigo said:

Thank you but do you know why this would spike only if I go over 5 hours without eating if I hads my lunch earlier or breakfast later this would not happen.

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If it is in the morning, Dawn Phenomenon can play a role with rising blood glucose in the early hours of the morning. It's where your liver decides to dump glucose to get you started for the day. Eating breakfast halts DP

aigo said:

Thank you but do you know why this would spike only if I go over 5 hours without eating if I hads my lunch earlier or breakfast later this would not happen.

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Hi, aigo, just a suggestion, but I'm wondering whether this might be a basal issue?

Bolus lasts for typically 3 to 5 hrs depending on the individual and amount.

So, say you do a bolus shot, it takes care of the meal, but wears out over 3 to 5. If basal is too low, the bolus can kind of be taking care of a too low basal too to an extent, and if you eat again within 3 hrs the second bolus will do so too, so you're maybe not noticing that basal may be too low as the bolus shots are covering it. But leave it 5 hrs, pretty much no bolus by then, so a too low basal will show up in a relentless rise, and adding in even an increased bolus will have a hard job of it.

Just a suggestion, could be other things. I'll sometimes deliberately delay a meal till well after the last bolus has worn out. If bg doesn't steadyish, it's a good clue basal may be too low and might benefit from an increase.

aigo said:

Thank you but do you know why this would spike only if I go over 5 hours without eating if I hads my lunch earlier or breakfast later this would not happen.

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Hi aigo. Not sure how long you've had diabetes, or when you take your levermir doses, but this sounds like something you might want to evaluate step by step. You have to narrow down the culprit. Determine the pattern of your levermir first, by going without breakfast and lunch on numerous different days and evaluating your test results.

Results should remain consistent if it's working properly (especially throughout the morning with no carb intake). Inconsistent patterns (different peaks/valleys each day, if any - or peaks/valleys on some days, and none on others) could mean that you may be developing a resistance to Levemir or that some of your dosage locations are not absorbing properly. If results are consistent then have a look-see on when the peaks/valleys are. You might have to change the time of day you take your dosages or simply be more consistent with lunchtime. Or maybe add a third shot each day. In the end though, I would recommend changing insulin brands regardless, if there are any peaks/valleys at all. I currently use Toujeo, and if I don't eat anything at all my blood sugar will just remain at the same level all day.