High blood sugars after lunch at work

Do you carb count? I've found with apples and oranges that the natural sugars in it push my sugars up as well, i've learned how much extra to give myself for these though i.e. I have altered my insulin to carb ratio for fruits.

Also your probably best testing at the 2-3 hour mark as your food and insulin will have peaked by this time and your sugars should be back down to what they were pre lunch. Have you ever tested 2 hours later or just the 1 hour?

Magcal91 said:

I have never carb counted before no?

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I'm not sure what insulin regime your on as your profile doesn't say, but your lunch is likely to contain above 100g of carbs which is quite a lot, whether your on MDI or twice daily injections you still need to know the carb value of your meals so that your insulin can do its job effectively, did your DSN or Consultant not advise you on this?

As other's have said, carb counting would help. A good book to buy is Carbs and Cals which has the nutritional info of almost any food. If you are consistently at 14-15 mmol/l after lunch then you need to increase your short acting insulin (if that is what you are on). A round of sandwiches will have around 35g of carbs, depending on what's in it and how thick the slices are, an apple has around 12g and small oranges have around 7g.

Are your levels consistently at 14-15 mmol/l after lunch, or are your levels fine after lunch on some days (assuming you have the same lunch)? If the latter then you may want to decrease the amount of carbs you are eating and consequently reduce insulin. This is because the amount of insulin absorbed after injecting can vary by about 30%. So if you reduce your insulin you are less likely to have random high results.

I use the carbs and cals app to work out how much to inject and have found it really useful as it has a visual representation of the food you are eating.

There is a lot of hidden sugar in fruit, especially dried fruit. Sultanas send me sky high for example. I also found this link really useful when I was first diagnosed:

http://www.diabetes.org.uk/Guide-to-dia ... e_targets/

I'd definitely speak to your consultant/specialist nurse about getting enrolled onto a DAFNE course (carb counting program) it will definitely help to figure out your insulin doses. As for your injections hopefully someone will comment shortly as since I've been on a pump I've forgotten a lot and wouldn't want to advise you wrongly with your am/pm doses.

Ah. Many diabetics are on separate long acting and short acting insulin (aka basal-bolus regime) where you have a single injection of long acting and short acting with your meals or snacks. NovoMix, however, has these long and short acting mixed together. My personal opinion is that you have more flexibility with basal-bolus as you can give yourself whatever dose of short acting you need to cover the carbs you've had. Might be worth discussing this with your consultant.

It's been nearly a decade since I was on NovoMix, but you need to eat to feed your insulin. In other words you need to eat enough to stop you going hypo or high, so perhaps consider eating fewer carbs with your lunch. Alternatively consider taking more insulin to cover the higher amounts of carbs, but please speak to your diabetic nurse or consultant before doing this as you will likely experience hypos if you get this wrong. I remember my hypos were around 2 hours after the morning injection so I snacked then which stopped them.

My sugars can deviate a fair bit at work, I've nailed it down to stress and have to make an effort to relax sometimes. I'm generally more relaxed in my new job and my sugars seem more stable. Carb counting should be first step tho, then you'd know either way

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Magcal91 said:

I have to 2 injections a day from the novamix pens, each time I have 9 units of it... It's used to be 14, then 12, then 10... I was experiencing alot of hypos with these doses however so I was advised to tinker with it until I found a dosage that stopped them.

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I would speak with your team again Magcal.

Faith makes a good point about getting enrolled on a carb counting course such as DAFNE but you do need to be on MDI (multiple daily injections) first as they are not aimed at people on twice daily injections, although there are some who may disagree people do find their control is much improved when switching from twice daily injections to a basal/bolus regime.