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How long before eating to take insulin

drahawkins_1973

drahawkins_1973

Well-Known Member
Messages
452
Type of diabetes
Type 1
Treatment type
Insulin
Hi All,

I think I'm recently coming out of my honeymoon period and I'm having real trouble getting my sugars down post eating.
I've reduced my carbs and am taking more insulin but I am still getting spikes after eating.

for example
today I was 6.7 when I tested first thing.
I ate 16g of carb and took 2 novarapid which is about the right I:C ratio
6.7 intial
2 hours later 11.2
3 hours later 10.2
4 hours later 8.7
4.5 hours later before lunch 6.5

so I end up back where I started but it takes a long time. (I've done a basal check and that seems ok)
I am trialling taking my insulin much earlier than I do now but wanted some suggestions as to sensible times to wait ( I appreicate it is dependent on starting levels and amount and types of carbs you are eating) but i feel a bit nervous waiting more than about 15 mins.

Does anyone have any advice.
Thanks
Andrea
 
thats a postpandal (sp?) rise and is normal both for diabetics and non. your bloodsugar is exactly right otherwise.
 
I find 15 mins max is sufficient time to allow the insulin to get a head start before the food begins to digest, this is injecting in the stomach mind where it works faster than in the arms, legs and buttocks.

I have read that some leave it longer especially in the morning, however if you do decide to leave it longer I'd be very careful and keep some fast-acting glucose to hand, much does depend on the food eaten as you say.

You may find something useful in the following article about post-meal spikes and how to prevent them:

http://www.diabetesselfmanagement.com/a ... ke-ii/all/
 
Hi Andrea,

I see similar sort of delays in my sugars coming down so I tend not to worry about my levels within a few hours after eating since the insulin (depending what you are taking) can be active for several hours.

Nobblehead raises some good points though, I tend to adjust where I inject and when (before / after eating) depending on what I am eating and how quickly it will hit me. For example wholegrain pasta I tend to go for buttocks, sandwich I usually use my arms but a nice treat (puddings :P ) tends to be stomache so I can catch them quickly.

I think as long as your levels are right by the time you get to the next meal then you are doing grand. That's pretty much what I took away from DAFNE after I had a chat with one of the instructors about seeing similar behaviour as you are seeing.

/A
 
Thanks all, thats good to know.

I inject in my stomach and so the novarapid should be getting in the system pretty quickly. I tend to be driving to work about 30-60 mins after my morning jab so I think delaying any longer than my normal 10 mins is prob a bit risky. I also read (and I think its cvoered in teh document you sent noblehead) that you can "hold back" some of your carbs, has anyone tried that?

I'd read a lot of advice saying 2 hours after eating you should be below 10mmol preferably 9mmol and so I think sometimes i just get caught up in trying to get things too perfect which is unrealistic I guess.

I do feel bit "groggy" when I'm running at these levels but maybe its because til now I've been honeymooning and my levels have been consisitently low, around 5-6 mark and so I'm just getting used to running higher.

Andrea
 
Hi Andrea, you should aim for your pre- and post-meal readings to be consistent with each other. Long-duration highs like that will certainly harm your HbA1c and put you at increased risk from complications. In fact, any highs will, so you should always aim to be between 4-7 pre-meal and 4-9 post-meal.

I used to get what you are describing, so what I did was to take enough insulin so that my pre- and post-breakfast readings were consistent and then have a carby snack 2 hours after breakfast to cover me until lunch time. I put it down to the dawn phenomenon; mine seems to have calmed down recently (since I started low carbing), so I no longer need a snack mid-morning, but I still need extra insulin for breakfast. If you do go down the snack route, you will need to experiment to see what amount you need. From memory, I think I needed around 15g, so I ate a cereal bar.
 
Sam - I see you saying the above regularly but I don't quite understand it.

Insulin like Novorapid has a 4-5 hour "life" and peaks around 2 hours. So say for example your BG was 5 pre meal. If you aim for 5 at the 2 hour mark you still have up to 3 hours of insulin and so run the risk of hypo before your next meal?

I aim for below 9 at the 2 hour mark with the intention of being back to 5/6 for the next meal. I just can't seem to wrap my head around your logic!
 
Hi Sam,

That sounds like a good idea I think I'll try that.

I've gone frmo easily being able to accomodate 2 shredded wheat and not hitting double figures to now having one slice of Burgen bread and my sugars going through the roof! It does as you say seem worse in the morning

I've cut my carbs to about 30g-50g at teh meont to see if that help.

Do you consistently see your post meal readings within range now you are low carbing?
Andrea
 
If you add a snack that you didn't previously require are you not risking weight gain?
 
Hi Hale,

I was thinking I might try to snack on some fruit which is what I used to do before I was diagnosed.

I actually find I am eating less for breakfast to lower my carbs so a couple of hours later i am quite hungry so could do with something to nibble on.

Andrea
 
Fruit is a good idea health wise, it just doesn't make sense to me to be feeding your insulin though.

Sam usually has good logic though so hopefully he can explain more when he's around next!
 
Hi Hale, you may have seen insulin profile graphs where there is an initial peak, before tailing off. The technical term for this is a "PK graph". The decay of blood insulin concentration is determined by the rate your body removes insulin from your system. The insulin you inject is nearly identical to human insulin and the artificial insulins have been designed to have the same PK graph (insulin profile) as insulin PK graphs for non-diabetics. For non-diabetics their insulin profile matches the absorption rate of glucose from food that is being digested. Therefore, you should expect your levels to be consistent if you get your dose correct.

Granted, there are of course other variables in this and we all know there's plenty of room for error, but by-and-large if you get your profile to match what your pancreas would've done and you get your dose correct, then your levels should be consistent.

Andrea, glad I can help! Yes, since low carbing my levels are nearly always within range. Wasn't always like this though, when I was on carbs I used to get a lot of highs and lows. Low carbing has reduced the frequency and severity of both. I can definitely recommend it and I can almost guarantee that it will give you near-perfect levels, but since you're new, probably best to give carbs a chance first!

Regarding weight-gain, I guess it's a catch 22. Slight weight gain from a mid-morning snack or high sugar levels - I know what I'd choose! Perhaps you can reduce your calories elsewhere so that you can accommodate the snack mid morning?
 
Thanks Sam, that makes a bit more sense! I guess it depends on the person, I personally see fairly dramatic drops in BG at the 3-5 hour mark (still in discussion with DSN over my basal though), so I suppose for others the insulin action time could be shorter and hence it's safer to aim for the 2 hour matching the pre meal BG?

Post honeymoon period I guess my body will have a better grip on things!
 
No probs. We all know that things don't always go to plan! I think it should always be the aim to have consistent pre- and post-meal readings. And you're right, we're all different, so it will be difficult for everyone to aim for this. A drop 3-5 hours after bolus is in a grey area of whether it's your basal or bolus, by 5 hours you'll have next to no bolus in you, but it's difficult to say.
 
drahawkins_1973 said:
I also read (and I think its cvoered in teh document you sent noblehead) that you can "hold back" some of your carbs, has anyone tried that?
Click to expand...

Is that the part where he suggest splitting your main meal in two and eating the remainder 2 hours later as a snack? No I've not tried that and wouldn't want to tbh, I prefer to eat my meals in one go and not have to snack between meals, besides dosing up front and not eating the whole meal might mean an increase in postprandial hypo's which I wouldn't want.

Take on board what everyone has said Andrea and all will become right in the end :)
 
Thanks noblehead.
For lunch today I waited 15mins and then ate the non carb portion of lunch followed by yogurt and fruit 10 or so mins later.
Levels were at low 8s 2 hours later and back to 6 before dinner so that worked well (hopefully not a one off!)
I'll try something similar for breakfast tomorrow and see if that helps.
This forum is really for getting sound advice so thanks for all the support!
Andrea


Sent from the Diabetes Forum App
 
Just a quick update and to say thanks for the suggestions.

The last 2 mornings I've given myself a little bit more insulin than I would normally ( just half a unit). My levels have been much better at the 2 hour mark, around 9-10 so at least a couple of mmol lower than previously. Having a very small snack (~ 5 carbs) and by lunch levels have been back to around 6.
Not perfect but much better.
It's the scientist in me - I'm a numbers freak!


Sent from the Diabetes Forum App
 
P.s I didn't mean to sound flippant or disappointed by saying it wasn't perfect I am really really pleased that I've seen an improvement as I've been in mid teens at 2 hours previously.


Sent from the Diabetes Forum App
 
Haha I'm an engineer.... I know all about the numbers!

I've had a great 2 days, didn't go over 6.9 since Tuesday! But woke up at 7.7 today. It's still only just out with my morning target but I was on such a good streak....
 
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