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How to stop spikes

Topher

Well-Known Member
Messages
202
Type of diabetes
Type 1
Treatment type
Insulin
I'm on a pump and my basal rates are perfect, keeping me around 5 during the day ( done my testing etc) problem is my meal spikes, I could be at 5, have some food, let's say brown toast with a small bit of butter, take my bolus 40 mins beforehand, and I still go up to 13 two hours later, but come back to around 5.5 four hours later. This seems to happen with all my meals now, any ideas, I'm not eating mad high gi foods etc, any help would be great- thanks
 
That is quite a spike considering your bolusing so far ahead, are your infusion sites OK? If someone has problems with lipohypertrophy this can make insulin absorption erratic......... although I would expect this might also effect your bg control even when your fasting, perhaps the more experienced pumpers might shed some light on this.
 
Indeed - Sounds strange. What is your bolus insulin type? And how many units do you normally take for e.g. such slice of brown toast? Just to know your level of sensitivity.
 
It does sound like you're having issues with the absorption of insulin. What kind of insulin are you using? There might be some faster acting analogs. Also changing the infusion site might help.

Ian Stonelake
 
How much are you injecting in one go? This could make all the difference.
 
I'm quite insulin sensitivity 1:17, so for one slice of brown toast that is 16.5g I take nearly 1 unit. I understand about the obsorption but I do come back to normal levels after 4 hours
 
Topher said:
I'm quite insulin sensitivity 1:17, so for one slice of brown toast that is 16.5g I take nearly 1 unit. I understand about the obsorption but I do come back to normal levels after 4 hours
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Did you yourself work out the 1u to 17g carb or was this worked out for you by the pump dsn?
 
I worked it out with my DNS, after other ratios left me high or low, this one brings me back to around 6 mail after the 4 hours
 
If you are using Novorapid, you could try Apidra or Humalog as they tend to have a faster onset or try eating the lower carb wayas that will lessen the bg rise, or carry on as you are and let the pump dsn sort out another ratio
 
Thanks , I'm on humalog, so might reduce the ratio to 16:1 and see how I go
 
Topher said:
I'm quite insulin sensitivity 1:17, so for one slice of brown toast that is 16.5g I take nearly 1 unit. I understand about the obsorption but I do come back to normal levels after 4 hours
Click to expand...
Perhaps try a different type/make of bread and see if that works. As you are back to normal after the 4 hours then something somewhere isn't quite right.
 
Yeah I agree, seems to happen to all my meals now at the moment
 
Another question if I may When you bolus 40 mins before you eat how much does your blood sugar drop in that time? Perhaps worth looking at that. If no drop then I would suggest it's a basal problem.
 
Cheers carbs rok, my basal levels keep around 6 during the mornings, I might try a different ratio.
 
Have you considered a super-bolus? This is where you add some of your basal insulin to the meal bolus.

Assume your basal rate is 1u/hour and you need to bolus say, 5u for the food.

You take 90% of the next two hours basal insulin (1.8u) and add this to your 5u bolus making a total bolus of 6.8u. You then set a TBR of 10% for the next two hours.

This means you are getting an extra ‘hit’ of insulin to knock the postprandial rise on the head without actually taking any additional insulin and giving yourself a hypo a few hours later.

The ratios above work for me, but you may need to adjust to suit.
 
That's great, will look into that cheers
 
Topher said:
Cheers carbs rok, my basal levels keep around 6 during the mornings, I might try a different ratio.
Click to expand...
Sorry didn't make myself understood very well.
Inject 40 mins before your meal test first obviously and then at the 40 min mark test again.
If your blood sugar has dropped then your basal will be fine if it's static then obviously a problem with basal same if your blood sugar rises then obviously a basal problem.
 
Ok thanks will try that so cheers
 
Don't change your ratio. Your bolus and basal are perfect. The problem is the food you are eating. Brown toast has "insanely high GI", basically the same as white toast. The only saving grace is the butter that might slow down the absorption of the carbs slightly.
 
Ok I might change it up a bit in the mornings and see what the outcome is, what do other people eat in the mornings ?
 
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