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Lunchtime insulin- which should I raise

Hattonma

Well-Known Member
Messages
82
Type of diabetes
Type 1
Treatment type
Insulin
So I have been closely monitoring my sugars of late in a push to get my average down. At lunch I am currently on a 1.5 ratio to 10 carbs. My sugars always tend to rise late afternoon so wondering if I am best raising my long or quick acting

Yesterday was a classic example. Pre lunch sugar was 5 - 4 hours later it was 10. I think I got my carb counting right. The only item maybe under scored was an apple. I had the following
-cheese salad sandwich. No mayo or bytter= 40 carbs
-pack of Hull hoops = 10
- apple =10
Total 60 = 9 units of insulin

Any suggestions welcome
 
I should just add in the past I have tried moving to a 2:1 ratio but that always sends me straight to hypo
 
Hello @Hattonma, that can happen to me too. Do you have a 1/2 unit pen ( are you pumping, as I can't help with a pump) because this could help? I have found by reducing my carbs and the type of carbs I eat, helps with not getting spikes later and some people have different ratio's for different meals. If I am very active, doing DIY or gardening, I have to take at least 1 1/2 to 2 units less., other wise I will hypo and have a big drop. It may require some tweaking with different foods and Insulin dose, but my 1/2 unit echo pen really does help me.
Best wishes RRB
 
Hi @Robinredbreast thanks for your reply. No I am not pumping just plain old pen. I don't have the half pen either just a full unit one.

I have an office job so don't do lots of exercise and usually eat the same lunch during the week(exciting I know)

I have contemplated increasing my ratio to 1.75:2 but working that out will be a bit more complicated

Monday and Tuesday I also had a similar increase of 5.
 

Hi, a half unit pen could help. I need more Insulin if I am more sedate and less when busy ( especially diy and gardening) I was on a 1/2 unit pen and needed a back up pen, but my one had been withdrawn so my DSN prescribed 2 Echo pens and they are great, it even tell's you previous dose and how long ago, like a sundial)
You could possibly change some of your lunch foods, or have a little less. When do you take your Insulin, this could be a factor as well ?
 
What was your BS 5 hrs after eating lunch? Wondering if timing of injection may help? Could you provide your readings and carb amounts for the rest of the day and also Basal amounts/timings too?
 
Yes, a more detailed timing list might help us

I second the half unit pen idea too.

Do you have similar problems after lunch when you're not at work?
 
What I would do is have a carb free lunch, tuna/chicken salad or something filling.
Check your sugars before lunch and don't correct it if it's only a couple of points out. Re check your levels 2,4 and 5 hours later recording your results. Correct your sugars now if they are out.
If it raises up further you'll need more background insulin in the morning, if it remains the same your ratio will need to go to 2-1 or as close to 1.75-1 as you can.
If your sugars drop, reduce your background slightly the following day, have another carb free lunch, eat roughly the same food again, and re test again. If it sorts it's self out by doing this, up your ratio to 2-1 and re check sugars after your first few days of this.
Always have hypo treatment and enough test strips at hand though


Good luck
 
Ok so yesterday was
Levemir 18 units 6.30 am
Pre breakfast blood -13
Breakfast 60 carbs. 6 units +2 correction. Time 6.45am
Lunch as above. Time of injection 12
Post lunch recording -10. 4.30pm
Tea - 80 carbs. 14 units of insulin. 30pm
Pre bed reading 13. 11pm. 3 units of correctional insulin based 1.5:2 ratio.
Levemir 16 units at 11pm
Sugar this morning 11
 

Thanks for the info, could you confirm if you did a BS test before Tea and also the time - I'm not aware of a time called '30PM'
 
No test prior to tea I used the earlier reading.
Lol that should say time 6.30pm for meal
 
I'd say your tea time ration is about right though, but what did you have for tea? Was it something fairly fatty/slow carb release? Wondering if your pre-bed correction was enough or not.

Looks like lunch ratio could do with a bit of an increase but not too much.

How comfortable were you with your breakfast correction of 2u - that dropped you by 8mmol (yet night time correction did very little - hence the question about what you had for tea)?

However maybe your Levemir might not be enough, what if your bolus ratios are right and your morning levemir is running out mid afternoon and possibly during the night? Only way to find out is a Basal test
 
Hi @Hattonma , as @slip said, I'd do a basal test first as you really need to make sure that's right first before moving onto your ratios.
 
I agree, go carb free and that will give you a true idea of your basal dosage needs.
Then you can check your ratios
 
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