Measuring carb effects

I'd suggest testing before you eat, then 1 hour after eating, & 2 hours after eating. Do this on a few different occasions.
I find that carbs have a bigger effect in the mornings than other times of day.

Robert

Im not sure about the effects of previous meals still left over but I would say that doing it in the morning / directly after you wake isn't the best time to do it. It's very common to experience the dawn phenomenon where the blood sugar rises due to hormone release around these times.... So you wouldn't necessarily get an accurate measure.

Also, if your Lantus isn't right then that would skew any results from a bedtime snack. I don't want to confuse you with advice that conflicts with what your DSN says, but I wouldn't recommend snacking before bed as its difficult to know whether your Lantus dose is correct. In fact, if you need to snack before bed then I'd suggest that your Lantus dose is incorrect.

As for testing after eating, I do it 2 hours after. If that is consistent with the premeal reading then your dose is correct. Sometimes I test 1 hour after too as this indicates the GI of what you've eaten. E.g. if before I eat I'm at 7, 1 hour later I'm at 12, then 2 hours after eating I'm back at 7, then I'll know that what I ate was too high in GI.

To confuse things even further, you might need more insulin at breakfast because of the dawn phenomenon. I need 2 extra units at breakfast because of this.

Because you're recently diagnosed, your DSN might be taking into account the honeymoon period where you'll start producing insulin for a short while before your pancreas gives up completely. During this period you're likely to have a few hypos. Maybe she's thinking of this, but it's difficult to know for sure. Some people like to have a snack before bed, I prefer to change my insulin to stop highs/lows rather that eat, but each to their own.

You can apply the same testing routine to eating meals as you can for snacks. Test before and 2 hours after; the odd test 1 hour after to make sure that you're not spiking won't hurt either. If you're having a handful of peanuts, or another small snack, don't take any insulin, but still follow the testing regime described above. A small low-carb snack shouldn't send you high. One unit of insulin changes your sugar levels by 2/3 mmol/l, so if the snack increases by that amount, then next time you have the snack take an appropriate amount of insulin. I have 50g of mixed nuts mid-morning and don't take insulin for it as they don't effect my levels.

Me too, I've got a PhD in astrophysics and now I'm a scientific technology consultant (beat that in geekiness!); involves broad science knowledge, writing software and lots of number crunching! You can't go wrong applying logic and numbers to diabetes, it puts you in good stead. Occasionally you get some results that you can't figure out, but generally speaking, spotting patterns in numbers and the reasons for them will do you well!

Yeah I do a bit of oil and gas contracting occasionally, I write risk analysis and explosion modelling software at Shell. Yeah I like the numbers involved with diabetes too, definitely helps I think.

Great thread

I was diagnosed on Monday, also a programmer type so I've been getting pretty analytical with my BG monitoring. yesterday afternoon I was testing every hour or so as I really want to get control nailed. I've almost run out of tests!

Last night I was experimenting in the pub. It was the first time I'd been drinking since starting Insulin therapy. I thought I'd test after each pint to see what was going on. Very interesting results:
Down after 1st pint.
Up after 2nd pint
Down further after 3rd pint and a bit of cycling.

I ate a load of pizza once I got home and took Insulin accordingly. What I hadn't realised is that the Alcohol was still lowering BG so that was fun... first hypo where I properly lost it. Actually I found the whole experience hilarious. Was laughing loads, wife found it very weird.

It sounds more fun that it is, believe me! Yeah I've heard that they don't let insulin-dependent diabetics off-shore. Bummer.

Jimmy, I'd hate to break it to you but beer is mostly off the menu. A pint has around 15g of carbs in it, so if you have a couple you can have some insulin for it, but if you have more to drink than that the the alcohol will bring your levels down too. The two combined can be a bit nasty, plus it's difficult to spot hypos if you're drunk! I stick to mixers, which is difficult cos I love beer! Once I've had a load of them and I notice my levels are dropping to say around 5, I'll have a cheeky beer to bring them back up. If I'm out drinking I'll make sure that I test frequently. Always have sugar and your meter on you.

Also, when I ate carbs, I found that I couldn't trust the carb quantities given for pizzas. One said it had ~160g carbs in it. If I'd bolussed for that, I would've been dead!

As for testing, before and 2 hours after meals (to check the bolus was correct) and before bed and upon waking (to check the basal is correct) is enough. Plus the odd one an hour after eating to check that you're not spiking (doing this alone dropped my HbA1c by 0.5%). Also, before and after exercise and before driving. (That sounds like quite a lot actually!)

SamJB said:

As for testing, before and 2 hours after meals (to check the bolus was correct) and before bed and upon waking (to check the basal is correct) is enough. Plus the odd one an hour after eating to check that you're not spiking (doing this alone dropped my HbA1c by 0.5%). Also, before and after exercise and before driving. (That sounds like quite a lot actually!)

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This is great advice re testing, been trying to figure out a more acceptable strategy so thanks!

I'm not ready to take beer off the agenda yet, no sir! :silent:

Yeah took me 9 years!!!

But I don't know if there's something that is best? A digestive? A piece of bread?

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Ideally, you should repeat this for every food that exists, and compile the results into your personal glycemic index.