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Post meal advice

asyarlk

asyarlk

Well-Known Member
Messages
155
Type of diabetes
Type 1
Treatment type
Insulin
This seems to be a regular occurrence and I'd like some advice please:

Pre meal: 6.2
1 hr post 12.4
1hr 15 post 8.4
2 hrs post 6.8
2 hrs 15 mins post 5.2 and still dropping. I have had a digestive as I can feel a low coming on.

I took 2u of novorapid and waited 8 mins before having breakfast. This was for 33g carbs.

Do you think I need to wait longer before eating? Will this stop the spike and then the low?

This is only when I have breakfast.

Thanks in advance for your advice!
 
Try waiting longer to prevent the spike, say 15-20 mins and see how you get on, QA insulin takes around 15 mins to work.

If you find your dropping too low between meals then check that your basal insulin is set at the right dose.
 
Thank you. I take 6 units of lantus at bedtime and this seems fine as when I don't eat carbs I stay very stable.

I guess I need to be brave and wait a bit longer than 8 minutes!! Would this wait stop the spike and the hypo?

Diabetes is a complicated business!!
 
asyarlk said:
Thank you. I take 6 units of lantus at bedtime and this seems fine as when I don't eat carbs I stay very stable.

I guess I need to be brave and wait a bit longer than 8 minutes!! Would this wait stop the spike and the hypo?

Diabetes is a complicated business!!
Click to expand...


Well that's good if your basal insulin is OK, what you could do if you do get on top of the spikes and still find you drop too low 2-3 hours after is ask for a half unit pen, something along the lines of the NovoPen Echo which dials up in half units and has a built-in memory function.
 
if you can confirm you basal is OK between breakfast and lunch then from your the readings you have provided the amount of insulin [bolus] was too much, as you continues to drop only half way into the activity of the insulin...........

in reality with only 2 units given the length of time this will last will likely be less than 4 hours for sure.....

if you dont end up on target by lunch then your insulin carb ratio needs adjusting [as long as basal is good]

for the spike you need to get the insulin in earlier............

i would do a basal test as its looking like you wont be able to go much lower with the bolus..........

so as noble says, half unit pen is worth a shot...........the next step is pump..........:)

basal test required to confirm all is OK between breakfast and lunch........
 
Since I am so sensitive to NovoRapid at the moment (and it sounds like you are similarly sensitive) I have asked my GP for the NovoPen Echo because sometimes (for example) 1 unit isn't enough but 2 is too much. Worth a shot?
 
I used to have similar issues around breakfast (huge spike followed by a drop) In the end I stopped having milk in my porridge and have soya instead (and less insulin) and that seems to have sorted it.

Someone on another thread suggested lactose free milk if you can't stomach soya (it is a bit bland!)

Matt
 
It looks to me like your insulin peaks after your food, which tells me that you should wait longer between shot and meal.

I was told Novorapid takes at least 15 min to start being processes in your body. Keeping in mind the glycemic index of your food, you can adjust with each meal to attempt to line up your peaks.

I find that if I eat breakfast cereals I peak like 45 minutes after eating, so I take my insulin like 30 min before the meal otherwise I end up like you and shoot up to 12 before the insulin brings me down.

So it will vary with each type of food, maybe do some reading on glycemic index and you can better understand how long it will take your food to peak and then play around with wait times until you start getting a feel.
 
Thank you for all of your advice. I will try again tomorrow but wait a bit longer and investigate the glycemic index.

I have just started on my novo echo pen which feels a lot better than my original flex pen. The insulin goes in so quickly without clicking down which is great for me as sometimes I can hesitate!

So tomorrow I will try 1.5 units if novorapid, wait 15 mins and see... If this works then great but if not I'll extend it to a 20 minute wait.

Everyday I learn more! Thanks everyone
 
The waiting game is scary at first, but now i try to wait at least 15min, sometimes as long as 30 minutes without any issues yet.

A lot of the time i will check my sugars and they will be between 4-5 pre meal, and i take my insulin and then begin to cook, knowing it will take roughly 20minutes before im actually eating anything and so far so good!

I think if you have dosed properly it will eventually balance itself out. If you eat too soon you will see your sugars spike and then drop rapidly when the insulin catches up, and if you wait too long to eat you will stay flatter after the meal and then maybe raise towards the end when your carbs catch up. I think the end reading after 4 hours will be similar but the path getting to it will be different.
 
asyarlk said:
Thank you for all of your advice. I will try again tomorrow but wait a bit longer and investigate the glycemic index.

I have just started on my novo echo pen which feels a lot better than my original flex pen. The insulin goes in so quickly without clicking down which is great for me as sometimes I can hesitate!

So tomorrow I will try 1.5 units if novorapid, wait 15 mins and see... If this works then great but if not I'll extend it to a 20 minute wait.

Everyday I learn more! Thanks everyone
Click to expand...


Just be careful if you do extend the time period of your injection in case you go hypo, so keep some fast-acting glucose to hand as well as your bg meter.

Without causing too much confusion it does depend on the meal when trying to get the bolus timing right, for example if a meal is high in fat this can delay the digestion of the carbs and this might catch you out if you inject ahead, so usually meals like this would require you to inject just before or after eating, but by trial and error you will find out what best works for you.

The following is a good explanation about preventing postprandial spikes, its from Gary Scheiner (Author of the book Think Like a Pancreas):

http://www.diabetesselfmanagement.c...blood-glucose-management/strike-the-spike-ii/

Pleased you've got the NovoPen Echo, it's a great little pen :)
 
Quick update:
I managed to wait 12 minutes before eating my bran flakes! At this point I was 7mmol. I took 1.5 novorapid.

1 hr post eating 13.9 - bit high!
2hrs post eating 7.7 (happy!)
3hrs post eating 6.0
And then before lunch 5.8

I didn't have a low and also no quick drop towards a hypo!! I feel so much better as hypos are such a drain on energy.

Tomorrow I'm thinking wait 15 mins... Do you think this will curb the 13.9 spike? What should I aim for 1hr after eating? I think 13.9 is a little high.

I am a creature of habit and love branflakes so if I can get this bit right I'll be very pleased!!

Thanks for your help so far! It's great to have this advice otherwise I would have my nurse on speed dial!
 
asyarlk said:
I have bought 'think like a pancreas'.... Brilliant read!
Click to expand...

It certainly is :)

With regards to your spike, by all means try waiting a little longer and see what results you get or you could try adding some healthy fats to your cereal in the way of seeds, adding fat to a meal slows down the absorption of the carbs and does help to reduce postprandial spikes.

Personally, I find porridge is much kinder to postprandial bg levels but if you want to stick with Branflakes then try and find a way around it, good luck anyway.
 
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