Post-meal high blood sugars - how to beat?

[Barney Willis]

Hi there folks!

So I am a member of the needle club (type one) for almost 8 years now. I have recently been redoubling my efforts to get the sugars under control after I came back positive for early moderate background retinopathy in one eye. I wanted to ask a question that has been worrying me:

After my evening meal (within 30mins-1hr of finishing), I notice my blood sugars elevate to very high levels (between 14-18mmol). The insulin brings be down to within the acceptable range by the time I go to bed. Any attempt to raise my insulin dose means I hit hypo when I go to bed.

So how can I avoid this bump? I know they naturally raise after meals so is it just a case of ensuring my sugars are at the right level before the meal? Is it the short term raising of blood sugars that does the damage or is it more having it elevated over longer periods of time?


Thanks




Barney.

 

[ElyDave]

1) why are you testing 30 mins to 1 hour after a meal? Even those who advocate post meal testting suggest 2 hours later and a 2-3mmol/l rise as a target.

2) I've been having some highs recently and have also been reading Pumping Insulin as I'm getting a pump later this year. One bit of advice I've picked up there is that the insulin takes 20 mis to kick in, so taking it 15-20 mins pre meal depending on level before and quantity of carbs eaten. I've tried that with some success

3) are you simply eating too many carbs at a sitting? The more you eat teh harder to get control even if you have the right ratio and good carb counting

 

[mo1905]

As Dave says, not much point in testing 30-60mins after eating as the insulin will not have had time to work. Having said that, readings of 14-18 seem very high. What are pre-meal readings and what sort of foods do you eat ?

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[Barney Willis]

I decided to test at that time out of curiosity more than anything - I wondered what my sugars were doing during that time! I dont think it is down to overcarbing - my shots are quite modest and, going on the reading I get before bed, on target for how much I am eating. My pre-evening meal readings are usually a bit elevated - around the 10 mark.

If the insulin has not had time to work within 30-60 mins after eating, I am guessing the food will have? Working on the idea that, when treating hypo's, food starts working to raise the sugars within 10 minutes. I think I might give Dave's idea of doing the insulin 15 mins before the meal a try - I want to see my readings never get above 10!

 

[CarbsRok]

The simplest way to stop after meal spikes is to inject at least 30 mins before you eat
Have you actually done any basal testing, so that you know exactly what effect your basal has on you at that time of the evening? Once armed with all relevant info you can then attack the problem with full knowledge.

 

[iHs]

With a bg of 10mmol before eating, a bg of 14mmol within 1hr, is not that bad. Are you giving yrself a correction dose first on the 10mmol so that the corrrction gets you back to a better target and waiting about 30-45mins before doing another bolus to eat food?

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[joha1971]

According to my diabetes care team: "fast acting insulin lasts for 4 hours so whilst it's OK to test after 2 hrs you should never take a corrective dose based on the results. Test before your next meal and correct accordingly.
If it is still high after the 4 hours then it may be due to your basal dose."

Diabetes is so complex with so much to take in and learn. Thank goodness for forums!