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Post meals BG

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nicola30

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5
Hi everyone, I have been reading your posts and I have found them very useful, so thank you.

I wondered if anyone could help? I was diagnosed with type 1 4 months ago, and I thought I was controlling it really well, but been to the docs yesterday and he said he would like my BG levels to be around 7.9 1-2 hours after meals, I am really struggling to do this. normally the are over 12, 2 hours after eating, but then drip to around 5 before meals. I am carb counting, and on a long acting insulin at night and fast acting with meals, do I need to take more fast acting?? oh I don't know what to do :crazy: .

thanks for any help xxxxx :D :D
 
By the sounds of it, you're taking too much long acting and not enough fast acting.

Have you done fasting basal tests? That will let you know if your long acting dose is correct. And then once you've got that sorted you can work on your fast acting ratios!

I was diagnosed 5 months ago :)
 
Your pre-meal levels are fine so I wouldn't worry too much to be honest. The only thing you can look at is what sort of foods you are eating. Even though you're counting carbs, it also depends on the Glycemic Index ( GI ) of the carbs. Google it. Certain carbs with a higher GI, e.g. rice, will cause a sharper rise in BG levels. Lower GI foods are slower releasing so you won't get higher spikes and your post meal readings will be lower. I know, it's so confusing lol ! I was exactly the same as you, I just counted carbs and pretty much ate anything. I never really tested post meal as all my pre-meal readings were fine. I only learned this myself a couple of months back. The idea is exactly the same, count the carbs. Just try for foods lower in GI. Good luck !
Mo
 
A couple of suggestions that might work for you as they did for me...

Try and read as much as you can about the Glycemic Index, there's some good books out there and you'll find a good selection of them on Amazon.

You could also try injecting your insulin 15-20 mins before you eat to give your insulin a head start on your food, I found by doing it made a big difference to postprandial spikes but I suggest you speak with your DSN first before attempting it, If you purchase the book Think Like a Pancreas by Gary Scheiner he talks about this in his book...... as well as loads of other helpful tips and advice.

Good luck!
 
Good advice so far, and as hale said the only way to be sure is to test your basal by missing lunch to see what happens to your levels. To do this you must not eat for 4 hours prior to the test. This includes any sugary drinks. Could be the gi of food as pointed out by mo, causing a sharp rise followed by a sharp fall. I had this exact problem when on mdi. Was my basal too high for the time of day, but when reduced basal was high in the morning. In the end I had the right basal for a good morning reading, used extra qa for lunch so I would be under 8. But, by doing so I knew I would need a carby snack usually 20 carbs to stay steady and avoid a hypo before tea. In effect feeding tbe last 2 hours of qa insulin. Now pumping am able to have different hourly basal rates.

Sent from my GT-S5360 using DCUK Forum mobile app
 
I'm not a T1 and don't use insulin, so I have no personal experience of your problem. However, I'm married to a T1 and we both found the book Dr. Bernstein's Diabetes Solution most helpful. Libraries don't seem to have it, but since it's not cheap, I'd ask there first, then go to Amazon.
Hana
 
this is all great advice thank you, I think ill have to look at what I am eating more, I don't think it helps very one I see dietician, DN and the doctor tells me different things, I think I have it clear then someone else tells me I should be doing something else

Nicola xxx
 
For type 1s a great book is Think Like A Pancreas. It explains everything ranging from basal tests to GI of food etc. I read it about a month after diagnosis and it has helped me so much!
 
Good advice so far. I'll throw my hat into the ring...

By two hours after eating/injecting your levels should be around the same as your pre-meal levels, if not your fast acting insulin needs changing. In my experience the two hour test should be consistent regardless of the GI index. A test 1 hour after eating will give you an indication of whether the food was too high in GI.

If you work on the basis that 1u of Novorapid will drop your levels by 2-3 mmol/l then you can adjust your insulin accordingly.

As hale said, if you experience much change between your post-meal reading and your next pre-meal reading then its likely that your Lantus needs changing. Pending any physical activity that may have changed it. The best indication that your Lantus needs changing is by comparing overnight levels.

Diabetes UK state that 2 hours after eating your levels should be less than 9 mmol/l.
 
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