post prandial highs

Do you carb count? Are you content that you have accurately counted the carbs in the meals that send you up to 400 (22)? Do you think your insulin to carb ratio is correct or could it need adjusting?

What is your pre prandial blood sugar?

What are you eating? Some foods can be quite tough to manage and might just mean taking a spike, but up to 22 seems rather a dramatic.

Do you pre bolus and wait for the insulin to start working before you eat?

This is a good article on striking the spike - https://www.diabetesselfmanagement....blood-glucose-management/strike-the-spike-ii/

glutenboy said:

Prob with pre bolus is that no matter what site i use belly 3-4 hours legs 4-6 i get these super highs for a couple of hours

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So do you have problems with your injection sites and insulin absorption, have you checked for lipohypertrophy in your injection sites?

Are you saying you have tried pre bolusing and you know it takes up to 6 hours for the insulin to start working? Usually it's more around the 30 minute mark. So if you have tried pre bolusing and you know your insulin is that delayed you might need to discuss alternative insulins with your healthcare team.

I have similar issues. Been t1 for about 20 yrs but just started using CGM about 3 weeks ago and pump about 2 months ago. My numbers will go to 350 or so for about 4 hours. During this time I will bolus several
times with 3 or 4 units. This seems to have no effect, even tried using standby pen with fresh humalog. When time period is up, things go back to normal, but I may have some insulin on board to deal with. During normal times, a 12 to 1 ratio works good. This morning I had 22 carbs with breakfast and it triggered the event of 4 hours at 320 and about 16 units of insulin to try and hold it steady......

Google "glycemic index" of foods/carbs. I use the same insulins you do, and to be honest I usually don't check mine 2 hrs post prandial, usually only before meals and bedtime and AM. But when I do they are never 350-400. But I do low glycemic carbs, maybe 50-80g/meal max. 1U/12g carbs is what I inject.