Ratio advice

[hale710]

I think my lunch ratio could be wrong but I'm not sure!

Monday 7.1 before 10.6 after..... But 5.5 by dinner

Tuesday 5.7 before 7.9 after.... 9.7 dinner (10g sometimes in between)

Today 6.8 before and 12.6 afterwards

I'm on a 0.5u per 6g currently. Should I change that to a 1:1 do you think? Afternoon highs are giving me a headache! But I'm worried that I often drop by dinner time even though I don't take a correction

The only reason I check after lunch (approx 4 hours) is before I drive


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[Engineer88]

hummmm I think we could do with more data hale. could we have a couple of 2 hour post readings and then a 4 hour post? am i right in thinking you split basal already?

 

[hale710]

No set basal dose of 2 units a day taken in the evening. I did basal testing overnight just after Xmas and it seemed correct. So I've no idea what's dropping me after 4pm! All I do is drive home, then vegetate lol occasionally take a shower which isn't exactly strenuous

I'll find my spare meter tonight and use it for a 2 hour reading. I have the doctor in Friday and he takes the readings off my meter and already shouts at me for testing too much. But he won't know I'm doing sneaky extra tests on my spare all the after readings above are at the 3.5 - 4.5 mark.

I don't like to correct between meals but ive taken a half unit before I drove home today (usually takes me down approx 3mmol/l) because my head was pounding at a 12!


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[mo1905]

If it's just lunchtime when you're having a problem I'd leave basal alone. May need to up your QA before lunch ? I agree though, more readings required.


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[Engineer88]

my thoughts are likely your basal is actually running out rather than your bolus being wrong. could you do a basal test in the afternoon after eating a carb free lunch? Omlette or similar should suffice.

 

[mo1905]

I'd have thought if basal running out you would have steadily got higher well into the evening too ?


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[hale710]

Yes that was my thought too mo, I take basal at 7pm with dinner so if it was running out I'd be even higher at dinner rather than lower?

I'll stick with the current ratio tomorrow and do extra tests. Then I'm off again until Monday so I won't include any weekend tests as I'm more active so it's not comparable!


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[mrman]

Hm, going low that time with a decent level after your qa has done its job, suggests thats the time you got too much basal, all be it 2 ubits, which, if you dropped you would have high morning readings, or thats the time your body is able to kick out a bit extra. If its happening regular, you need a suitable snack to have inbetween or, a larger snack to cover with a small amount if qa to get you to tea time.

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[noblehead]

I think my lunch ratio could be wrong but I'm not sure!

Monday 7.1 before 10.6 after..... But 5.5 by dinner

Tuesday 5.7 before 7.9 after.... 9.7 dinner (10g sometimes in between)

Today 6.8 before and 12.6 afterwards

I'm on a 0.5u per 6g currently. Should I change that to a 1:1 do you think? Afternoon highs are giving me a headache! But I'm worried that I often drop by dinner time even though I don't take a correction

The only reason I check after lunch (approx 4 hours) is before I drive

Not much to go on as others have said. The Monday readings before dinner looks fine and to avoid the 10.6 (and 12.6 spike you had today) try injecting 10-20 mins before eating as this might help, Tuesdays 9.7 before dinner would be down to the 10g snack you had, without insulin I too would see a bg rise as basal/bolus doesn't allow for snacking on carbs between meals unless you inject or your basal insulin is set too high.

 

[hale710]

The pre dinner reading I'm happy enough with, it's the 4 hour after I'm questioning.

I inject at my desk before going down to get my lunch. Usually that's a 10-15 minute gap between physically sitting to eat.

If I up the lunch dose I would need a snack daily at about 5pm to prevent me being too low. But then I get stuck in the stupid area of not actually wanting to eat always!

Ill monitor another week and throw in some 2 hour after testing to see what the spike is


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[hale710]

Spare meter located. Let the sneaky-behind-my-doctors-back testing begin


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[Engineer88]

I would normally agree that if basal was running out you would go higher but Hale is a rare beast who is still in honeymoon as indicated by only needing tiny amounts of insulin anyway. I would suggest your QA is fine (also possible it doesnt kick in quick enough but 4 hours post would not show this) and that you produce enough insulin naturally to bring BG down by before dinner and then continue.

Thats what I would be thinking anyway.

 

[hale710]

I have to agree about kicking in, I've thought previously that my insulin takes longer that you'd expect.

Ill attempt a lunch time basal test this weekend. I'm not promising anything though because weekends are often busy so I reduce my insulin anyway. Saturday could be a quiet one so I might manage then. (Provided I've stocked up on sufficient amounts of sugar free jelly haha)


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[Engineer88]

mine doesnt even start working for two hours and then bam drops like a rock. I'm talking I get frequent fall alerts from my CGM because im dropping at more than 0.17m/mol a min (1.7 m/mol in 10 mins)

 

[hale710]

Hence we should all have cgms!


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[hale710]

Does that mean you have fairly high spikes at 2 hours?

I don't tend to check then as per DAFNE guidelines (my fingers thank me for it) but out of curiosity I just did 2 hours after breakfast. Well that's plain terrifying.....


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[Engineer88]

yeah my 2 hour spikes can be huge (obviously im not as controled as you) say before meal im 12 then a large carb meal (rare these days) 70g of carbs thats a 14m/mol spike roughly. you see where im going...

Ps i ignore dafne on that case. limiting testing is poor at best. sensible testing is better. CGM reduces testing massively.

 

[hale710]

7.9 before breakfast and 13.7 at the 2 hour mark. Not ideal! 40g carb (a standard size for me for most meals) and 2.5 QA

I understand the spikes being an issue and that's why you test at 2 hour mark. But I'm always (or usually anyway) back to within range by the next meal so when I check at two hours and see it high I want to correct, but if I correct I'll be hypo by the next meal. Cue a shambles! So it's kind of lose lose


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[hale710]

BG 9.3 before lunch. Shambles. Definitely feels like honeymoon is ending. I eat this breakfast 3 or 4 times a week with no trouble. Fml.


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[Engineer88]

this is why Im an engineer not a dr of med. I have no bedside manner. My blood was 9.8 and i just had a wedge of cake. *shrug* **** happens its not the end of the world.

What time do you eat roughly? brek, lunch,dinner?