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Really puzzled by these sudden pre-lunch spikes!

V

victry77

Well-Known Member
Messages
260
Hello, wondered if anyone could cast their eye over these numbers and offer an opinion or two :)

Insulin
Levemir - A split dose of 4.5u before bed (10.00-10.30pm) and another dose of 4u at the same time in the morning.
Novorapid - Ratios between 1:7 and 1:8

OK, for the last four days I've been getting massive spikes when I test prior to lunch. My breakfast is always the same (half a bowl of porridge with a splash of milk, mixed nuts and a sprinkling of chopped fruit, half a piece of burgen bread toasted with butter). I take 4.5u for this with a 0.5u increase or decrease if needed at any particular time. My pre-lunch readings are generally fine (depending on the usual variables) but I normally come in anything from 5's-8's. I would normally have my lunch four hours after my breakfast.

But a few days ago, this started happening;

Wed
Morning - 6.7
lunch - 15.8
Gave a 2u correction with lunch which brought me in the 5's by my dinner at 6pm

Thurs
Morning - 6.1
lunch - 16.3
Another 2u correction which took me to the 5's again by dinner.

Fri
Morning - 7.1 (I decided to give myself an additional 2u in case I was very high again at lunch)
lunch - 17.3 (No effect from morning increase. Gave 2u correction)
Dinner - 17.1 (No effect again from correction. Gave an additional 3u correction with dinner)

I was up into the 20's in the evening. Took another 4u to bring me down to 8.5 by bed.

So, my waking reading today was 5.9. I went back to taking the usual 4.5u and I have just tested again (an hour earlier than I normally would for lunch) and I'm 16.3!! :banghead:

A couple of years ago when I was getting consecutive high readings later in the afternoon, I was able to successfully split my basal dose which remedied the problem. This time, though, I just have no clue what is creating such a spike. There have been times in the past were I have increased to 5-5.5u due to pre-lunch readings being 10-11. But this stopped after a short while. Those kind of spikes are not too alarming but getting way up in the teens is, especially like yesterday, hitting 20!!

Does anyone have any ideas as I'm really puzzled o_O
 
That is indeed puzzling!

Are you under any amount of unusual stress? Maybe you're getting ill/already not feeling so great? No hypos preceding any of these high readings?
 
Nope, nothing unusual going on. That's what is really puzzling me. Although, illness, such as colds/bugs never really spike me all that much. No hypos prior to spikes either.
 
If your morning readings are consistently in the right ball park, it looks like your total daily dose is about right. Could your basal be too high, compensating for a too low ICR? In other words, your basal insulin is dealing with the carbs that your bolus insulin is not sufficient for?

Regards.
 
A question I'd be asking myself is am I eating porridge hot (freshly made) or cold.
I spike less with reheated porridge, potatoes and rice.
Your porridge eating routine different? It seems how you cook carbs can make a difference for me.
 
For two years I was fine, then the same thing happened as you. I wouldn't go as high but I don't eat carbs. So now what I do is take my bs one hour after I eat an dif I'm rising ( which I always am) I take a small dose to stop the rise. Then two and a half hours later I test nad if I'm starting to rise I take another small dose. So usually 3 small doses between bf and lunch. I eat bf at 8 and lunch at 3. This system keeps me rock steady but loads of testing to figure out when the rises started.

If I skip bf it's worse!!

Do you bolus at all ahead of time?
 
So, I took a correction dose of 3u with my lunch today given I'd gone up to 16.3.

I tested 3hrs after lunch at 4.30pm and I was 7.9, but then I tested again 2hrs later before my dinner and I'd risen to 14!

Interestingly, Catapillar, you mentioned by the Levemir pen. I took the cartridge out and checked it (it is fairly new) all seemed fine but then when I put it back in and did air shots, nothing was coming out at all. I'm now wondering if it hasn't been delivering the full doses. Weird though, that the night doses seemed fine seen as though I was waking up with good numbers. I've changed the cartridge, though, so I'll soon seen of that was the problem. Thank you for thinking of this Catapillar. It's something obvious I should have checked but it really never occurred to me.

Shiba Park, thank you for the suggestion. Not thought of that, if the cartridge change doesn't help, then I will look at this.

ickihun, I've had the same breakfast for years prepared in exactly the same way, not sure why it would suddenly spike me so high but I guess anything is possible, eh?

noblehead, I'll see if this new cartridge makes any difference and if not, I will get straight on to a basal test. Thanks.

Kristin, yeah it's weird how things can suddenly change. I don't bolus too far ahead of time, but my routine hasn't changed, obviously, that's not to say my insulin needs won't change. So, I'll deffo try bolusing a bit earlier.
 
Daft question, have you checked your bolus pen too? I think you mentioned a few corrections that did nothing, might be worth swapping the cartridge and see how you go...
 
Victry, I always say the wind blew a different direction. Yours seems to be quite a gust though. I know I need a bit more insulin in colder gloomier weather. Believe it or not even the sun can change it. Could be I thrive in sun and don't get enough here.

The scary thing is things change back just as fast.

I tend to bolus 10 min before but I don't eat any carbs to speak of. But if your routine worked and now not that is really weird given your differences.

I used to eat one whole avocado bf and bolus one unit and stay steady until lunch. Now half and need two small units in between and staggered. However I have only been on insulin for three years. C peptide was .6 last year so my honeymoon seems to be over. Perhaps a pump would help but not ready for any new challenges right now. Tummy sticks don't bother me, it's the fingers and a pump doesn't elevate that.

Some days a half unit correction drops me 30 and some days nothing. I eat the same foods like you do. Frustrating to say the least...
 
Well, pleased to report a return to normal levels today. So, I can only assume it was the cartridge to blame. Weird, because when I went to bed after I'd put in a new levemir cartridge, it dawned on me that the reason I was getting nothing from the air shots was because when took the cartridge out to check it, I pushed back the windy thing that pushes it down with each dose and would have needed quite a few more air shots to get it back down to the right level.

Kristin, yes it can all be very frustrating, especially as you say, how quickly things can change. It was only a short while agao I was needing to reduce m breakfast doses due to sudden hypos before lunch.
 
I would say the over night insulin is not enough that happened to me so I up my over night insulin
 
Sometimes when the air shots don't work right changing the needle solves it. Some are clogged from the get go and some fire like crazy.
 
Yes I have had that problem too but I just change the needle make sure you check the pen to see how much insulin has gone in because you don't want to go low I wish there was someone who lived near me so I could meet up with I think that will help a lot
 
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