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Seem to have higher BGs for too long after meals

B

bonerp

Well-Known Member
Of late I have had a vitrectomy so it has kinda stopped me from doing much exercise etc. I guess this is impacting somewhat on my control which doesnt help when i need tight control at the mo grrrr.

I now seem to eat and do my usual bolus but even up 3 to 4 hours after the meal my BGs are high (circa 11-13).

Im not sure whether I might be becoming a little insulin resistant, but if I do more bolus mid pm to bring it down, I then crash an hour or so before evening meal for example.

Any suggestions?? I am going to try to do some basal testing but doubt that will tell me much as the problem seems to be post meals. Trying to get to less than 9, 2 hours after eating like the guidelines suggest is nigh on impossible.

cheers
Paul
 
Hi Paul,

I know my insulin requirements go up as soon as I stop exercising regularly. By that I mean going from running/gym/sport 5 times a week , to maximum once a week.

Is that what you mean by ' kinda stopped me from doing much exercise etc'? If so, it's very possible that this has affected your insulin ratios.

I'm not on a pump, but pressume the same principles apply regarding activity levels and amount of insulin required.

Did you plan for higher or lower activity levels when you started on a pump? The reason I ask is that I'm getting a pump in January and will be pushing the diabetes care team to help me out in that area.

Regards,
Sam.
 
I have pretty much given up any vigorous exercise and have done for past 4 months. I have increased basal rate and even increasing bolus still doesnt bring down the BGs quick enough. I am on Apidra as the is the quickest acting insulin too.

I have tried different cannulas and sites too.

Does the cold weather slow down absorbtion of insulin?
 
Bonerp

If you have done a basal test for a while, worth checking but from what you saying,,

You need to build an exercise profile on you pump, so the basal rate is set the compensate for the extra insulin needs you have after exercise..

This will also over come your problem with a correction dose sending taking you to low..

To help you build your exercise profile, take a look at before exercise, and after you may have to look at a long time after for an exercise time lack of effect on BG, check when you've taken your correction and how long between taking it, and you get too low as this is where you exercise might be catching up with you..
 
I know that when I go out for my afternoon walk with dogs directly after having my lunch, my levels would go low quickly. I am now bolusing at 1:17 for my lunch, and have also lowered my basals right down to 0.25 2 hours before my walk. This is just moderate exercise. My consultant told me that if my levels are going too high or too low 3-4 hours after I have ate, then it will be my bolus's that are incorrect. The rest of my bolus's are either 1:10 or 1:9, so I have had to change mine hugely due to the dog walk, as I was initially set up with everything at 1:10.

If you are going high after meals, then you should perhaps try changing your bolus to 1:12, then 1:11 and downward etc until they no longer spike. As well as of course trying to get a basal rate fasting done.....
 
the issue isnt exercise but probably more to do with lack of!! I have a rate when exercising that works.

Heres another example....

Last night went to bed on 9.8 so did a quick 2 unit squirt. Woke at 5am to 9.5 so did a couple more. Went to bed got up at 6.30am to 9.8 grrrr. 4 units and an increase to basal rate did nothing. btw at teatime my bg was 5.6 and I only ate some smoked haddock, a sweat spud baked and fresh veg.

The previous night my background worked fine... what the heck is going on??!

I have now increased my basal rate from 30 units per day to 35! I can't basal test as not able to get a stable couple of days to try it.

Whats making this worse is I really need good control following eye op and this isnt good!

I'm wonderin whether I have a bad batch of insulin?

thanks
 
I've noticed my daughter's readings will creap up slowly after she's had a meal with protein, like fish. She particularly likes fish so tends to have a large-ish piece. The protein seems to raise blood sugars over a period of a few hours but very gradually. The previous night when your bloods were good did you have a similar size portion of protein?

Your reduced exercise levels will have an affect on your basal rates. If we have a fairly inactive weekend we increase her basal injection over the weekend to compensate.

As you've recently had surgery have you ruled out the possibility of a mild infection that might be affecting your blood sugars? You may also want to ask your consultant if the blood sugars you're experiencing might be an after effect of surgery (not sure if you had a local or general anesthetic for that procedure) but I would guess that it might have some sort of effect. Stress also affects blood sugars so if you're more stressed than usual it might account for the inconsistent numbers?
 
Are you still using eye drops after your eye operation?

Eye drops tend to have a steriod in them, and this can bump up blood glucose, even in this small amount for some can have quite an affect on the BG..

Even though you say you are unstable, you still need to do basal checking, it might be that you have to do several for each section, but any information you get is better than nothing...

You might be better if your levels are being stubon with correction, actually doing a super/dual correction bolus to move them down..

Stand correction bolus but set a TBR for an hour or so, this generally more effective and brings them down quicker..

But also to look at is what you are doing, even though you say you'll not exercising (your normal exercise) you might have replaced it with another activitiy, I was suprised by how much my levels can drop just doing the ironing, not something that I would consider high activity, but Hubby gets the same sort of drop with ironing.. Polishing is the same so look at these types of activities simple ones that you don't think takes engery you may be wrong..
 
Hello Paul

This might be a basic stupid thing to say to you, but rather than altering your insulin to suit the carb, have you tried the other way and that is to alter the carb to suit the insulin. You'll probably be ok just reducing the amount of carb that you are eating so that you don't go so high. Sometimes just knocking 2 or 3gms of carb off food can work wonders and is so much easier :wink:
 
I've reduced carbs by eating veg and sweet spuds rather than normal spuds. Fish hasn't anything in but agree the protein may be affecting BGs a little as I'm inactive. Need a borrow a dog for a couple of weeks lol

Will try the idea of using temp rates more to increase over an hour or so. Like this idea. I also always thought that if I did a basal rate check with high BGs I'd just get a duff reading over that period? Hence trying to stabilise the area for a day then doing the test?

I have also been off the eye drops for a month now - the op was in early Sept and dont think I have any infection to do with that although have had a cold and cant shift the cough...

Maybe need an mot like my car had last night - that passed btw. Not sure I would at the mo lol.
 
bonerp said:
Need a borrow a dog for a couple of weeks lol
Click to expand...

Hana (hanadr) is always offering to lend her dogs to people who need a dog to walk! I wonder if you live near her? :) There goes your excuse... :lol: I doubt that she would part with them for a couple of weeks though, more like a couple of hours.
 
still having bother guys....

2 nights ago went to bed on 6.9 woke at 7.5. So basal is right for that period.....you'd think.
Went to work but had usual breakfast and usual bolus 1/1.2 ish. 15.7bg 2 hours later grrr took all day to get it down.

Last night had tea and after 2 hrs was 9.2. At bedtime it was 13.8!!! Grrrr.
So did 6 units to drag it down and went to bed.

Got up this morning on 13.5. Going to the vet now and will ask them just to shoot me.
 
Hope the vet says "NO!".

I don't claim to be an expert on pump therapy, I am quite new to it myself, but I do experiment with it...and I have noticed that sometimes this just happens.

How to deal with it? If your Bg was OK before meals, but goes up 2 hours after meals, then I would ask if you have tried any of the other bolus types..extended, or what may be be better, the one where it gives you, say about 50% immediately, then, the rest over an hours period?

If you basal is right...ie keeps yousteady, then, I would work on the bolus's...maybe your carb insulin ratio has changed?

Sorry if I am suggesting things you have already tried. testing and reacting to the results isn't an easy thing to do...but at least you are not staying high for days.

Possibly daft suggestion...are you certain that the pump is working, the lines are clear, no air bubbles etc? I know, if there was an obvious problem...changing teh set etc would have sorted this out, so that is why I was wondering, could the pump piston etc be having an internitant fault? I know, it is a bad chef, that blames the equipent...but maybe worth a quick check?
 
I have been wondering about whether the pump is at fault but I am told they check themselves millions of times a day and against failure. On that basis it should be ok.....

HOWEVER....

This morning 5am - 8.9. Did .5 bolus.

Got up at 7. 11.9!!!

I did 6 units (1/10) and went to have a shower. In 30 mins it had moved .4 downwards!!!

Eventually got it to 7 just prior to lunch. At lunch I had a sandwich and 4 units, and 3 hrs later it was 17.9. I even changed the set (again) and it kept going up until just now, even though I had done further corrections most of the afternoon.

Doc thinks I might have a virus and has given me some amoxycillins...

Still think I have a problem either with the batch of insulin, or pump, or maybe just me.

Anyone else think its worth trying with my spare pump??

I am even thinking of taking a pump break for a few days.

Basel testing not really helping either btw.

I have asked my nurse to provide details if a CGMS system. The medtronic one looks good at £750, and £30 a pop for the sensors...however it integrates better with their pump. As I am on the spirit and dont really want to pay the upgrade costs of a new pump at this point, its a bit out of the question.

Is there a market for 2nd hand pumps?? Comes with a spare!!!

Paul
 
If extra bolus aren't bringing you down, then you have to think of mechanics with pump/set/tubing (piston!!!).....probably a stupid question but have you reprimed to check that insulin is getting through?
 
yes when it shot up earlier I changed the cannula and squirted a little through and it seemed to come through.

On spare pump now so will see!
 
just wanted to give a quick update on this post. I was put on antobiotics for a viral infection following a cold. 4/5 days into a 7 fay course, bgs started to improve and now they are back where they were.

I'd left it for a good 2/3 weeks of poor control and trying to get it back under control to no avail, before I saw my quack.

Just remember folks, its not always down to something that you have control over....it may be viral! See a doc.
 
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