Type 1 Spiking 3 hours after meals

[JMoli]

Hi, I go through periods when I spike three-three and a half hours after lunch. I tend to have a sandwich and either a vegan cookie or crisps and pre bolus 10 mins, stay really nicely in range and then suddenly spike hours later. Does this mean that I should split bolus or extend/decrease my pre bolus timings? Any help would be great, I just can’t work this out?!

 

[KK123]

Hi, I go through periods when I spike three-three and a half hours after lunch. I tend to have a sandwich and either a vegan cookie or crisps and pre bolus 10 mins, stay really nicely in range and then suddenly spike hours later. Does this mean that I should split bolus or extend/decrease my pre bolus timings? Any help would be great, I just can’t work this out?!

Hi there, obviously we can't say what you should do but this happens to me too with certain foods (generally foods that are a mix of carbs & fat meaning there is sometimes a delay in digestion of the carbs because the fats are mucking it up..technical term). I know from my experience that my insulin will kick in to begin with and place me in range after 2 hours or so but then on hour 3, 4 or 5 it will start to rise again. To counteract this I may use another unit of insulin after the 3 or 4 hour mark (again, ONLY because I know myself and can make a very educated 'guess' at when to do it).It's called stacking and it can be very tricky to manage so whatever you do, make sure you test and test and test, it's VERY easy to miscalculate and end up hypo instead. Many do it for things like pizza or anything which is notoriously hard to bolus for as it can take a long time to digest.

 

[SJT1D]

It really is personal. Even different foods can do this for me! For example, I know for a sandwich I need to pre-bolus earlier (about 20-25 minutes, instead of my usual 10 -15). However for a pizza, this does not work. Instead, I need to do my normal 10 minutes pre-bolus, but at only 50% of the ratio, and then I need to take the other 50% at 45 minutes after I have finished eating. Each person is different, and even each food is different (makes our lives so easy to manage, doesn't it? Sigh).

I'd suggest maybe keeping a food diary for a week or two - write down what you eat, and the carb count etc - make a note of your pre-bolus times, test 2 hours after each meal, and see if there is a pattern with certain foods. It may be that there is no pattern, and each foods are different, but it would at least give you a starting point, and evidence, to discuss with your medical team, who would then hopefully be able to advise

 

[JMoli]

Hi there, obviously we can't say what you should do but this happens to me too with certain foods (generally foods that are a mix of carbs & fat meaning there is sometimes a delay in digestion of the carbs because the fats are mucking it up..technical term). I know from my experience that my insulin will kick in to begin with and place me in range after 2 hours or so but then on hour 3, 4 or 5 it will start to rise again. To counteract this I may use another unit of insulin after the 3 or 4 hour mark (again, ONLY because I know myself and can make a very educated 'guess' at when to do it).It's called stacking and it can be very tricky to manage so whatever you do, make sure you test and test and test, it's VERY easy to miscalculate and end up hypo instead. Many do it for things like pizza or anything which is notoriously hard to bolus for as it can take a long time to digest.

Yes, I think it must be the crisps/dessert that’s causing this to happen as I’ve tried sandwiches with all types of fillings and never have this problem until I add the other stuff - trying to increase my carbs to gain weight but I’m probably walking off all the calories with the three hour spike, ugh. I’m a bit scared of stacking but have started to read about sugar surfing, I’m assuming this is a similar idea. I’m going to try a split bolus tomorrow and see how that goes, I was hoping there would be an easy solution but guess it’s more experimenting! x

 

[JMoli]

It really is personal. Even different foods can do this for me! For example, I know for a sandwich I need to pre-bolus earlier (about 20-25 minutes, instead of my usual 10 -15). However for a pizza, this does not work. Instead, I need to do my normal 10 minutes pre-bolus, but at only 50% of the ratio, and then I need to take the other 50% at 45 minutes after I have finished eating. Each person is different, and even each food is different (makes our lives so easy to manage, doesn't it? Sigh).

I'd suggest maybe keeping a food diary for a week or two - write down what you eat, and the carb count etc - make a note of your pre-bolus times, test 2 hours after each meal, and see if there is a pattern with certain foods. It may be that there is no pattern, and each foods are different, but it would at least give you a starting point, and evidence, to discuss with your medical team, who would then hopefully be able to advise

Thanks, lucky you having cracked pizza! This only seems to be a problem with sandwiches when I add something fattier (pudding etc) I’ve worked out split bolus for other foods with some/sometimes very little success because I would go low after eating then high later but with sandwiches I don’t go low, I just go high but not a quick high. So I’m thinking I may have to split bolus but I was hoping I wouldn’t have to I suppose. Aargh, why can’t we all be the same and there would be a standard rule book to follow!