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Taking pre-meal readings only

W

WWood56

Active Member
Messages
41
Type of diabetes
Treatment type
Insulin
Hello again

I saw the DN this week. As my BG levels are still running high despite injecting Levemir 16 units at night and 22 in the morning, she has asked me to up the morning injection to 24 and take BG when I wake up and max twice in the day before meals only as maybe I will need to go on a mix or basal/bolus.

I don't understand why she is not interested in post meal readings (2 hours after). I would have thought if she was considering introducing bolus that the post meal readings would be relevant. When I asked she said there was no need as "everyones blood sugar increases after a meal". Well I know that but I thought the fact my post meal readings are anywhere from 12-20 is relevant information?

I also don't like the fact I am injecting night time insulin when I have no idea what my BG levels are at that time as my last BG test would be pre dinner time (5pm ish) and I inject at 9.

I am Type 2/ maybe 1.5. Diagnosed 3 weeks ago. Normal BMI. I just feel lost and that I am not understanding anything well. Can anyone help me understand please?
 
Your readings go up after you've eaten as you know so maybe she wants to see what level you are at before hand.

If you were only picked up 3 weeks ago it's going to be a while yet till they get you balanced.
 
I know I am being impatient, lol. Used to drive my ex husband crazy (probably one of the reasons I am divorced!).

She has already seen plenty of pre-meal readings as I was told by a different DN to test 4-5 times a day when I was diagnosed - morning, night, one pre and post meal and another pre or post meal.
 
I think the reason they are not interested in post meal readings is that there is still insulin working in your system. So, if it is high and you do a correction dose it could cause hypo. I don't fully accept this as I like to know if a new food causes a spike but apart from that I generally only test pre-meal. I always test before bed though.


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Thanks. I will see what she says when I see her next week.
 
been type 1 for 10 yrs now and never go without testing after meals , HBA1c of 5.9 , if you enjoy a varied but healthy diet then i feel it's essential to test after meals . Especially if you drive a lot as i do!
 
Thanks for the replies. This week she upped the dose to 28units in the morning and 16 at night.

Waking readings are fine between 5 and 6.5.
Pre lunch readings: 13.9, 7.4, 11.7, 13.3
Pre dinner readings: 10, 7.3, 6.2, 5.7
Bedtime readings: 13.8, (missing), 14.7, 16.2

I am not sure what to make of it all really.
 
Have you asked for an anto body test? (GAAD i think?)
 
No I haven't. What would that be for?

I had a hard enough time getting a HBa1c test done when my initial fasting test came back normal. The hb test came out as 10.8. Coupled with my second fasting test of 11 mmol, they told me I was diabetic after all and type 2, maybe 1.5.
 
It would help if the DN would return my calls. So frustrating. I feel like I have been diagnosed and dumped because my levels have come down from scary levels.

I have upped morning dose to 30. Pre-meal readings are generally 12 - 15. I had one reading of 6 when I hadn't eaten for hours and had been very busy.

I guess I will just have to keep calling.

Rant over.
 
I also don't like the fact I am injecting night time insulin when I have no idea what my BG levels are at that time as my last BG test would be pre dinner time (5pm ish) and I inject at 9.
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Well, the insulin you take won't have any immediate effect on your blood sugar, and I am not aware of anyone suggestion to change basal insulin based on an acute high/low so there is no need to worry about that part.

Pre-meal readings are generally 12 - 15.
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That could suggest that you don't need bolus insulin - BG of 15 in the morning is waaaay to high (5 is normal) but BG seems to return to this baseline before the next meal.
I don't understand whey your DSN would bother with this guessing game when you could simply test is beyond me.

Your DSN will be working from the same rule book as we are, and in the meantime I'd suggest having a look at this document by the Greater Glasgow and Clyde diabetes team on insulin adjustment (superficially "8 point profile"); whilst it's technically for children it applies to adults as well and is one of the easiest to understand guides I've seen
 
That link is really helpful, thank you!

Btw, my morning (waking and pre-breakfast) readings are fine, between 5 and 6. It is the pre-lunch and dinner and night time readings that are 12-15. I will call the DN again today.
 
Btw, my morning (waking and pre-breakfast) readings are fine, between 5 and 6.
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In that case, I'd say basal is fine but you need bolus but I don't know the protocol for adding bolus to T2 regimes - you probably have 20ish BG after meals and you'd ideally want that to be <7.8.
 
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