Trying to understand BG levels

[Sobo82]

Hi just wondering if anyone experienced anything similar with me being newly diagnosed and obviously still learning i test my levels a lot trying to understand what foods do what to me and I’ve been more than happy with my progress over a short period of time but I’m noticing now that after 3hrs of my meals I’m dropping into the low 4s and sometimes 3s this has been happening over the last 4/5 days
Example before meal 5.5 2hrs after meal more or less same BG reading making me think my carb counting was going good but now 3/4hrs after meal I’m dropping low
Long lasting insulin 14 units 8pm each day
Novorapid 2 units to 10g carbs ratio
Any advice great full
Thanks Shaun

 

[Juicyj]

Hi @Sobo82

A change in your blood glucose readings means you need to review your insulin doses, so as a priority call your nurse today to review your insulin doses.

As your newly diagnosed you can experience the honeymoon phase which is where your pancreas will spring back into life for a short period of time, it is temporary but means your insulin doses will need careful monitoring to avoid hypos.

We cannot advise you in changes to your insulin here so hopefully a call to review today will sort this, let us know how you get on ?

Best wishes.

 

[Sobo82]

Hi @Sobo82

A change in your blood glucose readings means you need to review your insulin doses, so as a priority call your nurse today to review your insulin doses.

As your newly diagnosed you can experience the honeymoon phase which is where your pancreas will spring back into life for a short period of time, it is temporary but means your insulin doses will need careful monitoring to avoid hypos.

We cannot advise you in changes to your insulin here so hopefully a call to review today will sort this, let us know how you get on ?

Best wishes.

Thanks for reply juicyj yes I’ll ring today see what they say just confused why 3hrs after when 2hrs after getting good results I was going to change to a 1.5 from 2 units to 10g carbs ratio but didn’t want spike to high at the 2hr test

 

[catapillar]

To see if your insulin:carb ratio is working you are better off testing at 4 or 5 hours after injecting, as this is the duration of action of novorapid.

You are currently on a 1:5 ratio. This is double the standard starting point ratio of 1:10, which would be fairly unusual in someone newly diagnosed who is more likely to be more insulin sensitive, rather than less.

If you are going hypo at 3 hours post bolus, this suggests your bolus is too high.

When do you bolus and eat? Do you bolus and then eat immediately, or do you pre-bolus? If you bolus 15, 20, 30 minutes before eating this can help to avoid a post prandial rise and also result in a lowering of the I:C ratio because it means the insulin is in and working before the food hits the system, so it works more efficiently.

 

[novorapidboi26]

My first thoughts would be the insulin/carb ratio is out....but thats me assuming the insulin is gone by 5 hours......

So its a good idea to try and work out, on average, how long your bolus doses are lasting....

But ultimately a low is happening and so you will need to review the doses...

A similar BG to the pre meal at 2 hours although great, suggest the timing may also be out a bit....as in you may have left too much time from injecting till eating....

lots of things it could be....

 

[karen8967]

hi sobo82 im waiting to go on a carb counting course but its not till april 2018 so at the moment i use the ratio 1:10 i used to test 2 hrs after meals and my bgs used to be quite high but by 4/5 hours i was bk in range if i done the same ratio as you i would drop too low speak to your dn and see what she suggests as what is works for 1 person will not nessasarily work for someone else as were all different ,when i was first diagnosed i was on set doses of insulin and couldnt even walk across the room without collapsing from a hypo scarey stuff anyway hope your sorted soon let me know how you get on

 

[Scott-C]

Agree with all of the above. I'd encourage newbies to bear in mind that T1 is an inherently unpredictable condition. Figuring out correct ratios, pre-bolus timings etc is certainly a good starting point. But the truth of it is that once you inject insulin and eat food, they are going into a complex biological, chemical environment which involves factors that we simply can't measure but which may have a substantial influence on matters. For example, the same dose of insulin won't necessarily act in the same way two days running - some of it might be destroyed before it gets to work. Food might digest at different rates.

This uncertainty can be hugely frustrating even for experienced T1s. But it's important to realise that if something goes wrong, even once you're reasonably certain about ratios etc. it really doesn't mean you've failed. Sure some instances will be down to a miscalc (treat those as learning experiences) but others will simply be bodily processes just throwing some random stuff. So don't get too dispirited if it doesn't always go to plan - it's just the nature of the thing.

You'll maybe have noticed discussions about libre and cgm. These will become more and more common as time goes by. They are massively powerful tools for making small adjustments on the fly, in the moment, to tidy up the randomness.