| lgvincent'... VERY interesting.
What makes your situation frustrating is the rapid increase in BGL over a span of just 60 to 90 minutes. You can be fine one moment, and an hour-and-a-half later, find out that you've more than doubled your glucose levels, without having eaten anything for 4 or more hours!
You should watch what your amount of calories at dinner come in as being CHO, protein, and fat. Protein and fat require several hours of digestion time. It's possible that the protein and/or fat from your meal are hitting you. That may help you to start finding out when it's going to hit.
It sounds as though you're hitting your meals hard enough with insulin (any harder and you'd go too low).
Once you determine if it's high fat or protein, you'll be able to pre-empt your evening highs with insulin before it begins to spike up. It means more shots, but chasing down the cause of the 4hr. postprandial spike can be turned into a game that you won't let yourself be declared a loser.
One other problem is that you might end up gaining more weight with the extra insulin. You might look into Amylin (Symlin) when/if it is approved by the FDA. It's another shot, but it should tell your liver to not perform a glucose dump. Symlin is due for an FDA approval letter in the end of March 2005. Some fear it might not succeed in the marketplace, but its purpose to replace the other hormone produced by beta cells.
Clinical trials have shown symlin to reduce postprandial glycemic variations, but the true test will be when results are posted to the message boards.
Also, like what the other posters said, exercise will improve your insulin sensitity for 24 and even up to 48 hours. Exercise equipment will be cheap in the newspaper by March/April, when people start to give up on New Year's resolutions.
Dr. Quack  | 
