Post-Meal Bloodsugars

[belyro]

Just out of curiosity.....what's everybody's bloodsugar like, typically, about 2 hours after a meal? How high do you have to let it go to ensure that you don't go low before your next meal or snack?

[Cyborg]

100-140 is a good target...

[belyro]

100-140 is a good target...

But does it stay in that range for another 2-3 hours? Mine has to be much higher. Do you eat snacks between meals?

[spike]

But does it stay in that range for another 2-3 hours? Mine has to be much higher. Do you eat snacks between meals?

When I count my carbs right, I can eat more than 1/2 of a large pizza (I'm 6'4") and keep my bg's under 130 for more than 3-6 hours. It is nothing short of amazing what an extended bolus can do for you. Also called a "combo bolus". I take 60% up front and the rest over 4 hours to account for such a food's drawn out bg raising properties.

Other foods and with mistaken carb counting I might be over 200 within 20 minutes!

[Cyborg]

Usually the 2 hour mark is the high point if my insulin was taken correctly. I try to take my insulin far enough in advance to help drive down a high bg before eating. Symlin helps quite a bit with post meal bg spikes. I do use it, but not with every meal.

[BlueSky]

..... How high do you have to let it go to ensure that you don't go low before your next meal or snack?

My BG would normally be in the 120 - 140 range 2 hours after eating. If your BG is dropping after 2 hours, it probably means that there is too much basal action. You should be able to skip a meal (and the corresponding bolus) and your blood sugar shouldn't change much. You may need to reduce your Levimir to make this happen.

[grace girl]

I shoot for around 140-160...preferably the lower end. If I'm 130 or below at the two hour mark I have to have a small snack or I'll go low before the next meal, especially after lunch. (My am Lantus peaks around lunch time) I know that would indicate too much basal, but it's perfect the rest of the day, so I just keep a close eye on it in the afternoons.

[belyro]

My BG would normally be in the 120 - 140 range 2 hours after eating. If your BG is dropping after 2 hours, it probably means that there is too much basal action. You should be able to skip a meal (and the corresponding bolus) and your blood sugar shouldn't change much. You may need to reduce your Levimir to make this happen.

Wow....Mine goes down so much in the last few hours before a meal. The morning's are especially bad. If I'm less than 250 at 9am (I eat breakfast around 7am), I'll definitely need a snack before lunch. (I walk to work - 1/2 an hour.) In the afternoon and evening I don't have to let it go up so high. Just in the morning. I always thought this was at least relatively normal. My endo has never told me otherwise. *sigh*

[belyro]

I shoot for around 140-160...preferably the lower end. If I'm 130 or below at the two hour mark I have to have a small snack or I'll go low before the next meal, especially after lunch. (My am Lantus peaks around lunch time) I know that would indicate too much basal, but it's perfect the rest of the day, so I just keep a close eye on it in the afternoons.

This is nothing like me! :frown:

So if you're 160 and you, say, go for a walk in the afternoon.....how many carbs would you need to keep from going low?

[BlueSky]

Wow....Mine goes down so much in the last few hours before a meal. The morning's are especially bad. .....

Sounds like the Levimir is coming on too strong in the mornings. When are you injecting it? And are you splitting the dose? :hmmmm2:

[belyro]

Sounds like the Levimir is coming on too strong in the mornings. When are you injecting it? And are you splitting the dose? :hmmmm2:

I take 7 units in the morning (around 7am) and 5 at night (around 11pm). The night time dose is perfect.

[grace girl]

This is nothing like me! :frown:

So if you're 160 and you, say, go for a walk in the afternoon.....how many carbs would you need to keep from going low?

If I was 160 I would walk, and test. If it's within range at the two hour mark I'm usually okay for the remainder of the afternoon. It's being below 140 that's a problem. If I'm below 140 and not going to be very active I usally eat two tablespoons of peanut butter, and it will hold it steady. If I'm going to be really active I add some crackers to that. Today I was 75 two hours after lunch and I had an awesome mochaccino latte....I was 120 at dinner, so I think I've found a new cure!!:) :)

It sounds like your morning Levimar (sp) may be too much...I take my Lantus in two doses, and the peak I get from the am dose is what causes my afternoon problems. I may end up having to lower it at a point, but it's at least managable. Having to be a 250 to keep from going hypo is way too much.

[belyro]

If I was 160 I would walk, and test. If it's within range at the two hour mark I'm usually okay for the remainder of the afternoon. It's being below 140 that's a problem. If I'm below 140 and not going to be very active I usally eat two tablespoons of peanut butter, and it will hold it steady. If I'm going to be really active I add some crackers to that. Today I was 75 two hours after lunch and I had an awesome mochaccino latte....I was 120 at dinner, so I think I've found a new cure!!:) :)

It sounds like your morning Levimar (sp) may be too much...I take my Lantus in two doses, and the peak I get from the am dose is what causes my afternoon problems. I may end up having to lower it at a point, but it's at least managable. Having to be a 250 to keep from going hypo is way too much.


Wow...if I get exercise I need WAY more than a few crackers. I think you may be right about my morning Levemir. So why doesn't my endo tell me this??

[Emm]

Diabetics will always know more than any diabetes specialist, I think!

I agree, your levemir could be reduced a bit. It should just be enough to keep you level, regardless of meals (tho of course that's not always how it works out for everyone).

I try to keep my 2 hour BG under 7.5mmol (135). If I'm higher than 8 I'll take an extra dose of Novorapid to knock me down. High numbers scare me - I want to keep all my body parts as they are! (if only I could control the aging process too lol)

If I'm exercising more than normal I do need a small snack to keep me even, but most days I'm fine as-is.

Have a word with your endo and see what he/she thinks...?

[belyro]

Diabetics will always know more than any diabetes specialist, I think!

I agree, your levemir could be reduced a bit. It should just be enough to keep you level, regardless of meals (tho of course that's not always how it works out for everyone).

I try to keep my 2 hour BG under 7.5mmol (135). If I'm higher than 8 I'll take an extra dose of Novorapid to knock me down. High numbers scare me - I want to keep all my body parts as they are! (if only I could control the aging process too lol)

If I'm exercising more than normal I do need a small snack to keep me even, but most days I'm fine as-is.

Have a word with your endo and see what he/she thinks...?

How can I have diabetes for 25 years and not even know that it's possible to have such reasonable after-meal bloodsugars? I definitely need to talk to my endo. I just don't know why she wouldn't have encouraged me to do this already. She says "You need to get it down", but she's not great at giving me suggestions as to how. That's nuts.

[spike]

How can I have diabetes for 25 years and not even know that it's possible to have such reasonable after-meal bloodsugars? I definitely need to talk to my endo. I just don't know why she wouldn't have encouraged me to do this already. She says "You need to get it down", but she's not great at giving me suggestions as to how. That's nuts.

You'd be surprised then at how clueless some of our endos are. It's not just your endo that is out of touch. I had to drop my endo of 10 years in order to get a presript for a pump. He kept telling me a pump would cause more lows than what I'd already experienced. He couldn't have been more wrong.

[grace girl]

I've only been dealing with this for 6 years, but I've been through 5 doctors, two of them endos, trying to find someone who would actually help me. I like my current endo, but I've learned more right here on this forum than any doctor or cde EVER told me.

[belyro]

You'd be surprised then at how clueless some of our endos are. It's not just your endo that is out of touch. I had to drop my endo of 10 years in order to get a presript for a pump. He kept telling me a pump would cause more lows than what I'd already experienced. He couldn't have been more wrong.

Well now I don't know what to do about her. I already don't like aspects of her - including her bedside manner. I've come out of there crying the last two times I was in....she isn't great at helping, just at telling me that my A1C is too high. Maybe I need a fresh start with someone new. I'm going to see my family doctor in November and maybe she can give me a new recommendation.

I'm still blown away. Makes me feel a little stupid, actually. And a little angry, to be honest.

[spike]

I'm still blown away. Makes me feel a little stupid, actually. And a little angry, to be honest.

Bethany, I think I can honestly say that I know exactly how u feel. As miserable as I was on MDI, I should have checked into getting a new doctor literally years before I finally made the switch. As I look back on that period of my life, I wonder what in the heck I was thinking to have stayed with that sorry excuse of a endo for so long. I have boot prints on my rear from kicking myself! :) We wouldn't be the first patients who listened to their doctor for too long. The first step to change is to know that one is needed. I think you have begun that first step!

[belyro]

Bethany, I think I can honestly say that I know exactly how u feel. As miserable as I was on MDI, I should have checked into getting a new doctor literally years before I finally made the switch. As I look back on that period of my life, I wonder what in the heck I was thinking to have stayed with that sorry excuse of a endo for so long. I have boot prints on my rear from kicking myself! :) We wouldn't be the first patients who listened to their doctor for too long. The first step to change is to know that one is needed. I think you have begun that first step!

I'd say I have some thinking to do....but that would be an understatement.

[belyro]

Gosh, I hope my endo doesn't come onto this site. My pic's up and everything. :eek:

[spike]

Gosh, I hope my endo doesn't come onto this site. My pic's up and everything. :eek:

LOL Unlikely!

[CycloneKitty]

Find another endo. You have to be happy with who u see. After all - u are paying for their service and if u don't like them ... u won't be listening to them anyway. I went thru 7 endo's in a 10 year period - just couldn't find one i liked. One or two of them put me in tears ... to the extent that i didnt see anyone for a few years. But now I have a great endo and he is really understanding, informative, and very helpful. But for your own benefit ... search for another endo ... and keep trying them out till u find one u like.
:wavey:

[Emm]

How can I have diabetes for 25 years and not even know that it's possible to have such reasonable after-meal bloodsugars? I definitely need to talk to my endo. I just don't know why she wouldn't have encouraged me to do this already. She says "You need to get it down", but she's not great at giving me suggestions as to how. That's nuts.

That IS nuts!!

Have to agree with others here that it could be time for a new endo!

Endo or not, you'll learn a LOT by hanging around places like this - I reckon I double my knowledge daily just by talking to other diabetics, but often walk out from a doc/endo appointment with a look of disgust and the feeling that I'm lost & misunderstood!

Do some research, keep your meter handy (boy will you need it when you're making a change to insulin!) and keep on keeping on.... now that you're delving into all this info you'll be off to a new start!

Em.

[blue eyes]

Oh.. I haven't worked that out yet... not really...

It really depends on what I eat. I've figured out that honey sandwiches, possibly rice, some diet ice creams (my Mum only buys weight watcher ice cream) make my bsl a tad high

Can bee anything from 7mmol/l - (since end of Oct) 20mmol/l + (haven't gone > 24.4mmol/l )

[belyro]

I am learning so much here! Yesterday my husband was out playing poker and I had to wait up for him to get home so I could tell him all this! I couldn't sleep otherwise!

So I'm trying less Levemir this morning. I think it'll be rocky for awhile, figuring out how much I have to up my Humalog to compensate, but I'm on a mission now! :proud:

[Stuboy]

if you're going low after meals surely that's too much insulin... ? Either your rapid, or too much background.

[belyro]

if you're going low after meals surely that's too much insulin... ? Either your rapid, or too much background.

I'm not going low right after meals. I'm going high. But then it moves constantly downward until my next meal. Usually fairly quickly. Even more so if I get any exercise (even walking to run errands).

It's definitely not too much rapid. It's the basal I guess.

[grace girl]

I am learning so much here! Yesterday my husband was out playing poker and I had to wait up for him to get home so I could tell him all this! I couldn't sleep otherwise!

So I'm trying less Levemir this morning. I think it'll be rocky for awhile, figuring out how much I have to up my Humalog to compensate, but I'm on a mission now! :proud:

Just test a lot and you'll get it right. I've been through lots of that trying to get my lantus set right.
As to your doctor issue, you're not alone. The 2nd doc I went to was the one who actually discovered I was type 1, and then promptly put me on the wrong insulin regime, and never did anything to help me know how to use it properly. I stayed there for 4 years, with my bs getting worse, and at the end, this same doc yelling at me and telling me that I just didn't care.

There are good doctors out there, you just have to work at it sometimes to find them! So far I like the new one I've got, but I've only been with her since August, so she's still on trial. Time will tell.

[It Ain't Over]

Sounds a lot like what I went through just before I was set up on a pump. As the years tx with type 1 rolled by, my control with at the time Lente, slowly eroded. Very hard for me to get the sugars under 200 between meals.
When I tried more long acting, would get worse. Finally was sent to a top notch endo, he lowered the long acting and increased the short acting after meals.
The high's came into the 150-170 range and my A1c was no better than 7.2. Also started having a lot more lows and some trouble there. The endo used that to persuade my insurance carrier to pay for a pump. Instant improvement. A1c went down to 6.6 first check and the hi's between meals went to the 130- 140 range. Best was no more extreme lows and no more 911calls. Big difference. For the last year have been taking Symlin, now 120- 130.
Dr told me it is not uncommon for a diabetic taking injections to have increasing problems with this after 15 years. Some don't, I never did well on shots. Don't miss them now.

[lilituc]

How can I have diabetes for 25 years and not even know that it's possible to have such reasonable after-meal bloodsugars? I definitely need to talk to my endo. I just don't know why she wouldn't have encouraged me to do this already. She says "You need to get it down", but she's not great at giving me suggestions as to how. That's nuts.

Have you read Using Insulin by John Walsh? I highly recommend it. It's a lot of information, but it's a great resource to refer back to when various things happen.

[belyro]

Have you read Using Insulin by John Walsh? I highly recommend it. It's a lot of information, but it's a great resource to refer back to when various things happen.

Never heard of it. I'll have to take a look. Thanks!

[belyro]

OK, I'm down to 4 units of Levemir in the morning (from 7). I've also started taking my Levemir 12 hours apart (6:30 and 6:30 instead of 11pm and 7am).

I was too high this morning, and have been for the last few mornings. I think I'm going to have to raise my nighttime Levemir if I'm lowering my morning one. Seems to have an effect.

So I woke up around 14mmol/L (250mg/dL) this morning, took 1 unit of Humalog as soon as I checked, but didn't eat for about an hour yet, at which point I took another 6 units. I also took 4 units of Levemir. (Took 5 units last night around 7:00pm.) I had about 40g of carbs for breakfast (3 low-fat Eggos) and then walked 20 min to work.

At 9:30am, 2.5 hours after eating, I was 8 mmol/L (150mg/dL). This is great, right? Well, I'm convinced I'm still going to drop this morning. It's been dropping after breakfast and after lunch all week, even since I've reduced my Levemir I'm going to check again in a bit and post what my bloodsugar is.

So, can someone who was giving me advice on here re: reducing Levemir (which I think makes a TON of sense) give me some advice on what seems to still be going wrong?

Or maybe I'll prove myself wrong and still be 8 (150) next time I check. Here's hoping!

Thx.

[Gangrel]

Beth, I know we were chatting about this last night, but what do you use as a carb ratio?

It appears you took 1 unit of Humalog to fix the 14, which is fine, but then took another 6 a few hours later, and ate 40gs of carbs, correct?

I'm learning this week that my ratio appears to be about 0.07. So I take the carbs I'm eating, multiply it by 0.07 and dose that. So, for 40gs, I'd get 2.8, which i'd round up to 3.

If you took 6, PLUS walked to work, your sugars will drop a lot probably.......

Does this make sense?

In addition to all this, we should reduce insulin levels for exercise too, so I would gather a 30 minute walk would qualify......

[belyro]

OMG....I'm still 8 (150).

I can't believe this.

If this works, and this morning isn't just a fluke.....I owe each one of you who gave me advice a HUGE e-kiss!

I don't want to get my hopes up yet, but I don't remember EVER having a morning this stable.

Gangrel, my ratio has been is 10:1 at breakfast, and 8:1 at lunch and supper. But....now that I'm fiddling with my Levemir, this will be changing. I'll have to recalculate it once I've got the Levemir figured out.

OK, guys, I'm really excited here! :thumbsup:

[Gangrel]

Congrats Beth!

I thought my day was going good too until i dipped to 3.8 at 11..... so maybe my carb ratio still needs tweaking too!

[belyro]

I'm 6.2 (112)!!!!!!!!!

Time for lunch!

I'm so excited!!!! :D

[Gangrel]

:shakehand Good job!

Now, teach me o wise one. ;)

[belyro]

:
Now, teach me o wise one. ;)

Let's not get ahead of ourselves here......one morning of good bloodsugar levels is not enough to call me "wise".

[belyro]

OK....the bad news is, I was 13.8 (~245) 2 hours after my lunch today.....and the good/bad news is I'm now 12.9 (~230) an hour and a half later.

I know this doesn't sound good...but it's stable!! It's never stable!!!!! I always drop like crazy in the afternoon! So all this means is that I didn't take enough Humalog at lunch. If I had, I could have had stable good bloodsugar levels all day! Two weeks ago, if I was 13.8 at 2:30, I would probably be 8.0 (145) or lower by 4:00 and if I walked home on that, I'd be low before I got there!

This is working! It's progress! A little more tweaking of the Humalog amounts (and my evening Levemir) and I might have a pretty good system here!

Yahoo!!

[Gangrel]

see, i knew i could call you wise.... It's my women's intuition!

[belyro]

Well, after my walk home from work I was about 4.0 (72). That was a faster drop than I would have liked. I had a pretty stressful afternoon though, so I'm wondering if that had something to do with it.

I'm on an even keel again this evening, though - so far anyway.