Lower in hour 3 and 4

[kel4han]

Me again. Suprise. So, I know the whole absorption issue here, differences in what you eat when etc. But in learning about myself and Novolog (I am not on any basal) So what about this.....
Premeal (146)
I have learned I am high (235) at two hours.
(189) at hour three
(182) at hour four

So, wearing off at hour 4 (182) is obviously not a great number but I will continue to go down to normal (90) by hour six (if I make it that long without eating) Thanks to my honeymoon. Hmm time to increase carb ratio at this rate?? (I know to watch this a few days, experiment) But otherwise change the ratio by 5carbs or so? (Not pumping yet)

[xMenace]

You've completely ignored your basals.

It could be your bolus is low and your basal is high. If you increase your bolus, everything is high and you'll hypo. My instinct says lower the basal slightly and increase the bolus by 5-10%.

Skip that meal and find out what happens without food/bolus.

Take small steps.

[kel4han]

Silly you, I am not on a basal.

[xMenace]

Why do we all have to be so different? Gawd that makes it so hard ;)

[Stuboy]

You might want to consider splitting your bolus... inject before the meal, and 1 hour later... play around with the split % untill you get it right... It helps me not to go really high when i have a chinese (only i split that bolus into 3 or sometimes 4!)

Good Luck! :D

[BlueSky]

.... (I am not on any basal) So what about this.....
Premeal (146)
I have learned I am high (235) at two hours.
(189) at hour three
(182) at hour four
..... Hmm time to increase carb ratio at this rate?? ..... change the ratio by 5carbs or so?
All those readings are too high .... It looks like you need to increase that carb ratio substantially. The fact that BG levels didn't drop to normal levels after the meal is proof of that. And it looks like you should be on a basal as well. The fact that you were 146 before eating shows that your pancreas isn't producing enough insulin to keep your BG at normal levels between meals. Some Lantus would help get your premeal levels into line.

You need to be careful that you don't confuse the effects of basal and bolus insulin here. And it makes the most sense to get your basal right before you start messing with your boluses. So I would suggest that you first titrate the basal dose to the level that maintains normal BG in the absence of a meal/bolus. Then increase your boluses to the point where they bring BG down to near-normal levels after meals. :wink:

[Lilly164]

The authors say that insulin is gone from the blood in 3-5 hours. It will lower your blood sugar (be effective) for 5-6 hours. This is why you were at 90 in 6 hours.
I think that you will go low
if you increase your insulin dose for that meal.
I suggest trying this: take the insulin 30 minutes before eating. It will have time to start lowering the 146 number.
If your BG is normal before a meal, I wouldn't advise taking insulin 30 minutes early.
The beginning of your post meal rise was the 146 at the beginning. Would working on that first help?

[Stuboy]

It depends on how long your insulin takes to start working. Novorapid starts in about 10 minutes. other take around 30 minutes to get to work.

It would probably prove helpful to you, to find an action profile for the insulin you are using, this way you can SEE when the insulin starts working and that might help you visualise what you need to do to control your blood sugar... yes, everyone is different, but it does give you a better idea of what the insulin is doing. I know it helped me out loads when my DE showed me insulin profiles for Mixtard and Basal and Bolus... made perfect sense!

[Cyborg]

Sounds like you under bolused or didn't take a correction bolus with your meal bolus. Also, try taking your meal bolus about 15-30 minutes before you start to eat, especially when your bg is already elevated at meal time.

[Scratch]

The authors say that insulin is gone from the blood in 3-5 hours. It will lower your blood sugar (be effective) for 5-6 hours. This is why you were at 90 in 6 hours.
I think that you will go low
if you increase your insulin dose for that meal.
I suggest trying this: take the insulin 30 minutes before eating. It will have time to start lowering the 146 number.
If your BG is normal before a meal, I wouldn't advise taking insulin 30 minutes early.
The beginning of your post meal rise was the 146 at the beginning. Would working on that first help?
He's 1.5, if his pancreas is still producing insulin, and it should be if he's not using any basal insulin, then it's not surprising that his blood sugar would continue to trend downward to normal levels.

I'd also supsect that if his blood sugar is 182 at 4 hours, then he didn't bolus enough insulin. He was close, his blood sugar was 36 points higher 4 hours postmeal, but if his bolus has been properly titrated for units of insulin to grams of carbs properly then he should have been at 146, if just aiming to get back to the premeal level. If I were at 146 premeal, I would have ended up adding some extra bolus insulin to get down to my target of 90 to 100.

[kel4han]

This is the thing here. I went to bed at 232. My morning number was the 146, fasting, for 12 hours. I am not on basal because I do not need it. I would need basal dosing if my numbers rose at any point in the day, they never rise, they always fall. If I can go to bed at 232 (11pm) and wake up at 146 with no basal, (last bolus was 530pm) that is a heck of alot of work my pancreas is doing itself. Am I wrong here? I think my ratio is pretty close and the insulin works for me for 5 hours. after that point, I still go lower becuase my pancreas works alot. In this "honeymoon" I feel more like I am Glucose intolerate, not Diabetic. Does that mae sense?