Why do I get such high blood sugars after dinner?

[NicHolzhauer]

I usually inject 6 units of Lantus at about 8-9pm, and do not eat much after. I check again about about midnight when I go to bed, and have a small something if necessary. I wake up at about 75 mg/dl, have breakfast, and before lunch at one pm I am around 95 mg/dl. After lunch at about 3pm I am about 100 mg/dl so I have a small snack to hold me over. Usually before dinner at 530pm I am at about 100 mg/dl again. Two hours or more after I eat dinner, my blood sugar goes to about 180 mg/dl to 250 mg/dl for some reason. When I eat something high in carbs i usually put in one unit of insulin to cover it, which works because I am in the honeymoon.

Here are my numbers from tonight for example:

5:12 131 mg/dl before dinner, bolused to cover a large meal of chicken tenders, toast, and a few fries.

6:19 66 mg/dl after dinner, had a sweet to raise it a little bit before dinner kicked in.

7:44 186 mg/dl two hours after dinner, seems like it would be good had i not had the sweet.

9:03 293 mg/dl :mad: i dont know how it got so high, i did not eat anything since the dinner at 5:30. it was reasonably high in fat, but should not have had this sort of delay. i washed my hands again and checked it on my other meter and i got 301 mg/dl!!! this is my highest number since dx!


what the heck is going on here? i only get these kind of numbers after dinner. i tried delaying my lantus until about 10pm but it doesnt help?

[Subby]

it was reasonably high in fat, but should not have had this sort of delay.

That's the thought I would be probing. How can you be sure? Especially in the case of high fat AND high carbs, as fries toast and chicken are all contributing to.

Dealing with it... maybe a split bolus could do the trick, half before meal, half later (you'd need to experiment with actual times and ratios). Something else to bear in mind, this is what I find: with those high carb / high fat combos, other examples are pizza and doughnuts I find that the prolonged, resistant spike means I need more insulin over the spike. Sometimes a lot more. I do so, or better still, generally avoid those combos. By way of avoiding the fat or the carbs, in any given meal. Here's my tip: fleshing out a meaty fatty meal with low spiking veggies instead of stodgy carbs - fantastic habit for a diabetic on many fronts. The old "meat and three veg" approach is great, once you eliminate veggies that are as spiking as bread or sugar (such as potato, perhaps corn, you need to test and find out for yourself which are the problems).

[Subby]

Looking at your Lantus comment, do you mean you suspect it's not lasting the distance? I'd do more on that front than delaying until 10pm. I'd go further with checking basal coverage. Simplest way I can think of is to basal test that time: don't eat an afternoon snack, skip dinner and test every hour around that time, see how your BG control goes. Maybe twice to eliminate random influences a little. If it stays stable, your basal is doing the job. If you are climbing in that scenario sometime 5 - 10pm, you know you need to fix that underlying problem.

Concise rules for Basal Testing (http://www.integrateddiabetes.com/pump_bt.shtml)

[jenb]

If you are going high each evening it may not be related to your meals - that's just coincidental. You're not taking much Lantus (6 units according to your signature); my bet is that by evening it's run it's course and you need more. Try doing some basal testing. You may find that you need to increase your dose and split it into evening and morning injections.

Jen

[kgm0612]

Here are my numbers from tonight for example:

5:12 131 mg/dl before dinner, bolused to cover a large meal of chicken tenders, toast, and a few fries.

6:19 66 mg/dl after dinner, had a sweet to raise it a little bit before dinner kicked in.

7:44 186 mg/dl two hours after dinner, seems like it would be good had i not had the sweet.

9:03 293 mg/dl :mad: i dont know how it got so high, i did not eat anything since the dinner at 5:30. it was reasonably high in fat, but should not have had this sort of delay. i washed my hands again and checked it on my other meter and i got 301 mg/dl!!! this is my highest number since dx!


what the heck is going on here? i only get these kind of numbers after dinner. i tried delaying my lantus until about 10pm but it doesnt help?

You ate dinner at 5:12, but tested an hour later and had a sweet to raise it a little before dinner kicked in? What did you have as a sweet?

[HollyB]

Not to be a downer, but expect to see and deal with more of this as your honeymoon wanes -- the spikes spike higher.

This could well be the fat in the chicken tenders talking to you - the fact that you were strangely low an hour after dinner certainly suggests it.

But if you find you are consistently high after dinner, your body probably just needs a bigger dose of insulin at dinner than at other meals. There are all kinds of variables with the rhythm of your day and your internal metabolism that mean you need more or less at different times.

My son needs a lot more insulin in the morning. When he was taking phys ed at school, he needed a lot less at lunch, and dinner was somewhere in the middle. Log your numbers and find out what your pattern is. Just be prepared for it to be a bit of a moving target until your honeymoon is over.