[mids1999]

I have been having this trend where my 2 hour after meal readings are lower then my 4 hr after meal readings.
Sometimes I am even going hypo at the 2 hr point to only be right on target at 120 at the 4 hr point.

What makes me wonder if it is the insulin working fast rather then delayed digestion is usually when I treat a high a majority of the correction takes place during the first .5 hr.

What do you think?

[seacomp]

What insulin are you using pre-meal? What kind of meals?
I can have a similar problem when I have a large meal with both high fat and carb content.

[Geoff]

It’s likely that if your bs is higher at 4 hrs than it was at 2hrs, your liver is compensating and dumping glucagon into to your system. This can be caused by an incorrect basel insulin level, i.e. to high. This has been happening to me lately, my endo told me to try reducing my basel dose gradually, and now it has stopped .

[Cyborg]

Perhaps it's gastroparesis...

[mids1999]

I am using Humalog in a pump.
The kind of meal doesnt really matter.
It happens almost no matter what I eat. Very high GI foods like glucose tabs excluded.

[Cyborg]

Many pumpers with gastroparesis solve the problem using an extended bolus while eating. Sounds exactly like what you need. Your symptoms are very similiar to the effects of Symlin. Try a 50/50 combo bolus over 2 hours and see if that helps.