[Hikeandbike]

I tested today before lunch, had usual 35 to 40 carbs, had usual 7 units humalog, was at 100, was curious so tested 1 hr after and was 198. Probly not so good to spike like that but if in 1 hour back to 100 is that okay or should it be more consistent?. I was always told by Dr. that sugars usually peak 2 hrs after eating. So, am I headin for 400+, should I reserve a room at the ER Inn? jk any feedback would be very appreciated! Thanks
Rich

[dgrilli]

I'm not sure but I will frequently spike very high very quickley.

[Ashtur]

It really depends on what you eat. The more highly processed, the faster the spike.

From my experience, the 1 hour may well be higher than the 2 hour, but the 2 hour is a good baseline for you to follow.

That said, to "mellow out" that one hour spike, get away from refined carbs or potatoes (so, brown rice, whole grain breads and the like), and some fat in the meal also slows the process and so moderates the spike.

[duck]

I asked this question of a few "experts" when I was seeking my current pump, and the general consensus was at NO time should you EVER be above 200. Now, we all know **** happens, but under ideal circumstances, you should never exceed 200. That's my over-arching goal nowadays.

[xMenace]

Try bolussing early, say 30 to 40 minutes even. Eat more complex carbs. Eat fewer carbs or spread them out over an hour or so.

[Cyborg]

Originally Posted by duck

we all know **** happens, but under ideal circumstances, you should never exceed 200. That's my over-arching goal nowadays.

I agree. IT does happen and the only thing you can do is either wait out for the duration of the initial bolus, or bolus again and watch carefully.

Happened to me tonight in fact... Went out for sushi and sake as normal, but tried a new restaurant. In my 70's when I sat down. Bolused for everything as usual, but some of the raw fish tasted sweet?!?! Got home and saw a 180 on the meter after I started sweating. I decided to just cancel the extended bolus, take the rest of it immediately and add a correction bolus on top, ignoring the IOB. Certainly don't want to go above 200!

Approximately 1 hour later, I was at 48! Glad I check often and keep a bottle of glucose in nearly every room. My wife also had a bag of Halloween candy on the counter. Gotta love those Reeses Peanut Butter Cups with only 10g carbs! Just wish there weren't so many calories...

Back to your original question, your bg should return to normal in approx. 4 hours, not 2, with a good meal bolus and accurate basal insulin.

[owlyn]

Commonly stated goals for PP (after meals) BG levels are:

2 HRS <180
3 HRS <150

So, 198 is above the 2 hour goal, so while not fantastic, it's not horrible either. Sounds like in this case maybe another unit of Humalog may have helped. It depends on soooo many things. Could also be the glycemic index of what you ate was high. For example, foods with low carbs but a high glycemic index may give you high 2 hour readings, but fine 4 hour readings. It just depends... Also, what is you insulin:carb:bg ratio? For example, mine works like this:

1 unit Humalog = 15 grams CHO = 30 points BG

most of the time

[shabbie6247]

hi rich,
i always seem to spike between the 1st and 2nd hour. but i have managed to reduce its occurance by eating less than 40 carbs in one sitting. also the suggestions to bolus early for a meal helps but i always forget
welcome to the forum btw

[Alice]

It's always going to be a different "spike" with different meals, typically. I don't worry too much about the spike...but check about an hour later to see if I was in the ballpark with my initial dose. If I hit a really high number one hour later, I usually take another unit or two.

I've had meals with no spike at all...then all that insulin I took makes me nervous...so I keep checking anyway.

Feed a cold, starve a fever? That kind of thing. If you are back to "normal" in two hours...you are doing very well. After that its a matter of food, luck & how low you're willing to go.

[Hikeandbike]

Thanks everyone! I think I'll try a little ealier bolus, Doc said I should bolus right before first bite of food, well lets see what happens. I don't tend to follow glycemic index much but is *food* for thought See Endo tomorrow for 3rd HbA1c, wish me luck, am kind of nervous because last visit was spilling a little protien. BP kind of high. Thanks again, you guys are cool!
Rich

[JJM335]

Interesting!!

American Association of Clinical Endocrinologists (AACE) recommended target is max BG (2 h PP) <140 (7.7), and there's another thread running on targets, where the consensus 2 h PP target seems to be 120-140 (6.7 to 7.7).

I have been using the AACE numbers as a target but it's really tough, most of the time I spike up to ~9 by 90mins-2h, although it drops quickly! My Diabetes Clinic have now suggested that <7.7 is really not achievable without resorting to a very restricted diet, because it's basically NORMO-glycemia, even healthy non-diabetics will spike transiently to 8 or more.

[Alice]

It's always lovely to "spike" at 140...but that's not always the end of the story for me. Often, if I have a low spike, I will go low 2-3 hours later...so, I see it as a multiple step process.

[Cyborg]

If you are going low before the 4 hour mark, then you are over-bolusing (assuming your basal insulin is correct). Thus, you are not counting carbs correctly or your I:C ratio is wrong.

To avoid the 2 hour spike, try pre-bolusing...