[heatherpetch]

Hi all i have now been on insulin for 68 days,all in all i'm feeling pleased with my self,counting carbs,but there is something i don't understand.If for instance i was going to eat 40 carbs which i would bolus 5 units of rapid for,then 2 hrs later i am already back down to post eating levels,could i then eat a small snack and not bolus for it,as i would still have some insulin working,this really confuses me.Also often i will bolus 2hrs later i would be in good numbers but the 3rd hour it rises Please could someone help put it in simple to understand please Thank you.

[fgummett]

I'm probably not qualified to talk about the "insulin on board" question... I rely on my pump to manage that for me. But in general you might want to do some additional testing to see how different foods affect you. High fat foods or foods that are slow to digest can have an effect more than 2 hours after eating.

[howdysf]

You probably could depending on how many carbs are in the "small snack."... I use Novolog and I find if I'm back to normal (90-115) two hours after eating, I will likely go low if I don't eat a little something...

[morrisma]

Another factor might be honeymooning. If you are still getting some honeymoon effect, then your insulin on board could vary wildly.

Either way, testing is the best way to determine if the snack will keep you steady or send you back up.
Mike

[sprzepiora]

Get a book called "Using Insulin" by John Walsh and others I got mine here.

Read the following knowing I just learned this Please consult your doctor.

The general rules of thumb is that for every hour 50% of the insulin "goes away". So given the example you gave:
With 5 units after two hours you have 2.5 units left which given you initial bolus you have a 1:8 ratio which would allow you to eat 20grams of carbs. After 4 hours there is nothing left of the bolus rapid insulins.

Again I hoped I learned this right, someone else pipe up and let me know I got it right

[poodlebone]

Originally Posted by heatherpetch

Hi all i have now been on insulin for 68 days,all in all i'm feeling pleased with my self,counting carbs,but there is something i don't understand.If for instance i was going to eat 40 carbs which i would bolus 5 units of rapid for,then 2 hrs later i am already back down to post eating levels,could i then eat a small snack and not bolus for it,as i would still have some insulin working,this really confuses me.Also often i will bolus 2hrs later i would be in good numbers but the 3rd hour it rises Please could someone help put it in simple to understand please Thank you.

What you eat plays a big role in how your numbers look 2, 3 4 or even more hours later. If you've even a high fat meal your blood sugar can be normal, or even low, at two hours. The fat delays the carbs getting digested, but over the next few hours those carbs finally hit your system and your BG will rise. Pizza is a classic example of this. All of the fat from the cheese slows down all of the carbs. It can be hours before it all finally hits you, and you end up with a really high reading.

If my BG was low at 2 hours, I would probably not bolus for a small snack but the only way you'll know for sure is to keep testing your BG to see how it reacts to different foods and different amounts.

[BlueSky]

Originally Posted by heatherpetch

... i will bolus 2hrs later i would be in good numbers but the 3rd hour it rises ...

This is what happens when you are unable to match the action of the insulin with the supply of glucose (from the meal) into your bloodstream. We all have to deal with this problem. Getting a handle on it is an ongoing learning process. The more carbo you eat and bolus insulin you use, the bigger the mismatches are likely to be. And the bigger the unintended swings in blood glucose become. Eating low-carb at this stage should make your life a lot easier.

Also consider that a big carbo load, together with the required insulin bolus, temporarily increases insulin resistance . More insulin is required to get the glucose into cells. The effect of this is that blood glucose goes up hours after the meal has been eaten, and the bolus insulin action is finished. This effect is, unfortunately not consistent. Sometimes it is more pronounced than at other time. It is another good reason to eat low-carb.

[parrotletzoo]

The Diabetes Mall, your source for the latest in diabetes information, technology, and resources, plus diabetes books, test strips, and products at discount. also has good information on the action times of insulin and carb counting. (obviously, you can tell by the link that it also has a store. I'm not affiliated with the store, I've never bought anything from it, I have no idea who's associated with it but it has durned good information if you sidestep the ads and go to information/resources sections)

[BlueSky]

Originally Posted by parrotletzoo

... I'm not affiliated with the store, I've never bought anything from it, I have no idea who's associated with it but it has durned good information if you sidestep the ads and go to information/resources sections)

This is John Walsh's website. From the About Us page:

Founded by John Walsh, PA, CDE and Ruth Roberts, MA, in 1993, our first informational web site appeared on the web in May, 1994. John and Ruth write best-selling books that show how to improve blood sugar control with diabetes. These books include Pumping Insulin(now in 4th edition, 1st edition published 1989), Using Insulin, STOP the Rollercoaster (now out of print), The Pocket Pancreas, and My Other Checkbook.

It is a very good website, and contains a lot of the information in his books.

[xMenace]

Heather, sometimes yes and sometimes no.

test yourself sometime every hour or even half hour and draw a graph. Eat a typical meal. It's an eye-openning exercise.

I found that if I bolus during high insulin resistance periods such as breakfast, then the tailing end, working during a lower period of resistance, works up to doubled it's strength. I do drop low before lunch but not before dinner.