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jentoe_22

Post Meal BLood Glucose Readings

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Hello everyone. I know its been a while since I posted anything. I have a question. I have been shooting for a post meal target of 140. I find that if I go to 140 after breakfast, I end up going low two hours later. I have no problems with my other meals. I switched to a 1:11 ratio for breakfast. Now I am going to 165-180 two hours after breakfast, then two hours later I am in my 100-120 target. My question is how high, is too high after a meal? Should I be worried about hitting 180 after a meal, knowing that once I am above 165 I am spilling sugar? I only get to see my Dr. every so often, so I figured I would pass this question on to you all and see if I could get some info. Thanks so much.

jen

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The most oft-debated question in Diabetic history I thiknk, lol.

 

In Canada (and me personally) we are taught to aim for a range of 7-10.0 2 hours after a meal. So, your 180 is perfect, as far as I'm concerned.

 

I wouldn't think you're "spilling" sugar then either, but i could be wrong.

 

 

Now, you will get different advice from different countries, and some on here are far more hardcore and think you should stay at 5.0 alll the time, but on my regime, a 10.0 (with proper basal and bolus ratios) will get me down to 4.5-7 before my next meal, so I'm happy.

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The most oft-debated question in Diabetic history I thiknk, lol.

 

I think this is the $64,000 question.

 

IMO, BG's should be lower than 140.

I've read that damage to the nerves start beyond that 140.

 

but the ADA says, it's ok 180 after 2 hrs meal.

 

You be the judge.:)

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But to me it's impossible to stay below 7.7, unless you bolus the crap out of yoru meals, and are always eating snacks?

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You can treat your bolus like a super-bolus. Try cutting your basals back to up the pre-lunch lows. This is what I often do.

 

Insulin pump - Wikipedia, the free encyclopedia

 

I think I am going to give that a try in the morning. I am going back to the 1:10 ratio, and going to cut back on the basal a few hours before I am typically getting the low. I normally run a .35 basal from 8am until I get home from work. Should I take it slow and try a .25 for a few hours before the lows are hitting? I have never experimented with the super bolus. I am figuring when I test for my two hour post meal reading, I will then run a temp basal for an hour or so, then see what happens at my four hour post meal reading. Does that sound approximately right?

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I used to go with the 180 guideline when I was using Humalog and then Novolog, because if I shot for 140 or less, I'd bottom out later on and I'd rather avoid those rollercoasters. I wanted more than anything to get those post-meal readings lower, but it was impossible.

 

However, on Apidra, I have now dropped my goal to 120-140, only because with Apidra it is possible for me to be there 2 hours after a meal AND to stay there until my next meal and not bottom out. For whatever reason, Apidra just works better in that respect, for me personally.

 

Anyway, I'd say that in aiming for 120-140, if Novolog makes you bottom out beyond the 2 hours, as it did with me, then stick with the 180 goal, I think that's fine. You can only do as well as the tools you have. :dontknow:

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The best after meal is 85-110.....good is under 140....and ok under 180...but above 180 is bad....above 240 is very bad!!!above 300 extremely bad...call doctor or make insuline!!!

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The best after meal is 85-110.....good is under 140....and ok under 180...but above 180 is bad....above 240 is very bad!!!above 300 extremely bad...call doctor or make insuline!!!

 

Oh my god, if I was 85-110 two hours post meal, I would bottom out before the insulin wore off. That can't be right. I thought that the ADA stated 140 was the post meal target everyone should shoot for. Now I am confused?????:confused: :confused:

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I would keep it at the 140 and just eat an 4-8 carb snack, this is what I do cause nothing else works for me.....and a cookie or a small piece of candy isn't so bad 2 hrs after breakfast and when i do this, my bg is gorgeous for lunch always around 90-107......I upping the ratio, and then eek the 180's I don't like to see those at all, but I figure no biggie since the snack makes me feel normal....LOL

 

Cheryl

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Hi jentoe, You may be having a low GI meal then since that your meal lasted more than the bolus so a superbolus is the go or a bridge bolus (As i call it) like take the bolus and eat then take the next bolus at the maximum last bolus.

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Hi jentoe, You may be having a low GI meal then since that your meal lasted more than the bolus so a superbolus is the go or a bridge bolus (As i call it) like take the bolus and eat then take the next bolus at the maximum last bolus.

 

I am not sure I understand what you are saying. Every morning I have a bowl of cereal, 8 oz of milk, and a small cup of cottage cheese. The carb count comes out to 68g every day. Same cereal. I bolus about 15-30 min before I eat because I tend to go high if I don't. Then I eat. I test two hours after the first bite that I eat and have been getting 130-140 with a 1:10 ratio. Then I test four hours after the meal, and end up being between 45-65. I am trying to avoid the lows. I had switched my ratio to 1:11 for the past few days, and now am getting a reading 165-180 two hours after eating, and 100-120 four hours after eating, which is in my target. I don't think my meal is lasting longer than my bolus. I am sort of confused about what advice you are giving here. Your help is much appreciated, I may just be reading it wrong. :o

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I would keep it at the 140 and just eat an 4-8 carb snack, this is what I do cause nothing else works for me.....and a cookie or a small piece of candy isn't so bad 2 hrs after breakfast and when i do this, my bg is gorgeous for lunch always around 90-107......I upping the ratio, and then eek the 180's I don't like to see those at all, but I figure no biggie since the snack makes me feel normal....LOL

 

Cheryl

 

That sounds like a good idea too. I am going to try cutting back on the basal a bit before the lows are hitting tomorrow and if that does not work, I am going to just keep some glucose tabs handy and fix the lows with that. I really don't like seeing the 180's, but don't like going low either. I am sure I will figure something out.

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I am not sure I understand what you are saying. Every morning I have a bowl of cereal, 8 oz of milk, and a small cup of cottage cheese. The carb count comes out to 68g every day.

Yep , That's low GI Just the milk will hang around for a while and so too the cerial as well not to mention the cheese!!!! will keep you high. Are you bolusing hard enough??

I bolus about 15-30 min before I eat because I tend to go high if I don't. Then I eat.

Do you test before you have an injection? like if i were say 6 / 100 BG then i would eat strait away but if higher then i would wait after the injection.

I test two hours after the first bite that I eat and have been getting 130-140 with a 1:10 ratio. Then I test four hours after the meal, and end up being between 45-65. I am trying to avoid the lows.

Jen, then you should have a nibble on something at that point of testing.

I had switched my ratio to 1:11 for the past few days, and now am getting a reading 165-180 two hours after eating, and 100-120 four hours after eating, which is in my target. I don't think my meal is lasting longer than my bolus. I am sort of confused about what advice you are giving here. Your help is much appreciated, I may just be reading it wrong. :o

 

Dont worry jen, I get the highs too and when i'm low is to have a jelly bean (Black ones please} :) Sorry if i did confuse you. :confused:

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Maybe I am just tired, and had a bad day. I am not trying to come off as unappreciative. I am not worried about staying high for long periods of time. I don't know where the GI comes into effect, because like I said in previous posts, I either go too low, or end up in my target four hours after the meal. The issue I am having is either going too low four hours post meal, or going too high two hours post meal. I can't adjust my bolus wizard to do a 1:10.5, so I am stuck using either the 1:10 or the 1:11. It seems that either way, I have one problem or another. My question probably should have been, which is the lesser of the two evils? Going to 180 two hours post meal with the 1:11,and then reaching my target four hours after, or reaching my target of 140 two hours post meal, and then going to 45 four hours post meal with the 1:10? The only reason I even changed from 1:10 to 1:11 is to avoid those nasty lows before lunch that were happening every, single day. Now I am fighting with the 180 readings two hours after breakfast.

I ALWAYS test before bolussing. I am on a minimed 722 pump, so I do not inject. But yes, I do test before each and every meal to do the math as to how much insulin to bolus. I have found, that even if my sugar is in my target range of 100-120 before a meal, I should still wait at least fifteen minutes after a bolus, to avoid a spike. If I eat straight away, or bolus after I begin eating, I always end up at 160-200 after a meal, not the 140 that my endo and I are shooting for. I guess I am just going to have to make a choice as to which I would rather do, deal with the mild highs for a bit, or deal with the lows before lunch and go ahead and have a small snack. I am sure I will get it figured out soon.

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No what i do is i eat the little carb snack when i test and if i am 140 or under i eat it....i am always fine 2 hrs later seriously that is what i meant, LOL.....Tell me how your basal cut back goes if it works for you i might try it, but i enjoy that cookie or mm's or a couple of reese's cups the minatures of course LOL....I am being bad but oh so good at the same time....LOL, but i will get something healthy too sometimes it depends on my mood, i do a cookie if i am not active i do the chocolate if i am.

 

I am sorry it is fustrating i was getting fed up with breakfast till i thought why don't i just flippin eat this small little snack 2 hrs after breakfast cause everytime it was 140 or under 2 hrs after breakfast i was going in the 50's before lunch, so instead of making myself personally crazy of a never ending battle I decided to just eat a tiny snack, before any hypo and like I said i am in a good range by lunch perfect.....so I just gave in cause insulin is so long lasting LOL....can't fight it with stubborn morning you are just like me my ratio is 1:10 and I have to wait 15-20 minutes to eat to bolus too....unless i am already low in the morning.....

 

Cheryl

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I understand your frustration with this problem... you try to get it right and it just doesn't quite work. When I was on Novolog, I tried out many things (except super-bolusing... didn't quite know what that meant, still have no clue) and it just didn't work out. So I learned to accept the 180 post-meal readings because I chose not to experience the lows later on. I hate feeding lows or snacking when I don't want to or when I'm still full from the previous meal. I don't think that a 2-hr period of you hanging about 180, which is on the way down anyway, is too much of a problem, but that's just me. Like you said, it's up to each of us to decide what guidelines to set for ourselves, and often that means choosing the lesser of two evils. :tongue: You could try the lower target for a while and see if you can handle snacking or preventing the lows. Being on the pump, and if breakfast post-meals are the biggest problem for you, I wonder if you could tweak your basal around to either increase during that post-meal time period to help keep levels down (this would be with a 180 guideline) or decrease your basal to keep you from bottoming out (this would be with a 140 guideline)?

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I understand your frustration with this problem... you try to get it right and it just doesn't quite work. When I was on Novolog, I tried out many things (except super-bolusing... didn't quite know what that meant, still have no clue) and it just didn't work out. So I learned to accept the 180 post-meal readings because I chose not to experience the lows later on. I hate feeding lows or snacking when I don't want to or when I'm still full from the previous meal. I don't think that a 2-hr period of you hanging about 180, which is on the way down anyway, is too much of a problem, but that's just me. Like you said, it's up to each of us to decide what guidelines to set for ourselves, and often that means choosing the lesser of two evils. :tongue: You could try the lower target for a while and see if you can handle snacking or preventing the lows. Being on the pump, and if breakfast post-meals are the biggest problem for you, I wonder if you could tweak your basal around to either increase during that post-meal time period to help keep levels down (this would be with a 180 guideline) or decrease your basal to keep you from bottoming out (this would be with a 140 guideline)?

 

 

 

I like when people say that, that 180 is ok......but being on my pump the type of snack is so so small, i think anyone can fit a 4 to 8 carb tiny thing in there mouth eat it quick and go, before a hypo, it doesn't take much on the pump to bring the bg up.

 

I also have a question on Apidra, Does it really work fast.....I get nervous about that, not so much at breakfast or lunch but i already have to most of the time wait to bolus for dinner for some odd reason, otherwise I'll get low, that is the only reason i am scared of Apidra, it works very quickly, but I like how it is gone so fast though, so maybe with me all the humalog running around in my system bumping into each other or stacking causes this and I might not have issue's with Apidra, I don't know I am so tempted to try it, I just don't want to plummit after i eat.....

 

Cheryl

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Just a teeny update. I tried the 1:10 with breakfast this morning. Before breakfast my sugar was 74, and got a two hour post meal reading of 137, I then cut my basal back to 50% for one hour, hoping that it would only effect the low before lunch and not have me ending up high later on. My four hour post meal reading was then a 77. I am going to try cutting back that basal a tad more tomorrow and see what happens. 77 is fine for me, but not what I would want to get if I was driving around. Seems like the idea of taking away from the basal works fine. We will give it a few more days and see what happens. :)

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Just a teeny update. I tried the 1:10 with breakfast this morning. Before breakfast my sugar was 74, and got a two hour post meal reading of 137, I then cut my basal back to 50% for one hour, hoping that it would only effect the low before lunch and not have me ending up high later on. My four hour post meal reading was then a 77. I am going to try cutting back that basal a tad more tomorrow and see what happens. 77 is fine for me, but not what I would want to get if I was driving around. Seems like the idea of taking away from the basal works fine. We will give it a few more days and see what happens. :)

 

Oh cool that is great news Jen, I am glad it seems like it might work, so let me know how it goes......yay

 

Cheryl

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The most oft-debated question in Diabetic history I thiknk, lol.

 

In Canada (and me personally) we are taught to aim for a range of 7-10.0 2 hours after a meal. So, your 180 is perfect, as far as I'm concerned.

 

I wouldn't think you're "spilling" sugar then either, but i could be wrong.

 

 

Now, you will get different advice from different countries, and some on here are far more hardcore and think you should stay at 5.0 alll the time, but on my regime, a 10.0 (with proper basal and bolus ratios) will get me down to 4.5-7 before my next meal, so I'm happy.

My Dr told me that a 'spike' of 10 - 14 is normal for my 2 hr after eating reading............... ???

Teejaxx

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Like Jen, I am now on Apidra. I only switched a couple of weeks back so it's early days, but so far it does seem to do the vast majority of its work in the first 1.5 to 2 hours and then back off. For most foods, this seems to work well for me.

 

Novolog used to get me exactly where I wanted at the 4 hour mark. Breakfast always used to have me really high. Apidra has sorted that out.

 

It does seem to have a bit of a second peak with me at hour 3-4, though not much. I eat a fairly healthy diet and there is normally something low gi in there, so the second little peak mops up that bit. Seems to back right off in me between hours 2 and 3 which is weird...

 

Gary

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I also have a question on Apidra, Does it really work fast.....I get nervous about that, not so much at breakfast or lunch but i already have to most of the time wait to bolus for dinner for some odd reason, otherwise I'll get low, that is the only reason i am scared of Apidra, it works very quickly, but I like how it is gone so fast though, so maybe with me all the humalog running around in my system bumping into each other or stacking causes this and I might not have issue's with Apidra, I don't know I am so tempted to try it, I just don't want to plummit after i eat.....
For me, yes, Apidra works very quickly, but that effect seems to vary among individuals. If I am less than 100 before a meal, I'll bolus after I'm done eating. If I'm 100-140, I'll bolus right before I dig the fork in, that seems to work well with food absorption and Apidra kicking in. But it literally starts working in 10 minutes - very nice when you're high and want to get back down. And yeah, it's gone faster too for me, so it can make super fatty meals a problem. Though I try to avoid those on the grounds of eating healthy anyway. :wink:

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After considering all the facts, my money is on the basal being a bit high.

 

I am actually 100% positive that is not the case. I have done numerous basal tests. When I do not eat, bolus, or anything, I have a steady sugar reading that may fluctuate ten points or so. I have done these tests by testing every hour from the moment I get up, until the next meal time, which would be lunch, and the lows do not happen. The only time I have these lows, is when I do in fact eat breakfast, and use my 1:10 ratio. When I use the 1:11 I do not have the problem of lows, but am hitting 165-180 two hours post meal, which to me, seems high. I am working on fixing this, and think I have it figured out. Breakfast is at a different time every day, so I cannot exactly plan ahead for my one hour of decreased basal. So, like I did today, I am going to decrease my basal for one hour, directly after my two hour post meal bgl.

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