Jump to content
Diabetes forums
  • Welcome To Diabetes Forums!

    Registration is fast, simple and absolutely free so please, join our community today to contribute and support the site.

Archived

This topic is now archived and is closed to further replies.

bigskygal

15g Glucose Challenge

Recommended Posts

bigskygal

I originally posted this in a thread in the Type 2 area, but decided to re-post over here to see if anyone else has any insight/feedback. Has anyone else tried seeing how much 15g of glucose raises your blood sugar? I tried this after reading Tribbles' post that it might help you to figure out how much your blood sugar is impacted by each gram of carbohydrate as I'm still having trouble figuring out how much fast-acting insulin to take. Any feedback most welcome!

 

Okay, since my insulin needs are bouncing all over the place, I decided to try Tribbles' 15g of glucose test last night. I hadn't eaten for 8 hours (early dinner) and hadn't had any fast-acting insulin since breakfast. Here are my results:

 

Before glucose: 99

20 minutes after glucose: 104

40 minutes: 158

60 minutes: 133

Next morning (7 hours later): 129

 

So, any ideas about what these numbers mean? If I take the 158 as my peak even though it happened a lot later than Tribbles predicted, I guess 1g of carbs raises my blood sugars close to 4 mg/dl (at least last night, I seem to swing around a lot). Or, do I take the 130 because that's where my bg ultimately ended up, in which case it's about 2 mg/dl rise per 1g carb. That's a pretty big difference.

 

And it brings up other questions...could I have an intact first phase insulin response as it took a while for the carbs to raise my blood sugar? Also, is the fact that my blood sugar stayed at the one-hour reading all night an indication that I'm not taking enough basal? :confused:

 

Thanks in advance for any insights on all this!

 

Kim

Share this post


Link to post
Share on other sites
PBER57

Being a 1.5 can have problems because your pancreas can be working better at times than other times. Have you considered R insulin vs the fast acting insulin for your meal time? Dr B uses R extensively which is slower and lasts longer flattening out the rise. Dr B only uses fast acting when he is in situations like restaurants when the time he is going to eat is more difficult. I use R and it lasts about 4 hours for me. The issue comes down to the individual as to how they digest food too. Some people I think digest better and others have a more delayed response.

 

As to your phase 1 alot of the readings would vary, at least they do for me, as to what I ate; greasy food vs salad for instance. Just eating 15 g of glucose tablets for me will raise me about 100 in a hour and my phase 2 would take me 4 hours to bring me back to the start point. Having said all this my issues are entirely different than your issues. Keep detailed logs and experiment. This takes a lot of tinkering.

Share this post


Link to post
Share on other sites
Subby
I originally posted this in a thread in the Type 2 area, but decided to re-post over here to see if anyone else has any insight/feedback. Has anyone else tried seeing how much 15g of glucose raises your blood sugar? I tried this after reading Tribbles' post that it might help you to figure out how much your blood sugar is impacted by each gram of carbohydrate as I'm still having trouble figuring out how much fast-acting insulin to take. Any feedback most welcome!

Kim

 

In terms of discovering your best dose, I think doing it this way is complicated. In terms of the insulin use, what you primarily want to know is how many carbs a unit of exogenous insulin covers, not how much x carbs raise your blood sugars. These two pieces of information may be related, but it's better to go straight for the direct relationship.

 

Again in terms of getting settled in with your insulin, I would pick a moderate, replicable amount of the kind of carbs you might normally eat, try a ballpark I:C ratio (I assume you have some idea already?) and try it. Adjust it up or down as needs be, according to the results you get.

 

Try that as your first "stage", if you want. If, once you have gotten the best results you still have issues such as early spikes/hypos, late spikes/hypos, then you can look at a range of other tactics. BEWARE of jumping the gun on making changes before you personally exhibit a reason to do it. You might have a slow reaction to carbs (or a reasonable phase one that reduces the initial spike) but you may also find that rapid acting does not work all that fast for you either. You need to seek evidence of what is going on for you, then reflect.

 

If you find that having determined the best possible I:C and tinkered with timing and even insulins, you still can't achieve what you want, you might be in the boat of going lower carb, or at least being very specific about different types of carbs and which ones with match your insulin. There is marked difference in different carbs and how quickly you might digest them. This might be partly informed by the GI index but personally I find that very hit and miss, and it needs to be informed by your own experience as to what carbs you can match and what are just too fast. The fat content also plays a big part in often slowing down the release of carbs: that might be good news across the board for a non-insulin dependent, but personally it's high fat/high or mod carb foods that I find the most troublesome to match.

 

You might also need a different I:C at different times of the day, so when you are starting off trying to pin at least one point of reference down, you might like to run that experiment at a similar time of day, too. Then when you try that food/insulin combo at another time and let's say it is not so successful, you know that it might be this issue that is complicating things, and you can look into determining a second I:C ration for that time of day.

 

And you might find there are variables all the time, especially as a 1.5 (I don't think you should expect this is a default until you have exhausted all other tactics for good insulin delivery). I find there is a certain amount myself, and I'm not 1.5. The main point is hone in in a fuzzy way, focus on improving your various challenges to a standard you feel is good but also reasonable given a fuzzy situation, rather that getting one thing or other perfect. You can always come back to it later.

Share this post


Link to post
Share on other sites
bigskygal

Subby,

 

Thanks for all the information in your reply. You're right that the important thing really is insulin to carbs rather than carbs to blood sugar...guess I lost sight of that. I thought I could get from one to the other, but I certainly have been seeing impacts from all the variables you mention (and some you don't, being female :D ).

 

I have been going on 1 unit of humalog lowering my blood sugar by 50 points, though that doesn't always seem to hold, and 1 unit of insulin for every 20g of carbs.

 

But I'm beginning to think I might be getting in trouble with timing...if it takes that long for pure glucose to hit my system, it's probably taking even longer with regular foods. So, I'm going to test a few times after eating without taking insulin to see how and, more importantly, when a normal meal impacts my blood sugar.

 

PBER...tinkering is where I'm at, probably need to get better at record keeping tho.

 

Thanks! And I'll post more data soon.

 

Kim

Share this post


Link to post
Share on other sites
lorilei

I rise approx 5 points for every gram cho...so 15 x 5= 75..i lower by 1:40..which is give or take..i think i lower by a bit more but I'm kind of used to this math ..so I think of everything in terms of 1:5, 1:15, 1:40...I'm really good at math that way:) I think schenier has a formula or scale listed in his book and I recall being fairly close..

Share this post


Link to post
Share on other sites
jenb

I'd use the peak level that you achieved as your guideline.

 

1 gram of glucose increases my BG by between 6 and 9 points. The best use of this information (at least for me) is determining what it will take to correct a low without overtreating it. The standard "eat 15 grams of carbs" recommendation was one of the worst I got at the beginning of my diabetes journey. I just could not understand why I was skyrocketing and then spending a day yoyoing between high/low/high/low. Simple arithmetic! 15 grams of carb took my BG 90 to 135 points higher; so correcting from, say, 53, I'd end up somewhere between 140 and 200! Not good if your target range is 70-100. Armed with the 6-9 point knowledge I now use one 4-gram glucose tablet and have completely eliminated the yoyo effect.

 

Anyway, Kim, this is probably a little off your topic but I hope it's useful anyway :o.

 

Jen

Share this post


Link to post
Share on other sites
lorilei

excellent advice jen..to each his own..2 days ago i watched the nurses treat a type 2 at 52bg with no sx's..and end her up at over 300..the sliding scale she's on and the protocol the nurses have at the senior day care i treat at leave little room for their own interpretation/knowledge..recently finding out about my own experience/knowledge of diabetes/insulin ( they didn't know for almost 3 years that i am diabetic..but i have helped a few of them with personl issues re: bg and insulin) )has made them more aware..but they can do precious little b/c they are held by md orders....and trust me..there is NO experience LIKE YOUR OWN EXPERIENCE

Share this post


Link to post
Share on other sites
jenb

Wow Lori - that must be so frustrating to watch. I know it's easier on the docs and nurses to use a one-size-fits-all approach, but even they have to recognize that their approach is not producing the best care. Argh!

 

Jen

Share this post


Link to post
Share on other sites
lorilei

yep jen..i could not help the grimace that crossed my face..and when it comes to ppl with whom i work..i almost feel like i have to walk away..i can toss some knowledge out there and try to redirect..but trust me..precious few ppl in our field will listen if they think they KNOW diabetes ( ie aced a test in it in med school etc)..a nurse whose husband i had helped just looked at me and kind of rolled her eyes bc she knew what i was thinking..sadly, i know that i cannot help but exhibit some signs of my own frustrations at this and i know the nurse knew i was exasperated..it was easier in the proverbial "closet" so to speak b/c i would just tune out and walk away and let my own denial wash over me...i have thought of getting my cde so that i can wear a badge and give some feedback that others might actually weigh with their own opinions/preconceived notions...

 

i have already heard once or twice.."but this person is a 2"..like i would have no idea about bg control as a 1 b/c their needs are different..and that is true to some extent..they are..but BG, insulin, and corrections..they are what they are..and not a half followed protocol thought out in the 80's...arghh..vent still brewing..

Share this post


Link to post
Share on other sites

×

Important Information

By using this site, you agree to our Terms of Use.