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Spiking

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
M

May Rhymer

Member
Relationship to Diabetes
Type 1
My husband, Joe, for no reason spikes in the evening. He is Type 1, for almost 30 years.
He carb counts, has the Libre Sensor, however, we're at a loss on understanding these spikes.
Any hints/tips would much appreciated.
Thank you
May
 
Hi May and welcome to the forum.
We need a bit more info please 🙂
What insulin does Joe use and how long before meals does he inject if on MDI?
 
Hi is on Fiasp.
He injects 5 mins before a meal.
Before breakfast 18 units.
Before lunch 6 units
Before dinner 18 units.
He is not overweight and is relatively healthy.
 
You say he carb count so I assume by the doses stated he eats the same amount of carbs at each meal everyday? (if that makes sense?)

Has he tried adjusting the time he pre boluses by?
xx
 
May Rhymer said:
Hi is on Fiasp.
He injects 5 mins before a meal.
Before breakfast 18 units.
Before lunch 6 units
Before dinner 18 units.
He is not overweight and is relatively healthy.
Click to expand...
Wow that is a lot of bolus insulin.
What time does his spike happen after he has eaten? Also what are his numbers before he injects?
 
Kaylz said:
You say he carb count so I assume by the doses stated he eats the same amount of carbs at each meal everyday? (if that makes sense?)

Has he tried adjusting the time he pre boluses by?
xx
Click to expand...
Yes, he has the same amount of carbs to match to his meals every time.
 
His sugar level tends to go up as the evening commences. He can be around 10/12 prior to his evening meal, then end up at 18/ 20 by late evening. Subsequently, he has to take an another couple of units.
 
May Rhymer said:
for no reason spikes in the evening.
Click to expand...

For what little it's worth that's the main time I seem to spike too.

I suspect it's that I'm a bit less insulin sensitive in the evening, combined with that being my main meal of the day, and I don't usually do any exercise then (since it's late and now dark and rainy). I often go for a walk during the day (if only to buy some food). So my guess is that I'm relaxing more after dinner and using less energy.

My (partially effective) solutions involve eating a bit less in the evening, splitting the bolus (and using more), trying to do something other than watching TV after dinner (even if it's having a bath). (Most effective so far seems to be just to eat a bit less in the evening. Since I'm a bit overweight after all this working from home that's acceptable, but may not be what someone else would want to do.)
 
What basal insulin is he taking? Has he basal tested recently?
xx
 
Bruce Stephens said:
Since I'm a bit overweight after all this working from home
Click to expand...
Sorry to go off topic but seen a few mention that, my partner put a bit on while he was on furlough, he then started to lose it again when he went back then obviously he had his accident and piled it and more back on over the 10 weeks he was signed off for, he's on week 3 of being back again and with a 1 mile walk to get there from his bus stop he should lose it again in no time lol xx
 
Kaylz said:
Sorry to go off topic but seen a few mention that, my partner put a bit on while he was on furlough, he then started to lose it again when he went back then obviously he had his accident and piled it and more back on over the 10 weeks he was signed off for, he's on week 3 of being back again and with a 1 mile walk to get there from his bus stop he should lose it again in no time lol xx
Click to expand...
 
Many thanks Bruce, I might try giving him less food in the evening, however, if anything he's a little underweight.
It's quite hard for a Type 1 to put on weight unless he eats a lot of unhealthy foods which will obviously impact on his diabetes and overall health. A bit of a nightmare!
 
May Rhymer said:
Many thanks Bruce, I might try giving him less food in the evening, however, if anything he's a little underweight.
It's quite hard for a Type 1 to put on weight unless he eats a lot of unhealthy foods which will obviously impact on his diabetes and overall health. A bit of a nightmare!
Click to expand...
that's not true, to gain weight I ate chunks of cheese, boiled eggs, cold meats, nuts things that don't require insulin as they have no to very little carbs and I was severely underweight as I was suffering from an eating disorder xx
 
@May Rhymer when does your husband take in basal insulin?
I wonder if the spike is just before he takes it. If so, it could be that his basal is not lasting the full 24 hours and is running out in the evening.
 
May Rhymer said:
Many thanks Bruce, I might try giving him less food in the evening, however, if anything he's a little underweight.
Click to expand...

Maybe try the same food but just accept that a higher bolus is needed, and split it if necessary. (So take some 5 minutes before and some just after the meal, say. I'm using NovoRapid which is a bit slower overall but the same principle applies to Fiasp.)
 
Kaylz said:
that's not true, to gain weight I ate chunks of cheese, boiled eggs, cold meats, nuts things that don't require insulin as they have no to very little carbs and I was severely underweight as I was suffering from an eating disorder xx
Click to expand...
I was going to "Like" your comment.
But I can't split the comment.
I agree/like your comment about being able to put on weight without eating unhealthily.

But liking the whole comment seems like I like your eating disorder. I hope you are ok now.
 
May Rhymer said:
My husband, Joe, for no reason spikes in the evening. He is Type 1, for almost 30 years.
He carb counts, has the Libre Sensor, however, we're at a loss on understanding these spikes.
Any hints/tips would much appreciated.
Thank you
May
Click to expand...
Hi May,

If it isn't a shortage of basal, it could just be down to ratios.

My carb ratio for breakfast is 2units of insulin per each 10g of carb, its 1.5 units per each 10g of carb at lunch and 1:1 at evening meal. Perhaps it's just a matter of working out his evening insulin to carb ratio. It's not unusual for ratios to change from time to time. You said he is going up to 18 afterwards. That's like 30g of carbs too much food, or 3 units to lttle of insulin. If I was eating same carbs at each meal, I'd try increasing insulin by 1 unit each night until things level out.
 
I would also guess at not enough basal being Joe's problem.
Joe probably wont like it but I would suggest skipping an evening meal and testing every hour or two so he can see what is going on.

General rule of thumb though is not to eat until bloods below 8, so that could also be a factor in things.
 
Pumper_Sue said:
General rule of thumb though is not to eat until bloods below 8, so that could also be a factor in things.
Click to expand...

Yes, at least some of the time I've been a bit higher than I want before eating and that certainly makes spikes afterwards more likely.
 
Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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