Achieving steady blood glucose results

[Amity Island]

Hi Everyone,

People often ask the question of how to achieve a steady in range (4.0 min-10 max mmol) blood glucose (without the spikes) and until I started using this forum it was a question I also often asked.

So….here’s my Libre graph today. I was hoping others could add in their typical days using a c.g.m or Freestyle Libre device and to make it meaningful and helpful, add in their bolus timings, carbs/fats/proteins etc to help others who are also trying to achieve steady levels.

I’m not saying this is the case every day of the year and I’m not saying this is easy either, but generally, I can stay within a reasonable range most days/times. This was not the case when I first switched over from finger pricking – pre-meal only -- to a Libre which showed un-satisfactory post meal spikes particularly at breakfast. After changing food types, particularly at breakfast (e.g avoiding most cereals, breads etc) most of the spikes have now disappeared. The result below is based on a steady and correct background basal dose and is taken on a typical at the office day.

**N.B I understand that some people find it almost impossible to predict their blood glucose reactions and the advice above probably wouldn’t be that helpful.

BREAKFAST AT 7.30am 40g ALL BRAN WITH MILK – 25g TOTAL CARBS.

INSULIN TO CARB RATIO A.M -- 1.3u to every 10g CARBS

3 units of quick acting Humalog 25mins before eating (7am).

LUNCH AT 12.25pm PASTA WITH TUNA AND SWEETCORN 60g CARBS, QUORN SAUSAGES 20g CARBS, CRISPS 20g CARBS – 100g TOTAL CARBS.

INSULIN TO CARB RATIO P.M -- 1.3u to every 10g CARBS

13 units of quick acting Humalog 20mins before eating (12pm)

-------------
For dinner I will apply a ratio of 1 unit Q.A to every 10g of carbs 20mins before eating dinner.

 

[missclb]

@Amity Island – that's an amazing result, well done. I'm aiming for as flat a line as you have, but have a bit to go yet. I'm so impressed with your complete lack of spikes. Thanks for sharing your regime, it's massively inspirational. Do you find that once you're stable, it's easier to stay so? Is that graph quite normal for you, or is this a particularly good day?

Today is a bit of a wobble for me as I woke up with slightly higher levels than I would like thanks to a wee chocolate binge last night (!!) I didn't get my insulin quite right for it, but at least I was stable through the night, as my basal is correct. I have bounced around a tad today since my correction this morning.

I'm still refining my meal time ratios. I'm on the right road, but not quite there yet. I see profiles of faces in my daily graphs!!!

 

[Amity Island]

Hi Caroline,

My graph normally looks a bit more bumpy, more like yours on most days, up and down, but generally in range (which is my aim). I'm just trying to show that the big spikes can be avoided with the right food types / meal combinations and bolus timings. Yes, I would say that once your levels are steady, it is much easier to stay in range as you're not in a battle. The Libre has been eye opening and a godsent in managing levels. It does however require much more effort than I gave before I had the Libre however, after a few months of testing and trials though it becomes much easier. It is funny how some days the graph can be very flat and other days, even through the night, you can get little bumps.
btw How did you bolus for the chocolate? Did you take your insulin just after you ate or did it require a split bolus?

 

[missclb]

Hi Caroline,

How did you bolus for the chocolate? Did you take your insulin just after you ate or did it require a split bolus?

I've only just learned that you can split your bolus, I had no idea that was a thing until I did the BERTIE online. Do you do that? I haven't actually tried it yet. Chocolate does normally make me rise quite high, up to 2-3 hours after consumption. Last night, I calculated my dinner and post dinner chocolate snack, and injected for both before I ate. So it was in effect probably about 45 mins before I actually ate the chocolate, maybe even more. It was all quite late as I was at work until about 9pm, I checked just before I fell asleep and saw that I was still rising ever so slightly, so did a small corrective dose (with hindsight, it wasn't enough). It's all a fine-tuning, learning-curve right now.