Always hypo before lunch

[newbs]

I have to test my basal and plan to do so very soon, but in the meantime I was wondering if anyone had any ideas as to what I can do to stop hypos before lunch? Have spoken to DSN who thought my morn ratio too high (2:10) and basal too low (18u) but have tried tweaking that to no avail. Spent 3 days with a higher basal (19u)/lower breakfast ratio (1.5:10) and this meant mid-morn BG was 16+ but still crashed down to 2.3 before lunch. Have now adjusted morning ratio back up so 8.1 mid morning today, 2.8 before lunch. Nothing seems to stop me going hypo before lunch.

 

[novorapidboi26]

I would say continue to drop your breakfast ratio, but until you know if the basal is contributing you shouldn't really adjust the bolus.......

remember between meal readings are to do more with timing as opposed to dose...........

 

[newbs]

I would say continue to drop your breakfast ratio, but until you know if the basal is contributing you shouldn't really adjust the bolus.......

remember between meal readings are to do more with timing as opposed to dose...........

I've never really adjusted the timing, tend to always inject immediately before meals unless I know it is low carb and inject slightly after. I have now read up a bit and plan to try injecting 15 mins or so before breakfast as that is my problem area (with a lower ratio) to see if that helps. Thanks.

 

[Pumper_Sue]

Hi Newbs,
a simple solution for the time being would be to have a snack mid morning. Not ideal but if it works, why not?
Do you split your basal and what are your readings before breakfast?

 

[newbs]

Hi Newbs,
a simple solution for the time being would be to have a snack mid morning. Not ideal but if it works, why not?
Do you split your basal and what are your readings before breakfast?

No, I don't split my basal. My readings before breakfast vary quite a lot from 6.6 to 13.6 in past week.

I do sometimes have a snack but it is a pain because I am usually high when I would want the snack time wise, then when I hypo it tends to be nearer lunch time, I definitely get what you are saying though.

 

[everydayupsanddowns]

Really tricky to know Newbs. By the time your BG is falling you might expect your breakfast dose to be on the way out, which might suggest basal is running high - however some people get 5+ hours of action out of a bolus so hard to be sure.

Have you tried keeping breakfast ratio the same and reducing basal by 1u?

Are your levels OKish for the rest of the day?

 

[newbs]

Really tricky to know Newbs. By the time your BG is falling you might expect your breakfast dose to be on the way out, which might suggest basal is running high - however some people get 5+ hours of action out of a bolus so hard to be sure.

Have you tried keeping breakfast ratio the same and reducing basal by 1u?

Are your levels OKish for the rest of the day?

I have tried keeping ratio the same with a lower basal, higher basal and lower ratio, tried higher ratio with basal the same too but nothing at all seems to make a difference to my post breakfast level. Today I injected NR 15 mins prior to breakfast but still ended up 16.3 2 hrs later which dropped to 11 within 20 mins and continues to fall rapidly after that, I had a snack today to avoid the hypo as had to drive too.

My levels are pretty stable throughout the rest of the day, it's just the mornings I can't figure out.

 

[novorapidboi26]

You might need longer than 15 minutes....................

If your low by lunch it would suggest not enough bolus for your breakfast, regardless of how extreme the spike was........

What do you have breakfast?

 

[newbs]

You might need longer than 15 minutes....................

If your low by lunch it would suggest not enough bolus for your breakfast, regardless of how extreme the spike was........

What do you have breakfast?

Breakfast varies, always cereal though - I alternate between Weetabix (2), Shreddies, Porridge and Special K mainly.

 

[novorapidboi26]

Breakfast varies, always cereal though - I alternate between Weetabix (2), Shreddies, Porridge and Special K mainly.

Some may say that this is you problem, a lot of type 2 folk just cant eat that........as a type 1 its manageable with the timing, so I would experiment more with that.........

The absorption of cereals is reasonably fast I believe, with porridge being slightly slower, so you need to get the insulin in and ready to go long before you eat I think......

Could you have a carb free fry up one morning and see how that goes?....

 

[newbs]

Could you have a carb free fry up one morning and see how that goes?....

Mmm, sounds good!

 

[Monkey]

What works here is split lantus (23u about 9.30pm and 8u about 7.30am), breakfast about 8am (having taken humalog with lantus at 7.30am) and a mid morning snack.

Has taken a lot of trials to get there tho!

 

[schmeezle]

Hi newbs,
A big factor in spikes is also how fast the food is eaten. Along w/pre-meal bolus timing, yet more timing to consider.......fast carbs eaten in short time = spike.

Any chance you could add more time to breakfast? Or split into 2 chunks at least 30 minutes apart? Or something along these lines. Who wants mushy cereal.....so, may only work with porridge.

I would expect to use less insulin when trying this approach - you're allowing less insulin do more work when the "peaks" are more aligned. Another byproduct would be less frequent/severe lows. Dunno if that makes sense......