Basal/Bolus Type 2 glucose levels

[JimBear]

Hi folks,
I have been doing reasonably well since being prescribed basal/bolus but need a little reassurance please.

Generally, (until being put on Sertraline - see other post), my numbers have been pretty stable but I have a couple of queries regarding the resulting numbers.

Pre-Breakfast reading 6.5
Breakfast carefully weighed out and calculated and basal (30 units) and bolus injected together (and recently 10 mins prior to eating, and plus an extra unit to try and reach target of 5).
2 hours post brekkie reading: 8.9
Nothing further to eat and unsweetened tea/water until lunchtime.
Pre-Lunch reading: 4.3
Fast forward to evening:
Pre-dinner reading: 5.3
Everything carefully weighed and basal (32 units) and bolus injected together immediately before dinner.
2 hours post dinner reading:8.3
Pre-bed reading 6.7
Pre-breakfast reading 6.5

Those numbers have been pretty typical, but I am confused as to why post-breakfast my numbers are so high, then drop so much towards lunch. I am also confused as to why my post dinner readings are within acceptable range, as is my pre-bed number, yet it only drops a little over the course of the night and I can't seem to get it to come near 5.

I am sure I am doing something wrong but I am not sure which dose(s) need adjusting to try and keep things more in-line. (Post lunch numbers seem OK).

Any guidance much appreciated
Jim 🙂

 

[Kaylz]

6.5 is just fine to be sitting at and you shouldn't add anything for a 6.5 that's why you are lower by lunch time some people stay level overnight, dip and rise, rise and dip blah blah, its nothing to be concerned about, as far as I can see you are doing everything RIGHT apart from trying to correct a 6.5 🙂 x

 

[JimBear]

I thought if I could start the day off on a 5, then the other numbers would fall into place? Thanks for the reassurance 🙂

 

[Kaylz]

Anything between 4-7 is fine to be in some people don't correct unless over 10, just because you wake up on a 5 doesn't mean you will stay level all day and the other numbers will fall in to place, there is absolutely NOTHING wrong with the levels you have mentioned, yes there was a 3mmol spike after dinner but that spike may have been avoided by a change of bolus timing i.e longer between injecting and eating, as you've recently started doing with your breakfast, hell I started on a 5.0 today but I've been up in the 7's too due to having a hypo x

 

[Ljc]

Hi . Your numbers are pretty good. When I was first put on insulin I was told to do a correction if 15.0 or over. However personally I think that's far too high also I start to feel rough in the mid 9s so I now do a correction if 10.0 or over as we need wriggle room, injecting insulin is rather a blunt instrument and sometimes for no apparent reason, though our body does have one, we can drop rapidly.
If I'm near a mealtime, say around an hour , before a meal I wait till my mealtime bolus to do the correction
If my meal is more than an hour away , I do a conservative bolus.
It's safer to run a little high for a while than have a hypo.

I found this on our man website
Type 2 diabetes (Diabetes UK Council of Healthcare Professionals 2015)**

• before meals: 4–7mmol/l
• two hours after meals: less than 8.5mmol/l.

 

[JimBear]

Thanks LJC - I've been quite pleased I've managed to keep under 8.5 after meals most of the time, and I've always strived to be within the 4-7 for the rest of the time, though I like to try to keep between 4-6 where I can.