Bolus issues with evening meal

[Minnie19]

I’ve been struggling with high’s around 11-2am but otherwise I’m pretty stable. Despite increasing my basal between 9-12 it hasn’t made much of a difference. I’ve been to clinic today and was advised that it is likely a post dinner spike and that adjusting my carb ratio at dinner and giving my insulin earlier should help. So you tonight I changed my carb ratio from 1 unit for 13g to 1 unit for 10g and gave my insulin 20 minutes earlier. Half way through dinner I’ve had a hypos. Ended up having a lot of sugar to bring it back up, certainly was a bad one. But I’m surprised I haven’t ended up the other way. Still stable at 5.6! Any one else have similar problems? I’ve tried all sorts including using dual wave bolus and it just doesn’t seem to work. CGM for reference. Thanks

 

[Bruce Stephens]

Any one else have similar problems?

Yes, I find evening meals a bit tricky. I find it's easier just to eat a bit less carbohydrate for that meal. Or (just as likely) not to worry too much. In summer sometimes I go for a walk around the block, and that can help with a spike.

 

[Pumper_Sue]

The simple solution is to do a basal ie, skip your evening meal. If you are still going high then increase your basal at 9 AM so it catches the 11pm rise

 

[trophywench]

What did you actually have for your meal?

 

[Pumper_Sue]

Yes, I find evening meals a bit tricky. I find it's easier just to eat a bit less carbohydrate for that meal. Or (just as likely) not to worry too much. In summer sometimes I go for a walk around the block, and that can help with a spike.

What at 11pm at night? 😱

 

[Bruce Stephens]

What at 11pm at night?

After my evening meal, so 8 or 9pm. (If it's 11pm I just give up. Not every night can be perfect.)

 

[Minnie19]

I had a low carb halloumi, tomato and courgette bake for tea. The carbs was 1 slice of garlic bread with it, so only a small amount of carbs.

 

[Inka]

That was a big jump for your ratio. Perhaps try 1:12 and gradually increase if that doesn’t work? Likewise with bolus timing - move it forward 5 mins at a time. It’s tedious but better slowly and safely.

I find if I have a low carb evening meal my blood sugar often goes high a few hours later. It’s a lazy answer, but what I do is make sure not to have too few carbs. If it’s happening after other carbier meals, then bolusing more in advance and altering your ratio as you’ve done might work. If not, adjust your basal (with caution). I hate highs after my evening meal, so always test and correct if things look like they’re going wrong. If it continues after adjusting my ratio and timing, I then look at my basal.

 

[Pumper_Sue]

I hate highs after my evening meal, so always test and correct if things look like they’re going wrong. If it continues after adjusting my ratio and timing, I then look at my basal.

No1 rule of pumping is check your basal first.
It's so much easier and quicker than messing around trying different things and confusing everything in the process.

 

[Inka]

Hi Sue 🙂

I’ve never heard that rule before. Ignoring things like illness and set failures, I tend to find any highs I have are caused by meals - getting carbs slightly wrong, bolusing at the ‘wrong’ time, choosing the wrong type of bolus, etc, etc, so that’s what I personally look at first (unless circumstances point to it clearly being a basal problem, of course).

 

[Pumper_Sue]

Hi Inka and welcome to the forum.
Rule of thumb is normally if a problem ……. hypo or high within 2 hours is normally a bolus problem. Anything else as in Minnie 19's case would be down to the basal.
So easiest and quickest solution is check basal first, from years of experience it sure does save a lot of frustration as well 🙂

 

[Inka]

Thanks, Sue 🙂

 

[trophywench]

How much fat do you reckon was in that, Minnie? I find I always have really late spikes after high fat food. Makes no difference BG wise whether its mono saturated fat or any other sort. My body doesn't differentiate when it comes to BG - much the same as it couldn't care less BG-wise whether the carbs I eat are wholemeal, green brown or pink!

Halloumi is full fat, and of course whatever you spread your garlic bread with that contains the garlic - I mean I'd use butter but sounds like you are vegetarian