Bread.. Again.

C

Charl

Well-Known Member
Relationship to Diabetes
Type 1
Screenshot_20241030_154946.jpg
Usually have bread in some shape or form whilst at work for lunch, yesterday had
Bread, soup and some fruit
In total around 100 carbs, yes I know it's a lot, decided to change my bolus timing, took 5.5 units at 11.45 am, had lunch at 12am then took the other 5.5 units at 12.45 pm to see if my blood sugar rise would come down quicker which it did not, presume it's to do with the bread, anything else I could try apart from getting rid of the bread, novorapid is 1:10
Thanks
 
So that does look like a bit of a mountain but do remember that Libre has a tendency to over-egg highs so your BG may not have been as extreme as it looks.
The other thing to remember is that it is common to become insulin resistant when our BG gets high so it can take longer to come down
I have a couple of questions
- what was your reason for splitting your dose? It looks to me as if you needed more insulin at the start.
- have you tried pre-bolusing earlier (assuming it is possible at your work)? Some people find Novo(notso) Rapid, may need a bolus 40 minutes before eating. I am not suggesting going straight to such an early dose but it may be worth experimenting, especially as your BG has come down after 4 hours
- have you done a basal test? If you are building your bolus on a unstable basal foundation, it will be very difficult to get right.

Finally, please try not to judge the "right" amount of carbs based on what others on the forum report, especially as many of them have type 2 and maybe eating a low carb diet. If you can suss out your insulin, there is no reason not to eat 100g carbs if you want. I do not avoid pizza and that is usually more than 100g.
 
I wouldn’t have split the dose for that meal @Charl or at least not unless evidence suggested I needed to. Apart from @helli ’s great advice, I’d consider whether your ratio is right for that meal - that is, for lunch (any lunch) and for that meal (bread, fruit, etc) in particular. What did your blood sugar come down to before your next meal?
 
Another vote for injecting it all up front to prevent a spike like that and perhaps leaving longer between injecting and eating.

It looks like your levels were between 8 and 9 before lunch so that will also mean that you need to leave more time between injecting and eating than if you were at 5 or 6 before eating. Did you have butter on the bread? Fat/butter will help to slow down the release of glucose from the bread. Was it wholemeal or white. The fibre in wholemeal or seeded bread will again help to slow down the release of glucose which will slow the rise in BG and enable your insulin to catch up a bit, but essentially that graph suggests that you did not give your insulin enough time to hit the blood stream to match the carbs being released from the food.

In your situation, I would continue to have a very similar lunch but start by injecting all the insulin 15 mins before lunch instead of splitting it and see how that works out and then if you still spike high, I would experiment with injecting your insulin a few mins earlier every few days, so say 20mins before you eat and see how that works and if it still spikes too high after a couple of experiments, then try 25mins etc but you need to take into consideration your BG levels before you eat as if they are higher then it will take the insulin longer to overcome that and if they are lower it may well work much quicker.
 
Before next meal I had to top up with dextro as I was running low on my walk home...
Have tried bolusing earlier when possible but usually end up with an alarm just after lunch, had a change with the timing just to see if it made any difference to how long I stayed high, trouble is when walking home I top up with dextro then when home I'm usually low before my next meal so more dextro then I've evening meal to think about...Cheers
 
If you are walking home then you need to factor that exercise into your bolus calculation for that meal. Some people need to calculate their bolus and then reduce it by between 20-50% to account for exercise they will do later whilst that insulin is still active, or have a snack to provide carbs for that exercise.
 
Or, @Charl, just gracefully accept such a low could occur later in the afternoon and have a suitable snack in your pocket, perhaps something you would choose as a treat; then reward yourself accordingly. If this is going to be a periodic or even regular lunch routine, then clearly bolus adjustment for future exercise would be appropriate. But I find future exercise plans alter on the day, so I'm cautious about too much planning and the needing to correct because I've under-bolused. Horses for courses, methinks.
 
Charl said:
Before next meal I had to top up with dextro as I was running low on my walk home...
Have tried bolusing earlier when possible but usually end up with an alarm just after lunch, had a change with the timing just to see if it made any difference to how long I stayed high, trouble is when walking home I top up with dextro then when home I'm usually low before my next meal so more dextro then I've evening meal to think about...Cheers
Click to expand...

It’s not unusual to need a snack between meals if you’re walking/shopping/exercising. Try adding a small carby snack to ward off that drop. You might also need some Dextro before your walking, depending on how long it is, but a well-timed carby snack without a bolus should help.
 
I generally find that meals above a certain number of carbs can need a different ratio (extra insulin)

Having said that if you drifted low with the walk home it feels like you maybe just needed more of your insulin earlier.

Sounds really tricky with the walk home while the insulin dose is still pushing quite hard.
 
You must log in or register to reply here.
Back
Top