Double peaks

[janedent]

Does anyone else get loads of double peaks? They happen to me a lot. Take tonight... I took insulin, then 15 minutes later I ate 150g of pasta and some vegetables, that's all. BS was 13.7 after an hour and a half. I wasn't best pleased, but then it went down to 9.9 and I thought it was heading in the right direction. 10 minutes later it was 15. As I say, it's happened a lot recently. I keep increasing the insulin to carbs ratio and taking more Novorapid (I started at 1:12, now I'm 1:8), but it doesn't seem to make any difference to the double peaks. What am I doing wrong? How can I prevent this? Any thoughts much appreciated.

 

[mashedupmatt]

This does happen sometimes to all of us, but regarding Novorapid - I personally didn't find it as rapid as the name suggests (Disclaimer, this is my own experience and not medical advice) so had to take it a lot before the 15 mins recommended time - that may help avoid the double spikes but please do this gradually - try 5 mins earlier and if it is still happening, try another 5 mins before (so 25 mins before eating) - and this may also be different depending on which meal your are having - If that doesn't work, then maybe think about your ratios again, but I'd advise speaking to your healthcare team before doing so

 

[Inka]

I split the bolus for pasta @janedent You could try that. It’s a matter of experimentation as to the timings and the percentages of the split. I wouldn’t bother looking at the 90 min reading. Just look at the two hour reading if you want. The aim is to be back in range by your next meal (or bedtime in this case).

Also, are you sure your basal dose is correct?

 

[everydayupsanddowns]

Like @Inka I’m wondering about your basal dose @janedent

Especially if your bolus ratio has been rising recently. I find most often it’s a slight change in my basal requirements which can be throwing my meal doses out of whack (eg because my underlying BG is gently creeping upwards, rather than being held steady, so my meal doses are facing an uphill battle).

 

[janedent]

Thank you everybody - it's good to hear how others have tackled the problem. I've upped my basal dose slowly over the last couple of weeks (reckoning I've left the honeymoon period) and was pleased today that my morning BS graph was looking good. Of course, one swallow doesn't make a summer, but you gotta celebrate the wins.
I will try taking the bolus earlier at dinner time and see if that helps, and maybe splitting it too. And not panic about the BS number till 2 hours after a meal.
I have this rule I made for myself that when the after- dinner BS reading gets down to 8, I can have my pre-bedtime snack, which will hopefully (and usually does) keep me going through the night. But recently I've been waiting up to 5 hours to reach the magic number of 8 and find myself in the slightly ridiculous situation of forcing myself to stay awake in order to eat my supper.
Thanks again for all your thoughts. I will definitely try them all out.

 

[helli]

And not panic about the BS number till 2 hours after a meal.

Why only 2 hours when most fast acting insulins are active for 4 hours?

 

[janedent]

Pretty sure I won't be able to resist a peek though...