Help with snacking

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Abner55

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Hi all.. First question on the Forum..
My Wife is finding that she has to eat something every hour and a quarter to boost her levels as they drop at that time quite quickly, is this a usual occurrence, if not, is there a particular snack that’s recommended to keep levels up for longer?
Thank you
 
What blood sugar levels is she seeing and what medication is she taking for the diabetes?
 
Hi LucyR
Thanks for your quick reply
She is on Novorapid and Abasaglar, her levels seem to really drop quickly once they reach 8.5 and we try to react around the 7.0 mark to stop the fall
 
What is the lowest they drop to? If they’re dropping under 4 regularly then she needs to reduce her insulin doses. If you’re not sure on doing that yourselves then make an appointment with whoever she sees about her diabetes.
 
Hi LucyR
We try very hard not to let them get that low, so tend to react early because they look like they will just keep dropping!
 
Thanks Leadinglights
I have just read the reply and it was very helpful
Thanks for letting me know
 
Abner55 said:
Hi all.. First question on the Forum..
My Wife is finding that she has to eat something every hour and a quarter to boost her levels as they drop at that time quite quickly, is this a usual occurrence, if not, is there a particular snack that’s recommended to keep levels up for longer?
Thank you
Click to expand...

Hi @Abner55 Are these ‘every hour and a quarters’ related to her meals and mealtime insulin at all? Very roughly that kind of time is when you’d notice the bolus(meal) insulin starting to kick in.
 
Hi Inka
It seems to follow a pattern of breakfast at 8am, 9.15am levels drop (downwards arrow on libre) so have snack, 10.30 am etc. repeat process through the day
However, her basal insulin was dropped by one unit a few days ago and that seems to have made a difference, especially in the evening, so fingers crossed, thing may be getting better
 
That sounds like it’s the bolus(fast/meal) insulin then. If she’s dropping too low, try her reducing the bolus insulin or eating a few more carbs for that meal.

One thing to note as she becomes more confident, is that the timing of the bolus is important. If she has it too close to her meal, it won’t be working in time to stop a big spike upwards which is often followed by a big plunge down as the bolus starts working. Having the bolus injection slightly earlier smooths off the spike and reduces the plunge down @Abner55
 
Thanks Inka
She shall try having the bolus injection a little earlier as her levels do spike after meals, thanks for the tip
We can’t reduce the insulin as she is only on one unit per meal!
 
They make half unit pens @Abner55 🙂 Or you could simply increase the carbs slightly. When she moves her bolus injection earlier, do it cautiously in stages 5 mins earlier at each stage. She’s looking to find the sweet spot. This will often be different for each meal. As an example, I need 30mins in advance at breakfast, around 15 or 20 at lunch, and can basically inject right before eating for my evening meal. Her numbers will be different but it’s common to need different times for each meal.
 
Thanks again, Inka
They say you need a hobby when you’re retired.. dealing with the diagnosis seems to have turned into ours!!
 
Abner55 said:
Thanks again, Inka
They say you need a hobby when you’re retired.. dealing with the diagnosis seems to have turned into ours!!
Click to expand...
If you are able to post a picture of the Libre graph that might help people to spot what may be going on. Also how many carbs is she having at each meal?.
 
Hi Inka
20240407_103609.jpeg

Just been having a look at average carbs ( a bit new to this but used the carbs and cals book)
Breakfast 22
Lunch 44
Dinner 65
I have attached a pic of yesterday’s libre graph which shows the spikes after meals and when she snacks to lift levels
 
The downward drifting graph overnight suggests that her basal may still be too much. The breakfast spike would almost certainly be helped by cautiously extending the time between injecting and eating. I think the repeated peaks and drops after the breakfast spike are most likely caused by your wife panicking when she sees levels dropping and eating something to push levels back up. I think it is highly likely that her body is producing a reasonable amount of insulin itself still which may have improved since insulin was started (honeymoon period) and those ups and downs may be the body trying to push the BG down to normal levels and your wife panicking and thwarting it with snacks, rather than the breakfast bolus being too much OR it could be the basal is still too much during the day as well. I think one unit of bolus insulin is unlikely to be having that effect.... but I could be wrong. It is probably going to be a question of holding her nerve a little longer or having a smaller snack. The peaks are very uniform so I am guessing she is having the same thing each time.... what is she using?
 
Abner55 said:
Thanks again, Inka
They say you need a hobby when you’re retired.. dealing with the diagnosis seems to have turned into ours!!
Click to expand...

In Think Like a Pancreas, Gary Scheiner says Type 1 is a full-time job, and it really is! It does gradually get easier though so don’t let all this put you off. It takes time to get on top of things and your experience will increase gradually. You don’t need to know everything at once 🙂 If you take a fraction of what you’ve been told, then that’s good. Type 1 is a marathon not a sprint.
 
Hi Rebrascora
She tends to follow the same pattern each day, as we have an idea how certain snacks effect the levels
Generally the snacks are..
Morning.. First drop.. Toast and a scrape of marmalade
Second drop.. Banana
Afternoon.. First drop.. Orange, Banana, or pear
Second drop.. 3x Ryvita with peanut butter
Third drop.. 2x digestives
Evening.. First drop.. 2x Ryvita with peanut butter
Second drop.. 20 grams of Cornflakes or Granola to help overnight

Saying that.. the evenings have started to be a bit better with no real drops for a couple of evenings, and last night her levels stayed between 8.5 and 9.5 all night, so hopefully we are getting somewhere
Take care
Abner55
 
Ok @Abner55 well, some of those drops could be unavoidable (her own insulin kicking in late, a kick in the tail of her meal bolus, etc) but to have to have all those snacks shows something is a bit off with her insulin.

I strongly suggest she gets a half unit pen.

Also, what’s she eating for breakfast and lunch?
 
Wow, those are quite substantial snacks (about 20g carbs each), so I would say that this is likely her own insulin responding to bring her levels down and unlikely to be caused by an overdose of injected insulin. Basically, the insulin is doing what it is supposed to do and your wife's snacking is causing her pancreas to have to produce more insulin to cover what she has eaten. ie these drops are perfectly normal drops and will almost certainly level out in the 4s and 5s if she doesn't eat a snack. If she can get the injected insulin timing better she won't rise so much and then won't fall so fast, so the rise will not be as high and drop will be slower/gentler and less scary as a result.
 
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