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Help??

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Gillynumber1

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Type 1
Hi everyone, first time on here as I need some help!!
Often I have noticed my sugars jump really high when checked mid morning, for example this morning it was 8 after I got up. I had 2 toast and 2 coffees with milk, which I worked out as 2 each for bread and 2 for 400ml milk (in fact it was less milk than that) so that is 6, I took 7 units to bring my sugar down a little to hopefully 7. I have just checked my sugars and they are 15!!! I have had one cup of tea since with approx 100ml milk, which is half a unit, so why is my sugar so high???

any advice/ help would really help me out as I just don't get it?
PS - I definitely did have my levemir before bed last night so I know its not that,

Cheers Claire xxx
 
Welcome,

Could be your insulin/carb ratio............

I unit of insulin might not be enough for 1 carb portion (10grams)

Also timing of dose, matching the insulin activity to the rate at which the glucose is processed from the food is important and can prevent spikes like the one you mentioned, so injecting some time before actually eating is how you would do this, the time can vary, and is established by trial and error......🙂
 
Welcome to the forums Claire 🙂
 
Welcome to the forums Claire, snap, I'm 15 at the moment too :( and don't really understand it either. Does the ratio of 1 unit to 10g carbs usually work for you? It sounds as if it is not the right ratio. Our ratios can change over time as our bodies insulin needs and sensitivity changes. If that ratio usually works and you have been ok over the last few days, the only other suggestions I have are : have you washed your hands before testing? are you possibly coming down with a cold / illness?

Is that your normal breakfast? Sometimes hot milk affects my sugar levels
 
It's common for people to need more insulin in the morning. Have a word with your DSN and see if your ratios need changing. What are your levels like come lunch time?
 
Thanks

wow didn't expect so many replies so quickly, definitely some food for thought, thanks guys!
to be honest I have been diabetic for nearly 10 years and only recently started checking and recording my sugars, so finding it pretty confusing!! I guess a lot of it is trial and error..but will be trying everyone's suggestions out, thank you! xx
 
Hi Claire, welcome to the forum 🙂 Have you been diagnosed long? How long after eating did you get the 15? What sort of bread was it? What about your insulin - is it possible that it has been in the sun or got too warm? Sorry for all the questions but there are many factors that could be at play. I went for quite a while thinking that I was doing really well because I tended to test only pre-meal and I was usually nicely in range. However, when I started testing one and two hours after eating I discovered I was going up into double figures! Besides changing what I ate (I now have Burgen soya and linseed bread for my toast) I also started injecting about 15 minutes before eating as this gives the insulin time to get working as soon as the food is digested. If you are back in normal range after 4-5 hours after eating, then it would suggest that the dose is correct but your food is missing the insulin peak.

Why can't it be more straightforward? 🙄
 
Northerner said:
Hi Claire, welcome to the forum 🙂 Have you been diagnosed long? How long after eating did you get the 15? What sort of bread was it? What about your insulin - is it possible that it has been in the sun or got too warm? Sorry for all the questions but there are many factors that could be at play. I went for quite a while thinking that I was doing really well because I tended to test only pre-meal and I was usually nicely in range. However, when I started testing one and two hours after eating I discovered I was going up into double figures! Besides changing what I ate (I now have Burgen soya and linseed bread for my toast) I also started injecting about 15 minutes before eating as this gives the insulin time to get working as soon as the food is digested. If you are back in normal range after 4-5 hours after eating, then it would suggest that the dose is correct but your food is missing the insulin peak.

Why can't it be more straightforward? 🙄
Click to expand...
10 years ago I was diagnosed, I know I have left it rather late to sort! I ate at 8 am and then checked at about 10.30am. The bread (I'm sad to say) was Warburtons white toastie - am I better with a wholegrain bread? The insulin is kept in my handbag at all times (unopened in the fridge of course). So food missing the insulin peak - that means my insulin hits after my sugars have raised up?? do you always inject 15 mins before eating then?
Next question - snacks! I mainly snack on fruit, and was told to increase my next meal dose to account for it however that meant my sugars were off the charts, so am I better taking say a couple of units with an apple for example instead?
 
Hi Claire. Welcome 🙂

Some clinics and GPs do seem to over-simplify the carb/insulin ratios and adjustments when we change from day to day and hour to hour.

I hope you can bring your BGs back within range. Let us know how you get on.🙂

Rob
 
Gillynumber1 said:
10 years ago I was diagnosed, I know I have left it rather late to sort! I ate at 8 am and then checked at about 10.30am. The bread (I'm sad to say) was Warburtons white toastie - am I better with a wholegrain bread? The insulin is kept in my handbag at all times (unopened in the fridge of course). So food missing the insulin peak - that means my insulin hits after my sugars have raised up?? do you always inject 15 mins before eating then?
Next question - snacks! I mainly snack on fruit, and was told to increase my next meal dose to account for it however that meant my sugars were off the charts, so am I better taking say a couple of units with an apple for example instead?
Click to expand...

The wholegrain and seeded bread is released much slower than white, so better for the blood sugars..........

the time in which you inject before the meal will change, by time of day and by type of food.........your need to test foods and times of day to find out what suits you personally.......

If i was to snack, I would simply take the appropriate insulin for it, so whatever my ratio is at that time.........assuming you are on a quick acting insulin like novorapid/apidra then you should do this also, well, you should discuss it with your team, but they should know this........
 
White bread is worse than plain sugar I'm afraid! It actually pushes the levels up quicker than sugar because it has one less chemical process to through to convert to glucose :( The best breads to have are Burgen (as I mentioned) or any seeded wholegrain bread. The seeds help slow the digestion and it's a lot tastier than white bread! 🙂 It does sound like your levels have shot up after eating the toast and the insulin hasn't kept pace with it. It's a case of trial and error working out the timing and depends on what you are eating of course - with fatty food like pizza you might actually find you need to inject some before and some after as it can take a long time to digest.

I usually inject 15 mins before except if I am on the low side, in which case I will inject just before eating so I don't risk a hypo. Do be careful if you decide to try this, as people can be very different in how they respond.

Another thing to bear in mind, as you have been diagnosed 10 years, is that there might be absorbtion problems from your injection sites - do you rotate them regularly, and have to had any lumps?

As for snacks, again it is down to the individual. Your DSN suggests upping the next meal dose to account for higher levels caused by the snack, but you wouldn't get a person on a pump doing this - they would bolus for a snack if they knew it would raise their levels so personally I would apply the same principle and inject for snacks. Actually, I tend not to eat snacks as there is then the danger that, by having extra injections, you can end up 'stacking' the insulin and not really knowing how much is active (again, less of a problem on pumps as they will tell you!).
 
Hi Gilly

Welcome to the forums 🙂

Lots of good advice so far re: insulin timing and the ole tricky breakfast thing. The other thing to bear in mind is that you *might* be one of those people (I am) whose BG rises when they get out of bed. Usually something like 2-4mmol/L in the first hour or so for me without eating anything. Partly in my case this is a basal issue (I take mine in the morning so the last dose has faded and the next is in onset) but partly this is a hormone/liver/dawn phenomenon type thing.

What this can mean in practical terms is that you are dealing with more than just your breakfast. You may also find that your insulin does not begin to lower your BGs as quickly as is advertised on the literature. After some experimentation I've found that I need to wait 45 minutes or an hour after my breakfast dose before eating (and that's with low GI burgen type toast) if I want to tame the breakfast spike.

Oh and as for snacks, yes. I would always need to bolus for an apple. They are usually somewhere between 10 and 20g of carbs.
 
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I'm with Northerner on the snack issue. Insulin stacking can be difficult unless you can keep track of it. If I was going to have say, an apple, an hour after main meal, I would probably inject a unit more before the meal and hope I don't do anything too energetic in the meantime 🙄

If you can buy the book "Type 1 diabetes for children, adolescents and young adults" by Ragnar Hanas, it's very good at explaining all the ins and outs in clear, understandable language. And very few of us are anywhere near the young adult stage anymore but still benefit ! :D

Rob
 
wow this forum is great, wish Id found it 10 years ago - thank you everyone, and keep the advice coming please! see my nurse tomorrow with a blood splattered sugar diary- wish me luck!
 
Gillynumber1 said:
wow this forum is great, wish Id found it 10 years ago - thank you everyone, and keep the advice coming please! see my nurse tomorrow with a blood splattered sugar diary- wish me luck!
Click to expand...

Gilly good luck tomorrow hope it goes ok with nurse appointment
 
Gillynumber1 said:
wow this forum is great, wish Id found it 10 years ago - thank you everyone, and keep the advice coming please! see my nurse tomorrow with a blood splattered sugar diary- wish me luck!
Click to expand...

Good luck Claire! Hope all goes well for you at the appointment 🙂
 
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