High Afternoon Blood Sugars/Insulin Sensativity

[alanfsmith11]

Hi,

I have been type 1 for 18 years now and the last few years have been pretty much spot on with my control. I am on Novarapid and lantus and have been for the last 7 years or so.

The last couple of weeks my BS has been very up and down. I am getting a few high readings in the mornings, which i thought could be linked to my lantus. However, the main issue seems to be the late afternoon, i will get readings between 10-12 upto 4/5 hours after my lunch, i carb count and generally have been using 1:10 ratio which has worked ok up until now. It seems that no matter what i do my afternoon readings are always high. I use the same ratio for my evening meal and i seem to sometimes even dip too low a couple of hours after this so i am not sure if my insulin is having different effects at different times of the day or its my lantus which needs adjusting. I am quite an active person and exercise most days, this can have the effect of spiking my blood sugar too, but not too much to be honest.

I have spoken to my Diabetes clinic and they have mentioned about insulin sensitivity but i am at a bit of a loss about how to adjust things without it being up and down and like a yo yo.

 

[Inka]

It’s not uncommon to need different ratios for different meals @alanfsmith11 But before you experiment with your boluses, it would be worth doing a basal check to ensure that’s ok. If your basal is slightly off it makes it harder to get other things right.

 

[helli]

A few thoughts
- what time do you take your Lantus? Is it possible that it is not lasting 24 hours so you are lacking background insulin?
- have you changed you daily routine? For example, do you usually go out for an afternoon walk which you have been unable to do for the last couple of weeks? The exercise would typically help with your insulin sensitivity but without it you see your blood sugars rise.
- if you are less sensitive/more resistant to insulin in the afternoon, you may need to adjust your bolus ratio for different times of the day. So instead of 1:10 for lunch you could adjust this ratio. This may need some trial and error
- when I eat sandwiches for lunch, it becomes the most carby meal of the day. For e, higher carb meals require a second insulin dose, especially if they are also fatty such as a cheese sandwich.

 

[trophywench]

Like shedloads of other things @alanfsmith11 - insulin:carb ratios and our sensitivity to insulin, changes from time to time without us doing anything different whatever. Gnash your teeth as much as you like but honestly - resistance is futile mate! It happens, so we each need to adapt. End of message LOL

Testing your basal to see if that's adjusted as well as possible is indeed the first step, cos if it ain't you can adjust meal boluses until the cows come home and it still won't be quite right.

One of the main troubles (not the only one though) with Lantus is, if you change the dose or timing thereof it takes up to a full 72 hours to assess whether that tweak worked or not.

Anyway - here's how to basal test -

Basal insulins « Diabetes Support Information Exchange (diabetes-support.org.uk)