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High blood glucose levels
- Thread starter dougie19
- Start date
Sadly, there is not a simple answer but we can provide some pointers.
Firstly, are you confident that your basal (background) insulin dose is correct. I think if this as my foundation and just like when you build a house, if the foundation is unstable, anything you build upon it will add to the instability. So, the first step is to check your basal - what happens to your BG in the absence of anything that can change your BG such as food, exercise and bolus insulin.
Secondly, I would check your BG. I know your were discussing getting a Libre on your other thread. CGMs like Libre have a tendency to over egg high readings. Therefore, it is importat to double check them with a finger prick to confirm your 15 is really a 15 not a 12, let's say.
Only when your basal is close enough (you will never get a purely straight line), is it time to look at your bolus. With this there are two things to consider - how much insulin and when to inject. Errors in either quantity or timing can result in a high BG. The difference is what happens when your body has run out of active insulin (usually about 4 hours after injecting).
If your BG returns to what you expect, the amount of insulin was correct but the timing was wrong. You are trying to match the peak of the insulin activity with the peak of your glucose digestion and this can vary with different types of food. For example, we take fast acting glucose to treat a hypo and this can sort out a low BG in 5 or 10 minutes but if we eat a pizza, the fat will slow down the glucose digestion and it may still be causing a high BG for a couple of hours after eating. So, if your BG shot up to 15 and then back down to, say, 6 after 4 hours, your dose was fine but your insulin activity peak missed your glucose activity peak. In this case, you will need to pre-bolus earlier. The advice is trial and error with the same/similar meals and adjust the prebolus by about 5 minutes each time until you hit the spot. Yes, alas, you will have to eat more cake!
If, after 4 hours, your BG is still too high, you did not have enough insulin. In this case, you need to look at you correction and insulin to carb ratios. You may need to increase these. Again we are all different so it needs some trial and error. Do not be surprised if you need different ratios at different times of the day,
Firstly, are you confident that your basal (background) insulin dose is correct. I think if this as my foundation and just like when you build a house, if the foundation is unstable, anything you build upon it will add to the instability. So, the first step is to check your basal - what happens to your BG in the absence of anything that can change your BG such as food, exercise and bolus insulin.
Secondly, I would check your BG. I know your were discussing getting a Libre on your other thread. CGMs like Libre have a tendency to over egg high readings. Therefore, it is importat to double check them with a finger prick to confirm your 15 is really a 15 not a 12, let's say.
Only when your basal is close enough (you will never get a purely straight line), is it time to look at your bolus. With this there are two things to consider - how much insulin and when to inject. Errors in either quantity or timing can result in a high BG. The difference is what happens when your body has run out of active insulin (usually about 4 hours after injecting).
If your BG returns to what you expect, the amount of insulin was correct but the timing was wrong. You are trying to match the peak of the insulin activity with the peak of your glucose digestion and this can vary with different types of food. For example, we take fast acting glucose to treat a hypo and this can sort out a low BG in 5 or 10 minutes but if we eat a pizza, the fat will slow down the glucose digestion and it may still be causing a high BG for a couple of hours after eating. So, if your BG shot up to 15 and then back down to, say, 6 after 4 hours, your dose was fine but your insulin activity peak missed your glucose activity peak. In this case, you will need to pre-bolus earlier. The advice is trial and error with the same/similar meals and adjust the prebolus by about 5 minutes each time until you hit the spot. Yes, alas, you will have to eat more cake!
If, after 4 hours, your BG is still too high, you did not have enough insulin. In this case, you need to look at you correction and insulin to carb ratios. You may need to increase these. Again we are all different so it needs some trial and error. Do not be surprised if you need different ratios at different times of the day,
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
How long after your cake did you test at 15 and was that a fingerprick (CGMs can read higher than you are)? How far in advance of your cake did you inject?
How long have you had Type 1? Are you carb counting and applying insulin to carbs ratios for your food?
You could have a look at this website for education:
Bertie Diabetes
bertiediabetes.com
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- Relationship to Diabetes
- Type 1
- Pronouns
- He/Him
With cake I’d need to give the insulin a pretty hefty head start, especially if there’s any icing / dried fruit *except* if it’s a cafe stop half way round a walk. Then I can just dose-and-eat. 
Walking seems to super-charge my insulin on board, and a 5-10 minute stroll afterwards can really help to knock off the rise.
If walking I’d probably only have to 3/4 the dose too.
It’s always a bit of a juggling act @dougie19 - and we won’t get it right all the time. Just treat every set of results as a learning experience, and an option to add to the every-growing list of “exceptions to the rules” 😉
Walking seems to super-charge my insulin on board, and a 5-10 minute stroll afterwards can really help to knock off the rise.
If walking I’d probably only have to 3/4 the dose too.
It’s always a bit of a juggling act @dougie19 - and we won’t get it right all the time. Just treat every set of results as a learning experience, and an option to add to the every-growing list of “exceptions to the rules” 😉