High readings two hours after eating

[ronmac]

Hi all. I'm new to the forum and would like some advice.

I am a 72 year old male with T2 insulin dependent diabetes. I take my medication thirty minutes before my meals - 36ml of Humulin M3 before breakfast, two 1g Metformin tablets before lunch, and 26ml before my evening meal.

I don't usually take BG readings after eating, but decided recently to start doing so. They are always much higher than I suspect they should be. As an example, after a lunch today consisting of a small portion of chopped beetroot, 2oz of cheese, six slices of cucumber, a thin slice of ham, a small pickled onion, and two rice cakes, my reading was 15.7.

My preprandial readings are pretty good, but I worry about these postprandrial figures. If anyone has any suggestions, I'd appreciate hearing them.

Many thanks,

Ronmac

 

[DaveB]

Hi. Yes, 15.7 mmol is too high. Can you let us know your BMI or whether you are slim or overweight. The reason I ask is to see whether there is a possibility you may be a LADA and not T2 and if you have excess weight and whether you may have some insulin resistance. If the latter you would need to reduce your carb intake to help (perhaps you are already low-carbing?).Have you tried increasing your injection amounts by small amounts hopefully under the guidance of your nurse. You will need to check often enough to avoid a hypo.

 

[everydayupsanddowns]

Welcome to the forum @ronmac

Did you check before lunch today as well as after?

Diabetes can be fickle and contrary, and while it can be OK to have a reasonable idea of where your levels generally are, where things are going awry, often more data is helpful to begin to unpick things.

It might be interesting to do pairs of readings around lunch (or another meal) to see how your Humulin M3 is coping. That way you can see what the meal rise was, or whether on this particular day you just happened to have drifted into double figures by lunchtime.

M3 is a mixed insulin (for clarity, doses are measured in units, not ml), it has a proportion of faster acting and some slower acting insulins blended together 30:70. If you’ve injected before breakfast, the chances are it might be running out of steam a bit at lunchtime. Your carb load is pretty low from the example you gave, but if sticking with the mixed insulin you may need to cut them back further.

Alternatively you could ask about a more flexible MDI / Basal:bolus regime, where fast acting and slow acting are taken as separate injections, so meal doses can be varied, without changing the separate background dose

 

[ronmac]

Thanks for the replies guys.

To answer DaveB's questions, I am 5'8", 13stone and my BMI is 27. Try as I might, I cannot lose weight (although I've recently managed to get down to 12st 12 on occasion. I've always put this down to the insulin which I believe stops you losing weight, or puts weight on.
Occasionally, if I know I'm going to eat something that contains carbs, I increase my intake by 2 units.
I don't usually do before and after readings, but will now do so.
Obviously because of the lockdown, I can't see my diabetic nurse as there are no appointments for the next two months.
Thanks for your advice.

Regards, Ronmac

 

[ronmac]

Short update: Last night at 6.00pm, my BG was 6.6ml before taking my evening insulin of 26ml. At 6.30pm I ate a meal consisting of a small slice of homemade beef and mushroom pie with shortcrust pastry, runner beans, and an apple for dessert. I finished eating at 7pm. Three and a half hours later my BG was 10.3ml. This morning, at 7.30am, it was 9.9ml.

 

[everydayupsanddowns]

I ate a meal consisting of a small slice of homemade beef and mushroom pie with shortcrust pastry, runner beans, and an apple for dessert. I finished eating at 7pm. Three and a half hours later my BG was 10.3ml. This morning, at 7.30am, it was 9.9ml.

Well based on that single result, it would appear that your evening dose was not quite sufficient to cope with the meal and/or the glucose your liver trickled out overnight.

It woikd have been interesting to see the result at 8.30 (2 hours after you started eating) and how much higher that might have been than the 10.3 at 3.5 hours.

Pies can be tricky to estimate carb-wise, but often have more in them then initially imagine. Standard 3.5”(ish) diameter individual pies are often 60+g of carbs even though they don’t seem to have much pastry in them

 

[Gruers]

I’m fairly new here but really learning a lot
what should my approximate BS target Levels be am and pm ?
what am I aiming for?

 

[Deleted member 27171]

I’m fairly new here but really learning a lot
what should my approximate BS target Levels be am and pm ?
what am I aiming for?

For Type 2, the general targets are 4-7 before meals and below 8.5 2 hours after, but people are often given slightly different targets by their doctor that take into account individual circumstances. For example if levels have been very high for a prolonged time it can de a bad idea to reduce them too much too quickly so higher targets may be set and then reduced over time. Your Dr or DSN should be able to advise you of your own target levels over the phone without too much trouble if you’re unsure of what they are.

 

[rebrascora]

@Gruers

Are you on any medication and if so what?

Target range in the evening would be slightly higher if you are injecting insulin which is why I ask. Generally between 4 and 7 is what you are aiming for, but between 5 and 9 at bedtime if you are injecting insulin.... this is to keep us safer through the night. It also depends when you had your evening meal. If your test was within 2 hours of your evening meal then it might be OK for you to be as high as 8.5 when you are not using insulin because your body is still dealing with the BG from your food. Most diabetics who use insulin try to eat 5 hours before bedtime so that any dinner time insulin has gone from their system.
Sorry if that all sounds a bit confusing.

 

[Gruers]

Hi LucyDUK and Rebrascora
thanks for your replies I’m on Metformin 1000g twice a day and 2 Glizacide am
thanks for the numbers I’ll try to be close to them