Ideal mmol 2 hours after food ?

[Pat91]

Hello everyone, what level should blood glucose be at 2 hours after food and insulin. 6.9 before breakfast - 11.9 at the minute.

 

[Inka]

Your targets might be a bit more individual at the moment @Type1Pat as dropping the blood sugar too quickly can cause damage, particularly to the eyes. I can’t remember if my post-diagnosis target was under 12 or under 11 but it was around there. I think it was under 12 to start with, then over the weeks came down to under 10.

 

[helli]

Simple answer is "it depends".

Different food converts to glucose at different rates. This is the Glycaemic index. You probably know about fast acting carbs like Lucozade and Dextrose tablets that we use to treat hypos. These raise our blood sugars quickly. Other foods, such as porridge have low GI and raise our blood sugars much slower.
A healthy pancreas would release insulin as it sees the blood sugars rise so it would release insulin quickly for Lucozade and slowly for porridge.

We have injected insulin that works at a fixed rate. I believe you have NovoRapid. This is the action profile for NovoRapid


It starts working after about 15 minutes after injection but keeps working for up to 6 hours (the profile is slightly different for different people). So, if you have taken the correct amount of insulin for the carbs you have eaten (or, as you are currently on fixed insulin dose, eaten the correct amount of carbs for the insulin you have taken), when your body has used up all the NovoRapid you have taken your blood sugars should be back to the same level as it was before you ate.

Over time, as well as counting carbs and calculating the insulin dose, you can also start getting clever about when you take your insulin depending upon what you eat to try to match the peak of the NovoRapid graph with the peak of the carb absorption graph.

So, what should level should your blood sugars be 2 hours after eating? Depends what you ate and when you injected.

There is a lot on the internet about testing two hours after eating. This is mainly for people with type 2 and the two hours is an approximation for when the majority of their carbs would be digested. My understanding is this allows them to see whether their body is able to cope with the carbs they have eaten.

For someone with Type 1, four hours after eaten is considered more often because the majority of the NovoRapid has been used by then.

 

[Pat91]

Simple answer is "it depends".

Different food converts to glucose at different rates. This is the Glycaemic index. You probably know about fast acting carbs like Lucozade and Dextrose tablets that we use to treat hypos. These raise our blood sugars quickly. Other foods, such as porridge have low GI and raise our blood sugars much slower.
A healthy pancreas would release insulin as it sees the blood sugars rise so it would release insulin quickly for Lucozade and slowly for porridge.

We have injected insulin that works at a fixed rate. I believe you have NovoRapid. This is the action profile for NovoRapid
View attachment 16043

It starts working after about 15 minutes after injection but keeps working fo r up to 6 hours (the profile is slightly different for different people). So, if you have taken the correct amount of insulin for the carbs you have eaten (or, as you are currently on fixed insulin dose, eaten the correct amount of carbs for the insulin you have taken), when your body has used up all the NovoRapid you have taken your blood sugars should be back to the same level as it was before you ate.

Over time, as well as counting carbs and calculating the insulin dose, you can also start getting clever about when you take your insulin depending upon what you eat to try to match the peak of the NovoRapid graph with the peak of the carb absorption graph.

So, what should level should your blood sugars be 2 hours after eating? Depends what you ate and when you injected.

There is a lot on the internet about testing two hours after eating. This is mainly for people with type 2 and the two hours is an approximation for when the majority of their carbs would be digested. My understanding is this allows them to see whether their body is able to cope with the carbs they have eaten.

For someone with Type 1, four hours after eaten is considered more often because the majority of teh NovoRapid has been used by then.

Once again thank you for the reply, it really is appreciated. Ok so I will see what my levels are at lunch. Thanks again.

 

[Pat91]

Your targets might be a bit more individual at the moment @Type1Pat as dropping the blood sugar too quickly can cause damage, particularly to the eyes. I can’t remember if my post-diagnosis target was under 12 or under 11 but it was around there. I think it was under 12 to start with, then over the weeks came down to under 10.

Ok thank you. Maybe stick to checking before Meals instead of 2 hours after eating. Thank you.

 

[Inka]

Ok thank you. Maybe stick to checking before Meals instead of 2 hours after eating. Thank you.

@Type1Pat That makes sense 🙂 These early weeks are more about information gathering, as I said on your other thread. But one thing I would recommend is getting some digital scales and starting to be aware of carb amounts. Dont worry about counting to the nearest gram - just get an approximate idea eg if you’re going to eat a baked potato weigh the raw potato before cooking it, jot down the carbs in your Weetabix, etc, dish out your pasta then weigh it to se how much cooked pasta you’re having.

On fixed doses of insulin consistency is important. The idea that it’s somehow easier for newly diagnosed Type 1s not to bother with carbs too much is daft IMO. It makes it harder, not easier. When I was diagnosed and put on fixed doses, importantly I was also told a fixed carb amount to go with my fixed insulin dose. That made everything much easier. It also allowed me to move to proper carb-counting (ie adjusting my insulin for meals) much quicker.

 

[Pat91]

@Type1Pat That makes sense 🙂 These early weeks are more about information gathering, as I said on your other thread. But one thing I would recommend is getting some digital scales and starting to be aware of carb amounts. Dont worry about counting to the nearest gram - just get an approximate idea eg if you’re going to eat a baked potato weigh the raw potato before cooking it, jot down the carbs in your Weetabix, etc, dish out your pasta then weigh it to se how much cooked pasta you’re having.

On fixed doses of insulin consistency is important. The idea that it’s somehow easier for newly diagnosed Type 1s not to bother with carbs too much is daft IMO. It makes it harder, not easier. When I was diagnosed and put on fixed doses, importantly I was also told a fixed carb amount to go with my fixed insulin dose. That made everything much easier. It also allowed me to move to proper carb-counting (ie adjusting my insulin for meals) much quicker.

That's a good idea, never thought of doing that. Like you say the more info I have ie readings/carb amounts etc the better for my DN.

 

[Inka]

That's a good idea, never thought of doing that. Like you say the more info I have ie readings/carb amounts etc the better for my DN.

Not just for your DSN - for you. Eg if you eat a 175g raw weight baked potato and your blood sugar is great afterwards, you then know to eat similar again for your fixed dose. I can’t stress enough - fixed meal doses require carb consistency.

 

[everydayupsanddowns]

Ok thank you. Maybe stick to checking before Meals instead of 2 hours after eating. Thank you.

I think checking 2 hours after eating *can* be helpful when looking to check dose timings, but it is fraught with challenges, because the insulin still has a lot of ‘oomph’ left at that stage, and there is a risk of being disheartened or worried into messing with doses that actually would work out brilliantly by the end if their action.

I believe DAFNE very much advises against it, because of the potential confusion it can cause.

 

[Pat91]

I think checking 2 hours after eating *can* be helpful when looking to check dose timings, but it is fraught with challenges, because the insulin still has a lot of ‘oomph’ left at that stage, and there is a risk of being disheartened or worried into messing with doses that actually would work out brilliantly by the end if their action.

I believe DAFNE very much advises against it, because of the potential confusion it can cause.

What would be your advice for a high bedtime BG should I take an extra unit of fast acting or can this not be done as I have also taken my Lantus. Thank you.

 

[everydayupsanddowns]

What would be your advice for a high bedtime BG should I take an extra unit of fast acting or can this not be done as I have also taken my Lantus. Thank you.

Bedtime is tricky, because you will be asleep and less able to keep an eye on things... plus you may find that any ’Insulin on Board’ begins to act more strongly once you put your head down.

This is a question for your DSN or consultant to get their advice really - but I would be very cautious about adding extra insulin late in the day - certainly until you have a bit more experience.

What sort of bedtime levels are you talking about? And how do they compare to morning levels the day after?

 

[Pat91]

Bedtime is tricky, because you will be asleep and less able to keep an eye on things... plus you may find that any ’Insulin on Board’ begins to act more strongly once you put your head down.

This is a question for your DSN or consultant to get their advice really - but I would be very cautious about adding extra insulin late in the day - certainly until you have a bit more experience.

What sort of bedtime levels are you talking about? And how do they compare to morning levels the day after?

My pre bedtime reading was 10.5, have taken 1 unit of Novo rapid. Normally I will go to bed on a 6.5ish and wake up with around 4.8-5ish. may set alarm around 1 just to be sure.

 

[Robin]

My pre bedtime reading was 10.5, have taken 1 unit of Novo rapid. Normally I will go to bed on a 6.5ish and wake up with around 4.8-5ish. may set alarm around 1 just to be sure.

Setting an alarm is a good idea, until you get more used to exactly what your levels do overnight.

 

[everydayupsanddowns]

My pre bedtime reading was 10.5, have taken 1 unit of Novo rapid. Normally I will go to bed on a 6.5ish and wake up with around 4.8-5ish. may set alarm around 1 just to be sure.

I certainly wouldn’t worry massively about a 10.

The international consensus on Time In Range puts the ideal range as 4-10 and the aim is to keep within that 70% of the time, or more if you can manage it. But you can be put of range for up to 30% of the time and still have an optimal HbA1c 🙂

More detail here if you are interested:

Time In Range - useful for Libre / CGM wearers

I've been meaning to post this for ages, but kept forgetting! At the ADA this year the international consensus paper on TIR (time in range) was published by a panel of experts with a huge amount of knowledge and expertise in supporting people to use continuous data to help manage their...

forum.diabetes.org.uk

But yes, setting an alarm is a good precaution, especially as you are already dropping by around 1.5mmol/L 🙂