Little query

[gillrogers]

morning all, just a little query really. Always wondered when you’ve got you basal and bolus right how high can you expect your bg to rise after you’ve eaten. I think I read in the leaflet I was given ages ago that ideally no more than 4mmol? Or was I dreaming that?

This last week with this heat I’ve been going very low carb and my basal has been dealing with it for breakfast and lunch. Been getting the best results I’ve ever had. . It had helped not having any work on mind as it’s meant I can afford to go low carb physically.

Hope everyone else has managed the heat and their diabetes safely

 

[SB2015]

Morning Gill

The spike I will get after a meal will depend on

• How much time I allowed for the pre-bolus
  Where possible I inject sometime before I eat. This varies through the day.
  I am no always organised with this and if I am eating out I don’t chance it as I don’t know when the food will arrive.
• The portion size
  The more carbs I eat the bigger the rise
• The types of food I eat
  With high fat the carbs take longer to convert so I get more of a Lakeland fell rather than a spike
  Something like a Pizza will be a smaller spike but a stay up for ages

I don’t know what the recommended rise is, but I just keep mine to a size that I am happy with and accept than in some circumstances I will get bigger ones.

 

[helli]

To be honest, I try not to concern myself too much about a spike (levels go up and come back down again within a short period of time) - I am trying to do the job of an organ that people without diabetes do not have to think about so if I get my insulin timing slightly wrong, at least I have the dose correct. I am more concerned by the plateaus - go high and stay there as this usually means I have the dose wrong.

With a CGM, I think more about Time in Range than how high I go. I think the target it something like 80% in range with only 4% under target.

 

[gillrogers]

morning @SB2015 ,

Yes I had a good idea on the different factors. Now we’re well into summer I’ve moved from porridge to and oat and wheat free granola with blueberries, ground linseed and flax mix , chopped mixed nuts and Greek yogurt. My rise is about 4 mmol where as with porridge it was 6 or 7 and without the lyumjev I has hitting a rise of 10 with half an hour prebolusing. Now I’m not having to prebolus at all. Lunch is the same but my dinner can still be about 6.

 

[gillrogers]

To be honest, I try not to concern myself too much about a spike (levels go up and come back down again within a short period of time) - I am trying to do the job of an organ that people without diabetes do not have to think about so if I get my insulin timing slightly wrong, at least I have the dose correct. I am more concerned by the plateaus - go high and stay there as this usually means I have the dose wrong.

With a CGM, I think more about Time in Range than how high I go. I think the target it something like 80% in range with only 4% under target.

Hi @helli . I’m feeling my time in range is going in hand with my not so high by a mile spikes. Just wondering if perhaps a 1 minute preb could lower it slightly. The typical profile for lyumjev doesn’t pan out for me. Ie back down after an hour and level off . It tends to be a gentle downward slide back to we’re I started for my next meal. But I can live with that if it means I don’t have the half hour prebolus as I was getting before.

 

[SB2015]

Good to read of your experiences with Lyumjev.
It sounds like a quick acting insulin that is actually ‘quick’.
Still pondering a change over.

 

[helli]

Hi @helli . I’m feeling my time in range is going in hand with my not so high by a mile spikes. Just wondering if perhaps a 1 minute preb could lower it slightly. The typical profile for lyumjev doesn’t pan out for me. Ie back down after an hour and level off . It tends to be a gentle downward slide back to we’re I started for my next meal. But I can live with that if it means I don’t have the half hour prebolus as I was getting before.

My advice is to tweak as much as you feel comfortable with but remember to live your life. There is no point having perfect BG levels when that is all you have time and brain power for.
Personally, if my time in range was in hand, I would take a step back to avoid becoming obsessed with perfection.

 

[gillrogers]

My advice is to tweak as much as you feel comfortable with but remember to live your life. There is no point having perfect BG levels when that is all you have time and brain power for.
Personally, if my time in range was in hand, I would take a step back to avoid becoming obsessed with perfection.

I’m glad you said that @helli cos I just keep being told by dns and dr to concentrate on being in the range. And from what I see of other peoples screen shots of their libres in the range going up and down like yo-yos. I’m thinking that must be so much hard work! Sorry I’m in a bad mood tonight and want to comfort eat and can’t.

 

[gillrogers]

Good to read of your experiences with Lyumjev.
It sounds like a quick acting insulin that is actually ‘quick’.
Still pondering a change over.

It’s got to be worth a try @SB2015 . It’s doesn’t work for some and I’ve heard from some pumpers that it stops working after a while and you need good distance between every injection site. The additive can make it sting but I find not always and to be honest that little sting is worth it for me. There are times when I don’t feel it at all. It’s quite odd lol. If you do Facebook there is a Facebook group for lyumjev users.

 

[SB2015]

It’s got to be worth a try @SB2015 . It’s doesn’t work for some and I’ve heard from some pumpers that it stops working after a while and you need good distance between every injection site. The additive can make it sting but I find not always and to be honest that little sting is worth it for me. There are times when I don’t feel it at all. It’s quite odd lol. If you do Facebook there is a Facebook group for lyumjev users.

As my cannula stays in for two days and is in constant use, since my basal insulin is a trickle of what I use as a bolus. I reacted badly to FIASP. Hence my reluctance.

 

[everydayupsanddowns]

Good to hear you are getting on well with the Lyumjev @gillrogers

My recollection of recommended levels for T1 are 5-7 before breakfast and 4-7 before other meals, and then no higher than 9 by 2 hrs after meals.

Which would more or less fit with the forum suggestion for T2s of aiming for approx a maximum 2-3mmol/L meal rise (with perhaps a bit more slack)?

 

[gillrogers]

Good to hear you are getting on well with the Lyumjev @gillrogers

My recollection of recommended levels are 5-7 before breakfast and 4-7 before other meals, and then no higher than 9 by 2 hrs after meals.

Which would more or less fit with the forum suggestion for T2s of aiming for approx a maximum 2-3mmol/L meal rise (with perhaps a bit more slack)?

Thanks @everydayupsanddowns Aha perhaps that where I heard it from where I was originally diagnosed as type 2.

 

[gillrogers]

As my cannula stays in for two days and is in constant use, since my basal insulin is a trickle of what I use as a bolus. I reacted badly to FIASP. Hence my reluctance.

Ah I see @SB2015 . I’ll see if I can find out the active ingredients. I’m sure documentation tells us. The insulin is lispro which was what I was on before I changed to it.