Persistant post meal bloodsugar spikes

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Turtle11

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Type 1
Hi, I'm new to the site and I wondered if anyone could shed some light on my bloodsugars. I have been playing around with eating low GI foods in a bid to make reduce the spike post-meal levels. It really helped, but no matter what I do it doesn't stay within the standard target of 7mmol (usually around 10). I don't know why this is. I understand that everyone is different but I try hard to improve my levels and can't help but feel I am doing something wrong. If anyone has any information or tips it would be greatly appreciated 🙂 Thanks
 
Hi Turtle,

I think for most people with type 1, they would consider anything around/under 10 to be acceptable. However, I appreciate that acceptable isn't what some people are after 🙂 I have found over the past few weeks I always spike into the 9s before coming back down, for most of the food I am eating on a regular basis.

How long before eating do you bolus? The 'best' time is supposed to be 15 mins before eating.
 
If your spike is only for a short time it shouldn't really matter too much, or you could try taking your insulin earlier than normal before you eat?
 
Thank you for the replys 🙂 I asked to change to Apidra rather than novorapid about a year ago now for this reason, and it has been really helpful with bringing my bloods down if they go high and also at lessening the peak post meals (just now to the extent I want). I have been bolusing just before the meal because the onset time of apidra is meant to be very fast. I guess I could try before? To be honest I think it might be made worse by the way I bolus. I have trouble inserting sets full stop and when I do they tend to be painful when I inject over 2 units at a time. So I space it out. Its not by hours but I guess it does take me 20mins or so to do my full bolus. I don't really know what I should do about this. I love my pump and it really helps my control but there have been small downsides. I understand that less than 10 is ideal but I am admittedly a perfectionist and I always feel really guilty when I admit it to my healthcare team. They say it shouldn't be higher than 7 so I feel like i'm being accused of not trying hard enough when I admit that I don't manage 7 post meals.
 
How exactly are you bolusing? Your on a pump, so do you not just choose the dose and pres a button...?

The likes of novorapid and apidra do start to work quickly but everyone is different, I could test at 4.8 before lunch and would still feel comfortable injecting 30 minutes before eating, no doubt I will have dropped but not below 4.0
 
Turtle11 said:
...They say it shouldn't be higher than 7 so I feel like i'm being accused of not trying hard enough when I admit that I don't manage 7 post meals.
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Not being a Type 1 on pump, but being an engineer with some training in control...

But unless you are on CGM how would you actually achieve keeping the BG below 7 assuming you are starting from 5 ish? Unless you eat lots of small meals with less carb I would assume that matching the pump delivery profile to the absorption profile of the food would be very difficult.
 
Mark T said:
But unless you are on CGM how would you actually achieve keeping the BG below 7 assuming you are starting from 5 ish?
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It is possible, I have even done it on injections, but you need to deliver your dose a good time before you actually eat, and with the magical pump delivery methods it is made that bit easier...........

Even on a pump though, your team saying above 7 is too high, really?
 
novorapidboi26 said:
How exactly are you bolusing? Your on a pump, so do you not just choose the dose and pres a button...?
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Yes, but I can appreciate where Turtle is coming from - I find it really, really stings if I give a big bolus - Animas pumps deliver insulin really fast (way, way faster than Medtronic) so it can sting like heck if you're putting a lot of insulin through the cannula.
 
shiv said:
Yes, but I can appreciate where Turtle is coming from - I find it really, really stings if I give a big bolus - Animas pumps deliver insulin really fast (way, way faster than Medtronic) so it can sting like heck if you're putting a lot of insulin through the cannula.
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I see, that must be a pain the ass.........and I doubt you can change the speed of an up front dose......:(
 
Nope, the speed is set. Medtronic pumps take 2 seconds to deliver 0.1u. I haven't timed my Animas, but I think it's just as fast as injecting. The Animas allows you to 'slowly' deliver it, but that just means it leaves a couple of seconds between delivering each unit, it doesn't actually slow down how fast it shoots the insulin in.
 
So is that delay between units catered for times like these were people are finding it stings with larger doses.........
 
Not sure to be honest - I would guess it's more just preference? It's literally only a second or so in between units, so it's not like the tissue around the cannula gets a real break.
 
Utterly daft question from a new pump user here; I've never had stinging ever in my life except with Lantus - except when hitting a bad spot (hyperlypo thingies)

Now when I stick a cannula in an iffy spot it's all OK and lovely at first and all that jazz but then I start to get a horrid 'dull achy' feeling quite soon after the change and Lo and behold! my BG starts to rise. Even with a 'really good' spot I'm now advised to change sites every 2 days to help prevent any more damage.

So sounds a bit like that to me. I presume you have tried different cannulas and different lengths and all that jazz? Any 'virgin' areas of body you can have a go at?
 
shiv said:
Not sure to be honest - I would guess it's more just preference? It's literally only a second or so in between units, so it's not like the tissue around the cannula gets a real break.
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Thats interesting Shiv. Ive not had any problems or stinging when delivering large doses up front. e.g. just had large take away and delivered 14 units up front on a dual wave. I dont actally know exactly how long it takes going in but definately slower than injecting. Im on the roche combo, id say its about 1 unit per second as i can audibly hear the pump as it counts down on the meter.
 
I've not experience any stinging

But I don't use much insulin though perhaps this makes a difference, it a very rare occasion for me to have a dose more than 3 units!

Mind you saying about sets, when I was training the nurse told us that we would feel the cannualar when it was first inserted and this might last for a hour or so before the sensation wearing off... But I didn't notice it at all, and I think I've only felt my canular like this once or twice in all the time I've been pumping!
 
I find the longer I've had my cannula in, the less time it takes to sting. For example, I'm on day 2 of this cannula and I've just bolused 4.5u - which started to sting by the 3rd or 4th unit. If this was a fresh cannula, it would take much longer to sting.

I know I am quite sensitive to cannulas and things, I change mine every 2 days else it starts to really sting and levels start to go hit and miss!

edit: yep Ellie sometimes I do feel the cannula for an hour or so - or rather, the area is just a bit sore. I don't think much of it really as it has just had a massive needle shoved into it and pulled back out again!
 
shiv said:
Yes, but I can appreciate where Turtle is coming from - I find it really, really stings if I give a big bolus - Animas pumps deliver insulin really fast (way, way faster than Medtronic) so it can sting like heck if you're putting a lot of insulin through the cannula.
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Shiv,
if you havent already done so delve into the set up of your pump.
You can change the delivery speed of the bolus 🙂
Not sure but think the Roche pump is the only one you can not do this with
 
Hi Sue, I have done so. It has a 'slow' option, but all that means is that it leaves a bigger gap between giving the units of insulin, it doesn't actually slow down the speed at which it shoots it in.
 
shiv said:
Hi Sue, I have done so. It has a 'slow' option, but all that means is that it leaves a bigger gap between giving the units of insulin, it doesn't actually slow down the speed at which it shoots it in.
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Ah ok, that's a shame as mine can be set to deliver the bolus in minute intervals.
Can you do an extended bolus for say 15 mins or would this mess up the timing of your insulin peak?
 
Good idea, but the shortest period of time I can is 30 mins.

It's not a big deal, for me anyway; I know if I am more vigilant with my set changes, it shouldn't be a problem!
 
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