Post-prandial Problems

[Hagi Bhoy]

Hi guys, I am having a bit of trouble at the moment with my control.

My last hba1c was 8.8% which I'm not happy about and I have been testing and recording my blood glucose levels regularly for the last few weeks.

A lot of my pre-meal values are between 6-10 which I'm not unhappy about however my 2 hour post-prandials can be as much as 6-10 points above my pre-meal values. However, when I go for my next meal typically 4-6 hours later my pre-meal blood glucose will be back between 6-10.

Basically if I raise my insulin doses at meal times I will hypo before my next meal unless I eat something but that isn't always possible. But if I keep the same insulin doses I will always be high between meals therefore my average will always be high.

I'm getting a bit frustrated. My doctor has suggested either taking my insulin more than 10 minutes before my meals like 20 or 30 or carb splitting...eat some of my meal then snack later, which is kind of similar to raising my insulin and having to eat to stop a hypo later on.

Can anyone help or had similar problems? It's really been getting me down, I'm constantly worried about my BGL and it's starting affect everyday things in my life.

Thanks in advance.

 

[Northerner]

Hi Hagi Bhoy, welcome to the forum 🙂 I think your doctor has given you the best advice actually. I usually try to inject at least 15 minutes before injecting so that the insulin has a chance to start working before my food starts digesting, and this seems to help a lot with the post-meal spikes. Of course, it will also depend on what you are eating. The advice about splitting meal doses might apply if, for example, you were eating a meal with a high fat content like pizza, which takes a while to digest, as the peak of the food may miss the peak of the insulin.

As with everything to do with diabetes, it's all down to trial and error and building up experience of how you react - plenty of testing to find out the best compromise between what you are eating and when you are injecting. Eating low GI meals can also help with the post-meal spikes, as they should not be so pronounced. 🙂

 

[Hagi Bhoy]

Hi Northener,

Most my meals are low in GI so I guess maybe I'll have to start taking my insulin earlier than the usual 10 minutes.

I had wondered whether increasing my levemir does at night and reducing my novo rapid might help take the edge off the spikes. I duno if that'd work though.

Did you have a similar problem and change to taking your insulin 15 minutes before?

 

[Northerner]

Hi Northener,

Most my meals are low in GI so I guess maybe I'll have to start taking my insulin earlier than the usual 10 minutes.

I had wondered whether increasing my levemir does at night and reducing my novo rapid might help take the edge off the spikes. I duno if that'd work though.

Did you have a similar problem and change to taking your insulin 15 minutes before?

Yes, like you I thought I was doing fine because my pre-meal levels were always nicely in range, but I got a bit of a shocke when I started doing some tests about an hour after eating/injecting as I was zooming up 5-7 mmol/l! Adjusting the timing of my dose until I was getting a 2-3 mmol/l dose took a while, especially when I had to consider different food/time of day etc. For example, in the morning I am very insulin resistant, plus I get a bit of an unwelcome boost from my liver, so I can actually inject 30-40 minutes before eating and end up with a 2-3 mmol rise after 90 minutes. Later in the day I wouldn't leave it that long!

I doubt if adjusting your levemir would help at all, since your pre-meal and waking levels are good, so it sounds as though it is doing its job 🙂

 

[Hagi Bhoy]

Cheers man.

I know what you mean about different times of the day having an effect. For example, my dinner time meal 2 hour post prandials actually come down a point or two before rising back up a point or two an hour after that.

Glad to know there is a genuine fix to the problem though. And that I'm not the first to go through it.