hi guys, iv only been diagnosed for just over a month and I’m starting to get the hang of things like adjusting my ratios and working out my insulin sensitivity and adjusting for it, i was told by my dsn that two hours after a meal you bg should be between 4-8 which 90% of the time I am been a few lows and highs but my question is if your sugars go higher than 8 within the first hour but are back with that 4-8 range after 2 hours will it have any affect in the long term
Hi Daniel, if your blood sugar is going into double figures an hour after eating (presuming you were in range prior to eating) then it's probably a case of the timing of your insulin dose needing adjustment - inject earlier before eating and the insulin will be getting to work as the food starts digesting. This is pretty much a trial and error thing and you will inevitable get it wrong sometimes even when you think you've got it all worked out. I used to inject immediately prior to eating when I was first diagnosed, because that's what I'd seen the nurses do for me in hospital, and also what I was told to do. However, this is really for the sake of simplicity, so you don't forget in the early stages. Before long I started injected before eating, 5 minutes longer each time, and then testing to see the effect. I found that spikes of 12+ and hour after eating were coming down to 10s then 8s. The thing to be careful of though is not to try and inject TOO early, because then you have the opposite problem of your insulin being too active before your food gets the chance to raise your levels, and you drop low. As a rule of thumb, injecting 15 minutes before eating is suggested as a guide, but you do need to build up to this as it may be too early for you as an individual.
There are, unfortunately, many other factors that can also come into consideration:
1. Time of day - in the mornings you are likely to be more insulin-resistant so may need to inject earlier than later in the day. For example, for me I can inject 45 minutes before eating breakfast, around 30 minutes before lunch and 5 minutes before in the evenings!
2. Injection site - for me, injecting in my abdomen will mean the insulin absorbs faster, so I need to reduce the time before eating. Injecting in my posterior is the slowest.
3. Activity levels - activity prior to injecting, e.g. a run in the morning prior to lunch, will mean the insulin dose may need reducing as well as the timing.
4. What you intend to eat! - the type of carbs and composition of your meal will influence your timing decisions as well. Very slow-release carbs might need you to inject closer to when you eat. It's worth having a read of
The GL Diet for Dummies which gives you an idea of the overall GI of your meals.
You'll get a feel for all these, but it does take patience! It may seem very complicated to begin with, but things do improve. The main thing is not to be too concerned about being a couple of mmol/l above target after eating. This won't have any real impact, it's the sustained high levels that are more likely to cause problems e.g. 12+ before meals and 17+ after. The extreme spikes up and down should be avoided too - occasionally these are inevitable, but the aim is to try and 'smooth' these out in time so you find yourself in a tighter 'bandwidth'. A bit like walking a tightrope, at first you keep falling off, but eventually you get the hang of it if you stick with it!
🙂
