Seeing a change

[Jimmy2202]

Hi guys.
So I’ve had an interesting week, it’s actually been a very challenging one mentally. Numerous higher readings than normal, which have got me panicking. As in food spikes up to 18 mmol
Ive come to the conclusion my honeymoon period is coming to an end - 2 slices of toast never used to shoot me up 6 or 7 mmols that’s for sure.
Quick question: under what circumstances would you check for ketones? I’m presuming I wouldn’t check when I know my levels are high from a food spike?

 

[rebrascora]

I would test for ketones if my levels were consistently mid teens. So not a single spike which comes back down after an hour or two but if my levels were still mid teens by the next meal.
Timing of your bolus insulin is usually the cause of spikes which then return to normal levels before the next meal. Try prebolusing 5mins earlier and see how that works and if you still spike after 2-3 days of that, try another 5mins earlier until you find the ideal timing for you. If it helps you get some sort of idea of the variation which can be necessary, I have to prebolus 45 mins in advance of breakfast with Fiasp to avoid those spikes and 1hr15mins with Novo(not so)Rapid. Other times of day, it is only about 25-30mins but for breakfast my insulin needs a big head start because it is swimming against a strong current of of Foot on the Floor Syndrome/Dawn Phenomenon, which it has to overcome before it can deal with breakfast.
Not recommending you prebolus that far in advance yourself, as many people would hypo well within that timing, but don't be frightened to experiment with the timing and increase it slowly and carefully from what you have been advised until you find the best timing for you as an individual.

 

[Kaylz]

Are you having to correct or are your levels coming back down on their own? Also are you rising throughout the day or remaining stable? The honeymoon period ending generally means you'd require more basal and bolus ratios may need adjusted too but if your coming back down to pre meal levels without correcting then it may just be a timing issue

Regarding ketones I only check if above 14 for 2 tests spaced 4 hours apart or if I'm feeling unwell xx

 

[Jimmy2202]

Are you having to correct or are your levels coming back down on their own? Also are you rising throughout the day or remaining stable? The honeymoon period ending generally means you'd require more basal and bolus ratios may need adjusted too but if your coming back down to pre meal levels without correcting then it may just be a timing issue

Regarding ketones I only check if above 14 for 2 tests spaced 4 hours apart or if I'm feeling unwell xx

Sorry - yes I forgot to say that my levels always come down after ready for my next meal.

 

[Kaylz]

Sorry - yes I forgot to say that my levels always come down after ready for my next meal.

In that case it would be a timing issue with your bolus, how far in advance of eating are you taking it? Like @rebrascora says it's a very individual thing as for me I need to take mines 25 minutes before breakfast and dinner using thighs but for tea I use my stomach and have to inject immediately before eating or I end up hypo so it's not only the time of day that can effect the timing, it's also the site you are using and the type of food you are eating xx

 

[everydayupsanddowns]

Hope you get to the bottom of it @Jimmy2202, and can work out a spike-busting bolus timing if that’s what it ends up being. Go cautiously if you are experimenting with prebolusing, as you don’t want to swap one spike frustration with a hypo one!

 

[Jimmy2202]

In that case it would be a timing issue with your bolus, how far in advance of eating are you taking it? Like @rebrascora says it's a very individual thing as for me I need to take mines 25 minutes before breakfast and dinner using thighs but for tea I use my stomach and have to inject immediately before eating or I end up hypo so it's not only the time of day that can effect the timing, it's also the site you are using and the type of food you are eating xx

Ok. I will work on the timing of bolus.
I must admit it Varys day to day, up to 15 mins before.

 

[Jimmy2202]

Hope you get to the bottom of it @Jimmy2202, and can work out a spike-busting bolus timing if that’s what it ends up being. Go cautiously if you are experimenting with prebolusing, as you don’t want to swap one spike frustration with a hypo one!

Will do, thankyou.