Lately I've been walking from work and have reduced my nova rapid dose for lunch, reason being is half way home from work my readings would drop into the 5s so I was having to top them up to get home, usually take my rapid around 11.40 ready for lunch at 12, four hours later I'm making my way home, had a few occasions where before lunch my readings have been around the 10 mark and stay up to sometimes 15 till I start walking home then they will drop, is it what I'm eating that's making the spike last longer, on some occasions it could be just a tin of soup and 2 slices of bread, I do card count and have been making changes to my dosage but struggling to get a happy medium so to speak...Thanks
-
Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
-
Learn more about joining the Diabetes UK Support Forum team here: https://forum.diabetes.org.uk/boards/threads/volunteering-opportunities-why-dont-you-join-us.112862/
Spike for how long.
- Thread starter Charl
- Start date
Soup and bread has quite a few carbs - I often have soup + bread for lunch (especially now it's getting colder) and a typically carb count is ~70g (Heinz Lentil and Bacon + 2 slices granary bread), so it's quite a lot of insulin and if I needed to walk while that was still active I'd also be going low. If the timing's wrong, I can also quite easily run high due to the quantity of carbs.
Options I'd look at are to pre-bolus to ensure your BG is dropping before you eat, though this may be difficult at work due to timings and potential to get caught up with something which stops you eating when you need to; split bolus and reduce the 2nd half to allow yourself to run a bit higher before you walk home/have less active insulin while you walk; eat a decent uncovered snack before you walk home.
Options I'd look at are to pre-bolus to ensure your BG is dropping before you eat, though this may be difficult at work due to timings and potential to get caught up with something which stops you eating when you need to; split bolus and reduce the 2nd half to allow yourself to run a bit higher before you walk home/have less active insulin while you walk; eat a decent uncovered snack before you walk home.
Come on, 70g of carbs is not that much and whether it requires quite a lot f insulin depends upon your insulin requirements.
I quite often eat more than that without spiking.
I appreciate it maybe quite a few for someone following a lower carb diet but I find that I can eat that kind of lunch without high spikes through the correct insulin dose and timing. And I do not have the kind of job that enables me to take a walk afterwards.
I appreciate we are all different and there are different ways of managing our conditions (and lifestyle).
Fair enough, it's all relative, for me that's a fairly considerable number of carbs in one sitting (it's similar in size to my supper which is my large meal of the day).
It's an interesting point as to how much insulin one requires - even with a vastly different insulin sensitivity the effect of the insulin required to mop up 70g of carbs is not insignificant (whether it need 30U or 3U) and presumably has the same downsides in that the larger the quantity of carbs and insulin cover the larger the BG effect of any errors in carb counting/insulin sensitivity prediction/insulin efficacy.
My afternoons can be unpredictable, but actually worse is that most of my school week afternoons are spent sitting at a desk doing work until I get up to rush around madly to pick my children up (driving) in the early afternoon. So while I can eat 70g on a day with a fixed afternoon (and no change in activity) it's less easy with a change of activity in the middle (while both carbs and insulin are still active). It can be done with a pre-bolus and splitting bolus, but my comment about the quantity of carbs/insulin and potential for error still stands, I think.
@SimonP that argument about great carbs = greater insulin = greater risk of error has been around for most of the 20 years since I was diagnosed. But so has the argument that diabetes should not restrict your life which includes food and exercise. It is important to find what suits you and your lifestyle. If you find you need to restrict your carbs as your afternoon is unpredictable, that is what suits you. I prefer to manage my insulin for the food and afternoon I have ahead,
It is easier with a pump to suspend basal to deal with those unexpected bursts of activity but it was never that difficult to eat some extra carbs.
It is easier with a pump to suspend basal to deal with those unexpected bursts of activity but it was never that difficult to eat some extra carbs.
I'm not arguing for food restrictions and certainly not for exercise restrictions, but it does IMO take some planning.
With larger quantities of carbs/insulin in play the errors have a larger effect - as you say a pump can solve this, likewise so can splitting bolus (though it's perhaps a bit more faff depending on how many doses you split it into) and something like a change in activity level means you have to think about this.
I still eat soup and bread for lunch and I also happily ride a bike for 12h stretches, but both require a bit of planning and monitoring 🙂.
- Relationship to Diabetes
- Type 1
- Pronouns
- He/Him
Not really on-topic with the thread, but as an aside I often find soup one of the harder meals to estimate.
I usually seem to need additional insulin over and above what I have calculated (wildly guessed) for the meal.
Still love it though. Especially as we come into the cooler months
It’s just one of the meals I have to have a workaround for, to get more reliable maths. There are a few that see to have their own version of Diabetes Maths for me. 🙂
I usually seem to need additional insulin over and above what I have calculated (wildly guessed) for the meal.
Still love it though. Especially as we come into the cooler months
It’s just one of the meals I have to have a workaround for, to get more reliable maths. There are a few that see to have their own version of Diabetes Maths for me. 🙂
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
… and back on topic
If reducing your insulin at lunch time is not working for your walk home I would suggest the same as @SimonP and take a small snack before you set off. Depending on the size of this snack and the length of your walk you might want a bit of insulin but a lot less than normal. If you do that you could then do your proper dose for whatever lunch you choose, with the appropriate pre bolus timing if possible.
When I first got a sensor I saw the size of spikes I was getting after meals. This prompted me to reduce the size of my meals (smaller spikes) and then to work on the timing of my bolus as this gave the insulin time to get going and meet the rise in glucose form the food. The timing can depend on the time of day and the nature of the meal. A bit of trial and improvement.
If readings are weird it is worth checking things with a finger prick.