Spikes

[Wendal]

Hi Charl,
Presumably you have tried experimenting in terms of timing of your insulin dose to when you eat as to me you seem to have your insulin dose quite a long time before you eat.
Particularly if your meal leads to slow release of glucose like high in fats etc I can foresee that you might have a imbalance in timing and possibly heading towards hypo territory.
Just checking.

 

[rebrascora]

That is a very noticeable trend of spikes after breakfast and after lunch and then the drop after lunch shows quite clearly in the daily patterns.
It looks to me that you need more prebolus time rather than more insulin. The spike after lunch (and breakfast) is because the glucose from the carbs is hitting your blood stream before the insulin.

 

[Charl]

Usually take insulin around 30 mins before,should I be trying 45 mins etc.

 

[rayray119]

Usually take insulin around 30 mins before,should I be trying 45 mins etc.

Didn't you say the spike will happen 2 hours after eating if so taking ealier probably wouldn't be help. Could log the when you eat on the libre on the app then we might be able to offer more advice.

 

[rebrascora]

What was the meal you had at lunchtime? You need to consider how fast or slow it will release. So if you are eating a white bread sandwich, try a wholemeal or seeded loaf to see if that will slow it down a bit. Plenty of salad (fibre) or cheese (fat) in it will help to slow it down a bit.
If you are currently prebolusing 30 mins, a jump to 45 in one go may be a bit much and risk you hypoing mid meal or just after, so try 35mins tomorrow and then 40 the next day and see if the spike is coming down any and then try 45 if necessary after that.
I used to need 75 mins at breakfast with NovoRapid for a relatively slow release breakfast (yoghurt and berries) and 20-30 mins for other meals, BUT I don't eat bread as it spikes me quite badly because it is very quick to digest in my system. I now use Fiasp which is quicker than NovoRapid but it can be a bit quirky and took me a long time to get the hang of it so not sure I would recommend it as a first option. I still need 45 mins prebolus at breakfast with Fiasp, but just 10-20 mins at other times of the day although I follow a low carb way of eating, so most of my food is slow release, which helps.

 

[Charl]

For lunch I had a tin of soup 18.4 carbs...2 x slices wholemeal bread total 36 carbs, kiwi fruit 4.7 and an apple 11.8....

 

[Wendal]

Usually take insulin around 30 mins before,should I be trying 45 mins etc.

Hi Charl,
None of us can give definitive advice just options for you to try and see if you work out how your body responds to the different variables and then try and learn how to better manage your diabetes.
Remember to only change/ test one variable at a time so keep the rest consistent.
Firstly you need to establish the right amount of insulin for a given meal and once you are happy with that correlation then you can work on the timing.
So if you want to judge what is ideal time to take your insulin say pre meal you would pick your time say 30 minutes and inject your insulin and have a regular meal and see how your BG reacts.
Repeat once or twice the procedure ( ensuring there are no other changing variables so similar exercise etc).
You should start getting some consistency and can then better judge if you ned to vary your insulin timing.
So if you are dropping before/soon after your meal then you probably need to take your insulin closer to your mealtime and vice versa.
Everyone should get a prandial rise in BG following a meal and you are trying as much as possible to get your insulin to peak as close to possible to your BG peak.
It is not easy and you will always get other influences such as stress,illness etc but I find a step by step understanding of how my body reacts the best way of managing.
ATB

 

[SB2015]

As others have said extra insulin to tackle a spike will lead to a hypo as you are finding. It is the timing of your bolus that will help to reduce the spikes. There is no simple answer as we are all different, but it is a case of trial and improvement. This is supported by your graphs, where you are hypoing after meals. That means that you have too much insulin, not too little. Some exercise after your meal will also help to manage the spikes.

There are many factors that we need to take account of which impact our Bg. We each need to work out what works for us, and there are lots of ideas above to try.