Two hours after?

[Lisa65]

Just thinking that without CGM or extended after meal FPs, there's no way of knowing that the "BG should return to baseline within two hours" guidance for type 2 necessarily holds true for everyone. Sometimes two hours after eating (tonight for instance) my BG hasn't even started to rise, let alone peaked and gone back down.
I had a slightly odd dinner, a piece of salmon, a bit of chicken curry that my friend from Sri Lanka gave me, and just a tiny bit of the rice she also gave me.
I'd have expected the rice to hit quickly, even though I only had a couple of small spoonfuls. I guess the rich curry and oily fish slowed it down.
After 2.5 hours I finally got a small rise of 2mmol presumably from the protein in the chicken and fish. But it probably won't go back down all night now, as I tend to wake up pretty much the same level as I went to bed.

When I finally get my meal time insulin, how could I even inject for that? Or would I not inject for protein even though it causes a slow rise?

 

[everydayupsanddowns]

It’s interesting what the detail of CGM can reveal isn’t it!

I remember the difference it made to be able to suddenly see what had been going on ‘between the dots’.

For me a slow-absorbed meal like that often is best handled with a split dose… a proportion of the calculated dose before the meal, and the remainder perhaps an hour or two after the meal. This can spread the action of the insulin over a longer window.

But of course, because this is diabetes, the precise timing and amounts of the splits will be different for each individual!

 

[harbottle]

When I used sensors, I saw that a daal (Lentils, tomato and low fat coconut milk) caused BG to rise almost 3 hours after eating.

 

[helli]

But of course, because this is diabetes, the precise timing and amounts of the splits will be different for each individual!

And if you really want precise timing, it will differ every time you eat exactly the same meal
Thankfully, precision is needed as much as BG in range 24 hours a day 7 days a week 52 weeks of the year. 🙂

 

[Inka]

Not sure what you mean by ‘baseline’ but I assumed you meant pre-meal blood sugar? If so, that’s not the case and it won’t be the case when you start on mealtime insulin. Protein does give a delayed rise in the absence of carbs/not enough, and sometimes that rise is prolonged.

As @helli says, we don’t need to worry too much about these variables. It’s the overall direction of travel and control that’s important 🙂

 

[Lisa65]

@Inka I meant that it's suggested that we test before eating and then two hours after to see if that meal is OK for our blood glucose ie not a large spike, because T2s don't usually have the option of mealtime insulin to bring it down.
Still waiting to hear from the hospital about my carb counting course at the moment!

 

[Inka]

That’s what I thought 🙂 Your blood sugar doesn’t have to be back to your pre-meal reading at 2hrs, just ideally under 8.5🙂 I know you’ve also had a later/slower rise from the protein, but you’ll get experience in assessing and dealing with that as time goes on.