Weird levels (no surprises there...)

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FairyNuff

FairyNuff

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Relationship to Diabetes
Type 1
For the last few days, my BS level after my evening meal is lower than my level before.

They have me test an hour after each meal, I've seen other people say it's 2 hours... not sure why I'm different.

Oh I get so confused with all this 🙄 how many years until I get it all sorted?
 
I think you are pregnant right?

The targets are different for pregnancy. Testing at 1 hour is encouraged in pregnancy. Generally in diabetes though testing at 2 hours is normal so thats why you have seen people talking about 2 hour testing and aiming for less strict targets than you are.

If you are lower after eating then your bolus doses are probably working quite well, but if you were high pre meal then basal dose needs looking at.
 
Ah thank you Nikki, yes am pregnant, so that explains the one hour thing.

Basal dose is my slow-acting insulin that I take before bed, is that right? So my bolus is dealing with each meal, but I might need a bit extra slow-acting to keep my levels lower all day... Thank you so much, that makes sense 🙂 x
 
yes basal is the slow acting and bolus the rapid acting before meals.

To check if the basal dose is right one of the best indicators is the before breakfast readings. If they are in range then your basal is pretty good. That time is best to look at as the only insulin working at that time will be the basal.

Are you in frequent contact with your DSN? I know through pregnancy some people's insulin needs change almost daily so it's good to be in close contact.
 
I'm ranging between 5 and 8 pre-breakfast. After breakfast is goes up to 14, that was after one weetabix today... Then by 11, it was 3.4 and I was hypo. I then spike at about 12.

Then the evening meal is typically 6-7 before, dropping to 5-6 afterwards.

I speak to my DSN most days, they are very supportive, they are happy to leave the insulin as it is for now, but want me to eat something mid morning to try to avoid that dip. I know the obstetricians will want the insulin to go up again when I see them tomorrow. They think it's better for the baby if I'm constantly hypo. I want what's best for the baby, of course I do, but I have two other children to look after and I can't do that if I'm constantly shaking and feeling faint.
So am stuck in the middle really with the advice from the professionals, time to try to understand it a bit better myself and make more of my own choices I think. I want the levels lower, but not too low. Thanks for helping me try to understand this 🙂
 
FairyNuff said:
I'm ranging between 5 and 8 pre-breakfast. After breakfast is goes up to 14, that was after one weetabix today... Then by 11, it was 3.4 and I was hypo. I then spike at about 12.

Then the evening meal is typically 6-7 before, dropping to 5-6 afterwards.
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This sounds very similar to something I've been trying to tackle for a while.

Here are some thoughts you can add into the mix/discuss with your DSN. They may be entirely inappropriate for someone during pregnancy!

Firstly I've given up on Weetabix. Even though it's quite high in fibre its carbs race into my system at lightning speed. It's actually in the high GI bracket, with a similar score to doughnuts, rather higher than chocolate.

Secondly even though you went to 14, you dropped to hypo before lunch. This sounds like your breakfast dose was too high, but acted too late.

The spike at 12 is more than likely due to the hypo (either the treatment or a little liver-dump fun)

My current tactic is to inject for breakfast, but leave a little gap before eating. I have to be careful not to get distracted! 10 mins, 20 mins, half an hour, depending on my fbg. This seems to give the insulin enough of a head start so that it's up and running when my breakfast hits my system.

When I get it right my 2 hour readings are mostly 10ish, falling down to 5-7 before lunch.

You might want to talk to your DSN about it in the light of your hypo concerns. No fun being low with little ones about.
 
That is great advice Mike, makes sense, thanks for that 🙂 Will discuss with DSN.

I am tucking into my Weetabix as I type this lol so one last day of them. Don't like them anyway, make myself eat them. I started out on branflakes but they weren't good for me either. Anyone have advice for a good cereal I can try? I promise to not let this turn into SpecialKgate... 🙂

I know oats are very good, but I don't think I can stomach porridge, even Weetabix make me retch sometimes :/ Has anyone tried Oatibix?
 
Currently trialling Dorset Cereals. Really nutty, simply nutty and simply delicious mueslis seem not too bad so far

Apparently Burgen/stoneground/seeded breads are not too bad if you are a toast type
M

SpecialKgate... Rofl! 🙂
 
My dietician told me that Weetabix is like mashed potato - because the food has been mechanically broken down it will enter your system a lot faster even though it is wholegrain. She recommended special K, which I quite like at the moment!

R
 
Incidentally, and this goes against what you've been told about post-meal testing, so probably very unhelpful, the dietician said she wasn't interested in the post meal test, as it was the pre-meal level before the next meal thar told her whether we had the dose right or not...
 
richardq said:
Incidentally, and this goes against what you've been told about post-meal testing, so probably very unhelpful, the dietician said she wasn't interested in the post meal test, as it was the pre-meal level before the next meal thar told her whether we had the dose right or not...
Click to expand...

Nope I'd completely agree with that.

It's only this year I've started doing post meal tests in any kind of systematic way. I used to test premeal only, and as you say this lets you know whether the dose you gave for the previous meal was accurate, and allows you to make a slight correction for the next meals dose if not.

I've heard of some HCPs calling tests in-between meals 'false highs' because they show a 'work in progress' of the insulin with a ~4hour activity curve.

But

The (incredibly demanding) targets for both T1 and T2s include a level at 2 hours after eating of approx 9mmol/l. I know from recent experience that I can quite easily shoot up well into the teens after breakfast and still come down to decent levels before lunch.

My current project is attempting to level out my graphs. I've heard about research that suggests it is the 'spikiness' of your graph that relates to risk of microvascular complications rather than simply the Hba1cs averaged result.

It's just a shame it's so stupidly difficult!

🙄
 
you're absolutely right about it being stupidly difficult...

The main problem I find is that pattern spotting is difficult because there are so many variables to consider, such as basal dose, temperature, exercise, diet, and just feelinng under the weather all seem to make a huge difference, and it's difficult to say which one is affecting the BG levels!
 
also thrown into the mix is the seemingly conflicting advice from different HCPs!
 
I was the same after dafne, only pre meal matters.........but I recently found out that I was spiking to about 18 2 hours after lunch but returning on target at dinner.........the effects of this high were unpleasant so I started testing to investigate the food I was eating.........I now eat salad instead of bread....

So in some ways type 1s also should look at the carbs there eating to try and even of the peaks and troughs...............
 
That sounds like excellent advice...

My control isn't quite good enough to recognise the highs yet, in fact sometimes I still feel a bit hypo at about 5mmol, and have to resist the temptation to snack before I have tested! so I could well be spiking at quite high levels after meals and not noticing at the moment
 
When I say unpleasant I mean thirsty and just having a feeling, I seldomly actually feel bad until I am in the 20s, and even then its only sore muscles..

I have also felt low at about 7, it was a while back mind you......
 
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