When is an after meal reading too low?

[Lanny]

Since being put on MDI of insulin 6 years ago, my GP Practice nurse gave me a target range of blood sugars to aim for:- 2 hours after meals 7.0 to 10.0. I was told that the bolus insulin I’m on, Novorapid, is active for 4 hours & if after meals it’s lower than 7 I could go hypo! So, I would snack if it was around that! But, recently with my BS in general coming down I’ve been hovering around that figure after dinner for a while now & have found my waking BS rising if I snacked but, ok, & even better, if I didn’t: 6.8 2 hours after, then falls to 5.8 after 4 hours. My waking BS has been coming down but, still always higher than going to bed.

Now, today 2 hours after lunch my BS was 5.8. A couple months ago, I would be having fake hypo symptoms but, with lower BS generally now, I don’t feel anything & really don’t want to eat again. So, I’m sipping 150ml of fruit juice.

Back at the end of Jan. & the start of Feb. 2018, I felt hungry & wanted/needed to eat again if my BS was this low 2 hours after: not hypo so, no treatment but, eating again as insulin is active for another 2 hours.

But, paradoxically, I’ve been finding, these last couple of months, that Novorapid DOESN’T last the full 4 hours for me now & tails off just after the 2.5/3 hour mark AND BS even starts rising a little before lunch! It always seems to be after breakfast & before lunch that that happens. As today, waking/before breakfast BS 6.2, after 6.3, before lunch BS 8.4 & after 5.8.

What figure would you consider you need a snack for?

 

[Emmakeets]

Hi @Lanny I personally wouldn't snack for anything over 5. As you need to be above 5 to drive if you are on insulin that tends to be my target as I am out and about driving most days.

I'm sure others will be along soon with their advice but I believe the guidelines for type 2 are before meals 4-7 and after meals below 8.5.

 

[Robin]

The question is, though, if you are in the 5s two hours after eating, with insulin still on board, will you drop too low by the four hour mark? I find it's a question of what you ate, if it was something with protein and fat in it, the insulin will be starting to tail off, but you've still got part of the meal still to digest, so they sort of balance each other out, and I tend not to drop further in the second half of the Bolus. If I've had something very carby, though, and it's all but digested by the two hour mark, that's when I could drop too low in another hour or so,

 

[Lanny]

The question is, though, if you are in the 5s two hours after eating, with insulin still on board, will you drop too low by the four hour mark? I find it's a question of what you ate, if it was something with protein and fat in it, the insulin will be starting to tail off, but you've still got part of the meal still to digest, so they sort of balance each other out, and I tend not to drop further in the second half of the Bolus. If I've had something very carby, though, and it's all but digested by the two hour mark, that's when I could drop too low in another hour or so,

Thanks for that, @Robin! 🙂

That’s very useful & makes sense to me! That’s maybe what I noticed about the duration of Novorapid as I’ve been eating less carbs & eating more protein & fat!

I tested at the 3 hour after mark & it’s dropped a little to 5.1, even with the juice! I had home made veg soup with bread & butter for lunch! Will test again at 4 hours!

 

[Alister]

Only a new T2 but on basal only insulin.
I think in your case it would probably be most sensible to just keep an eye on things & only load up if you see the figures dropping close to or into the hypo range before your next meal.
reading other posts here it seems to me the medics are so worried about us going hypo that they are scared to let us manage things too well.

 

[Lanny]

Whew! Just after the 4 hour mark & BS has risen to 6.2! 🙂, more of a releived emoji!

I wonder if my liver got a bit concerned & dumped a bit of glucose which is taking effect now that the insulin is gone?

I hed noticed, @Alister , that my target figures were higher than most people on here but, my BS has been high all year, after hospital stay in May 2017. I hadn’t been unduly worried as my BS levels hadn’t been near the range that others aim for! I had started to worry a little bit, recently, with my levels coming down & approaching that range!

I’m now there with a perfect day of readings yesterday, the first in a year, all in the sevens & one blip of 8.8 before lunch: again that little rise after breakfast/before lunch!

I’m a bit lower today!

 

[C&E Guy]

Last night, 2 hours 10 mins after injection and dinner, I was at 4.4. Couldn't work out why.

So I had some juice and a couple of Jelly Babies. All back to normal and scored 9.9 first thing this morning.