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Why, Why, Why??

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H

heasandford

Well-Known Member
Relationship to Diabetes
Type 1
Why is it that insulin is too slow when you eat nice bread (I love bread!) but when I had a lovely slice of toast last night after a hypo it then took one and a half hours before my BG went up.
 
Strange observations there! Are you eating the same bread for both? Are you having anything on your bread / toast that would change the absorption rate?
 
No, same, toast with marmite, bit of butter. Most people here seem to think bread causes a spike - I make my own (breadmaker!) seedy bread.
 
Were you using the toast to treat the hypo or was it a follow up after some fast acting carbs ?

Rob
 
To be honest no one will ever know 🙄

Different times of the day, different basal requirements which (unless pumping) you are having to 'hobson's choice' with one that mostly sort-of works. TBH I suspect even for pumpers different days have variability and even an huge number of basal profiles would not be enough to guarantee that the liver was kept happy.

Sometimes insulin seems absorbed and active at lightning speed, other times it can take a good hour to finally start working. But I've ever found a satisfactory way of identifying exactly what is going on because everything affects everything else and as soon as you begin to observe one, you change the outcome!

FWIW I would never treat a hypo with toast. However speedy it seems to be when I don't want it to be, I just couldn't rely on it to hit the system quickly enough for a hypo.

Annoying really, as it could be a time when you'd choose to eat all sorts of yummy things that you can't normally because they are too fast, except that when you need them they ain't fast enough!! 😡
 
Yes, I know you are all right and I should have taken the usual lucozade, but ....! Your last sentence, everydayupsanddowns, sums it all up! Just a rant I think, and I really don't want to give up my bread!
 
The digestive system actually changes when you're hypo. The transit speeds up (for most things 🙄) and BG will rise a lot quicker.

But the delay from anything but the quickest (glucose laden liquids, preferably fizzy) is too much to get you from the "just out of trouble" numbers to the "able to get up and do stuff" range.

Coke or lucozade should do in 15 minutes what bread will do in 60. Once you're back in range, lucozade will prob send you soaring into the high teens within minutes where bread will put you in double figures within half an hour. Still a big difference but ust one of scale.🙂

Rob
 
heasandford said:
Just a rant I think, and I really don't want to give up my bread!
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Have you experimented much with dose timing for bread Heasandford?

If it were me I'd throw a few test strips at it and see what came out. eg:

Test before, inject, wait 10-15 minutes, eat bread, test after 60 minutes, 120minutes, 180 minutes, 240 minutes.

Spot the 'peak' and if necessary move the injection 'back' 15 minutes. In which case you might:

Test, wait 30 minutes, test, eat bread, test, test, test.

To be thorough you might want to run the tests more than once (certainly once you seem to be getting it nearly right).

I realise it's fairly high risk, but I regularly wait 30-45 minutes after injecting before eating lunch, and sometimes longer at breakfast because tests with a 'thigh shot' have shown that it can need that long to start working.

Hope you find a method that works for you.
 
OK, I have resisted doing this because I find timings so hard especially when I'm making dinner, or before breakfast, always at the last minute. I have screen dumped your reply and will put it up in my kitchen - now I am going to be 'home alone' (all fleeing the nest this month) I really have no excuse!
 
I can inject up to an hour before eating breakfast without going hypo - at other times of the day I would definitely be hitting the floor! My HbA1c came down from 5.9% to 5.4% once I started injecting 15-30 mins before eating, rather than immediately before which is what I always used to do.
 
Northerner said:
My HbA1c came down from 5.9% to 5.4% once I started injecting 15-30 mins before eating, rather than immediately before which is what I always used to do.
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I don't doubt that at all Northie. As soon as I started looking at my 1hr and 2hr levels (inspired by D&E T2s on forums like this) it made me realise quite how long I was spending in double figures every day.

M
 
heasandford said:
Why is it that insulin is too slow when you eat nice bread (I love bread!) but when I had a lovely slice of toast last night after a hypo it then took one and a half hours before my BG went up.
Click to expand...



Assuming you ate the toast soon after treating the hypo with glucose then the delay would be caused by the bread delaying the glucose, the best way is to treat the hypo with glucose then wait 15mins and test, if your bg is climbing out from the hypo then it's safe to follow up with a slow acting carb such as toast.

One of my failures as a young diabetic was to overtreat a hypo with fast acting glucose but not follow this up with slow acting carbs, from a low bg reading I would sky rocket within the hour to double figures and be toatally miffed why this was so, dsn explained that eating a piece of toast would normalise bg and keep it within single figures, took this advice on board and never had a problem since🙂
 
I really should know what you say, sometimes it's just about acting on it. Thanks for sorting me out - what I really want is not to have to do it all!
 
Sometimes I wish there was a like button on here. Some really good helpful replies to this thread.
 
And of course if you go low enough to cause a liver dump, all the toast does is replace what the liver has dumped. But then you'd have a higher BG, FROM the dump.

Be nice if it was simple like me ......
 
Just to continue the breakfast theme, I've noticed that summer months, when we were walking the dogs at maybe 10 or 11pm, the carry over effect of the exercise, before going to bed, meant a good waking BG and quick & sensitive response from insulin at breakfast.

Now we're walking the dogs about 7.30/8pm, Im sitting around for several hours before bed, negating the benefits of the walk and the waking BGs and whole morning sensitivity has gone out of the window.

Maybe those who are active in the evening get better morning/breakfast responses than those (of us) who site around. Also, note the drinking of alcohol in the evening may suppress the liver's glucose output in the morning, giving a seemingly better BG but maybe not improving sensitivity.

All very complicated and makes my head hurt at times but I try to get a handle on what's happening on the inside so that I can work out a response to the chaos that doctors call 'control'.🙄

Rob
 
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