Yet another darn conumdrum

[gillrogers]

So got a stable basal and more or less sorted my bolus timings out. So now introducing a morning snack. My snack bolus ratio seems right at 1:20. Im back to where i started after 4 hours. But as i dont follow the lyumjev profile of back down in an hour and flatten out all the snack is doing is keeping me up longer and then giving me the illusion that i need a correction for lunch when i dont. Its complicated further by the way the levemir will drop me at lunchtime by 1-1.5 mmol in an hour or two. Aha does that mean the the basal is coping with the snack in which case i need to up the snack bolus by half a unit which would give me a bolus ratio of 1:10? My correction factor is 0.5 unit for 1.5mmol or 1 unit for 3 mmol.

 

[everydayupsanddowns]

It’s a thorny one @gillrogers

And one of the reasons I have generally ended up avoiding regular snacks that need insulin.

Might it help to use an app for dose calculation that tracks ‘insulin on board’? That way at least you’d be able to see how much of your snack dose was theoretically still active at lunch.

I’ll move this thread to the General Messageboard where it might be more visible in case anyone has any experiences to share.

 

[helli]

@gillrogers do you consider insulin on board when you calculate your insulin dose?
If your levels are in the 8s when you come to eat lunch but your last insulin dose was only 90 minutes ago, you will still have insulin on board which, if you correctly calculated your snack dose, would bring your levels down so no need for a correction.

I would also question if you have your basal stable if it brings your levels down by 1 - 1.5 mmol/l in an hour or two. If it is definitely your Levemir doing that, your basal is too high.

 

[Inka]

Just ignore the illusion, which you’ve correctly identified as such. I like snacks and simply bolus for them, and ignore any higher than usual number rather than correct it as I know I have insulin on board. It’s just like bolusing separately for a two course meal, but with a bigger gap probably.

 

[gillrogers]

@gillrogers do you consider insulin on board when you calculate your insulin dose?
If your levels are in the 8s when you come to eat lunch but your last insulin dose was only 90 minutes ago, you will still have insulin on board which, if you correctly calculated your snack dose, would bring your levels down so no need for a correction.

I would also question if you have your basal stable if it brings your levels down by 1 - 1.5 mmol/l in an hour or two. If it is definitely your Levemir doing that, your basal is too high.

Yes I understand about the insulin still on board. The snacks the dsn wants me to have are high fats and proteins so another bloody problem to get weight back on me. At this rate im going to be injecting every two hours all day at this rate! DSN realised its not really practical.

Yes got one of those apps but im still can’t fathom out what my ratio is for that time so it can work the right amount out from insulin still on board from breakfast.

I just feel which ever way I turn im stuffed I either go sky high or I drop. No in between at all.

 

[gillrogers]

Just ignore the illusion, which you’ve correctly identified as such. I like snacks and simply bolus for them, and ignore any higher than usual number rather than correct it as I know I have insulin on board. It’s just like bolusing separately for a two course meal, but with a bigger gap probably.

Yes that’s what I’ve done. The problem is dealing with the lunch bolus two or 3 hours later but then the app that calculates how much I’ve still got on board should help with that if I’ve got the ratio correct for the snack.

 

[gillrogers]

Do crisps slow down sugar release? I’ve not eaten crisps for yonks and decided to give them a go at lunch time as I’ve been told to get my calories up. So started bolused 15 mins after my meal and went almost flat for an hour then started going up and kept going for 3 hours! I had a pastrami salad sandwich and walkers ready salted crisps. Didn’t come back down with my usual bolus ratio.

 

[helli]

The crisps are unlikely to be the thing that slows down the carbs
It may be the fat in the pastrami or it could be the bread (I find sourdough can be very slow to have an affect). It may have been your snack.
Or it may be nothing to do with what you ate..

In your position, I would not jumped to any conclusion. I would try to reproduce the food again and see what happens.
Or even just try the crisps when you have no insulin on board.

 

[gillrogers]

Thanks, im thinking it might be my anxiety over me being sensitive now to the lyumjev. Really struggling to get this back under control. Still waiting for a new prescription to go back to lispro.