I posted on the flatliners group, but I didn’t receive a response. I am hoping I will get one on the main page.
I have been trying REALLY hard to get a flat line, but I always spike 2-3 hours after eating. I ate at 1:20pm today & spiked at 3:30pm. I corrected it because if I didn’t the spike would just keep going up & up. I obviously over corrected today:( I am taking regular insulin (injection) because I eat protein & fat. I didn’t spike earlier in the day because I didn’t eat.
What should I do? Is it just a matter of increasing regular insulin?
I was experiencing diabetes burn out last month - big time. So, I ate horribly, gained a bunch of weight. I am now trying to get in under control, but I’m feeling a bit defeated. I HATE getting lows because I can’t stick to my diet as I have to keep correcting.
First of all, even with that spike this is a really good line. So well done on even achieving that level of control!
Secondly, is this a consistent enough pattern or is this just an occasional thing? Because I don’t know any diabetic that flat lines 24/7 365 days of the year, nor any non-diabetic for that matter.
I don’t use regular insulin, so I’m not as familiar with its profile, however you may need to consider giving a second bolus an hour after eating if you’re finding consistently that you’re going high 2-3 hours after eating. A lot of people who still do MDI will give two boluses with each meal, which works in a similar fashion to a pumps extended bolus. If I did not do this, I certainly would go high consistently 2 hours after eating. I do use Novo rapid though so I can’t directly comment on how this would play out with regular insulin.
Do yo exercise regularly as well? I constantly underestimate the power of exercise in keeping my blood glucose levels flat. I tend to find it helps even more so with going higher later at night if I eat either a meal higher in carbohydrates, or strangely a meal lower in carbohydrates but with a large amount of protein.
I agree with @Donman90 that this is a very good line. It looks like you topped out at about 7 (126) after starting at about 5(90). That’s a mere 36 point rise which isn’t optimal but hardly deserves the title of a spike. You will burn out again if you try to keep your blood sugar in a a 40 point range (80-120 for example) and feel that anything less is if not a failure then at least a problem.
I’ll say it again. This was a very good line until you over corrected. If your tools don’t allow you to give yourself a smaller correction, don’t correct in similar situations.
Yes, the spike is not much of a spike - more like a rise, but if I didn’t correct, it would keep going up. It goes up after after 3 hrs of eating every day, so it is consistent.
I will do a second bolus after eating to blunt the rise & I am going to talk to the diabetes educator about a pump later this week.
I know I might burn out again, but I’m only 36 & I’ve been getting burning in my feet - I’m a bit scared
Thanks for the advice - it made my day to get some support from fellow diabetics!
I would fully expect BG to peak an hour or two after eating (or even three hours, depending on many variables such as what you ate). Even non-diabetics don’t flatline. Is it your experience that, without a correction, the line “would just keep going up & up”? If so, maybe you’re not getting enough of a bolus. Perhaps your insulin-to-carb ratio needs some adjusting.
Also, given that you corrected and then dropped quickly, I wonder if you still had sufficient insulin on board, and you hadn’t allowed that enough time to work on the carb before adding to it with another dose. Hence it’s maybe not so much an overcorrection as a not-needed additional dose of insulin. Have you experimented with a longer pre-bolus time?
Though avoiding carbs is not a bad thing, I always cringe a bit when people talk about eating only protein and fat. There are many more foods that contain carbs than people think. There are obviously carbs involved with a bolus. And fat always slows down absorption, which makes the rise occur later than expected (depending on the amount of carbs actually eaten, the glycemic index of the food, and the amount of fat).
That said, @the_explorer, you don’t mention what you actually ate (carb wise). I would ask:
Check your afternoon fasting Bg and see if you have a natural afternoon rise, or you are flat all afternoon when fasting.
Keep in mind that fat delays absorption, so the idea to split your bolus is good. Or delay it. It depends.
You say you ate “protein and fat” at 1:20pm - so I would ask “what is the action you entered at 2pm?” And all the actions around noon that were entered.
You just aren’t providing enough information to make an educated response.
That line looks great. I take three units before eating, try to eat a moderate number of carbs, and then correct after the meal. My numbers are great.
The problem is when my pattern is interrupted by a ball game. I forgot to correct and spiked horribly. It took a long time to get my numbers back to good. The point of this is the presence of human errors and simply forgiving yourself.
I “generally” love my numbers, except when I don’t.
Here’s my last 24 hours – which have been a virtual nightmare!
The overnight high was just super stubborn and took most of the night to fix – that mini spike at 4am has me confused, since I’d not eaten in at 5-6 hours by then and usually don’t see 4am spikes. The day spikes were also bad, but again, there’s room for confusion. The double spike at lunchtime and after were actually pretty typical of that meal (yes, I had too many carbs!). The “dinner” spike, though, is again confusing: I ate NOTHING after lunch (finished around 1:45pm) and drank nothing except water – yet I got a HIGHER spike after 7pm than I had from my high-carb lunch! Came back down easily enough, but why the spike - and such a high one!??
I’ve been going through this same confusing roller coaster, too, the last week or so. As a result I’m taking about 3 times my normal insulin per day due to corrections. My food intake has been much lower, too, as a result, while I try to get a handle on these spikes. For example this morning I woke to a bg of 110, already too high. I accepted it though and took my insulin from my OmniPod which included a correction and then waited for the “bend”. After 40 minutes or so, nothing, still 110-120. So, cautiously, I decided to take the hounds out for a walk which turned into about 2 miles, very slow, stroll for 2 hours. When I got back, xDrip+ showed 69, and fingerstick showed 71. So my insulin taken nearly 3 hours earlier, enough for 30g plus correction, 2.35u, barely effected my bg in comparison what it should! I took another 2u for actually EATING my breakfast of 1/2 yogurt+ berries and 1/4 cup chia pudding. An hour later, and now my bg is 73. Perfect for the moment, but I took twice the amount of bolus, plus walked, plus waited 3 hours! Crazy. This is what has been going on pretty much repeatedly all day. not sure if it is a result of my 3 day fast a few weeks ago or maybe my insulin sensitivity has just drastically reduced suddenly.
Sorry, @the_explorer, I didn’t actually answer your question but I agree with @Donman90 recommendations, be prepared for corrections and if there is a consistent pattern, be prepared for a second or third bolus.
One way to manage any post-meal spike is to walk for about 30 minutes while your insulin peaks. Regular insulin peaks in 2-4 hours so a walk at 3 hours will likely help. That action profile is the nominal action curve and your experience can vary. In fact it can vary in the same person by time of day. But it’s a good enough estimate to use. For me, walking is a wonderful catalyst that makes my insulin work well.
