So, what is a realistic target BG in between meals for T1s? I ate a lunch with approximately 30 carbs around 11:30. I took 3 units of humalog. More than 2 hours later and I’m at 150. For some reason, I lately seem to have trouble getting down below this between meals. Am I just being too much of a perfectionist? Are bad things happening in my body at 150?
I consider a between meal number as being 3-4 hours after meal and being a fasting number. The truth? A realistic number is 83 mg/dl. If you have a fasting number of 150 mg/dl then you have some room to improve your basal levels.
Now, as to what a good 2 hr post meal number target is, that is an entirely different question. For myself, when I started insulin last december, my target was to be below 140 mg/dl at 2hrs after meal and that I would correct any readings above 180 mg/dl at 2 hrs. I’ve since tightened up my control and target 120 mg/dl at 2 hrs after meal and will correct any numbers above 140 mg/dl. But this is not my “between meal” number. At 2hrs after meal, I’ll still have perhaps as much as half of my bolus on board and I will drop further.
But blood sugar targets are a personal choice. I follow a strict low carb diet and am very consistent and controlled about things. Not every one can or should run their life like I do.
My goal is 80-90 between meals, not that I consistently achieve this. Your bolus ratio may need to be fine tuned &/or basal. Some meals take longer to digest.
One of two things: For us 150 is a very good two hour postprandial and she may either drop to target or even lower than that. If she stays at 150, I assume it is is either a basal issue or combination of foods just did not digest right, needing more insulin than I gave. ICRs are not perfect; for us, they are just ball park, i.e, right most of the time. I always suspect basal first because her ICRs stay relatively stable for a long chunk of time. P.S. If insulin is no longer working, I would not leave the blood sugar at 150 between meals but would correct to target of 100.
I think you are doing well. I don’t think there are complications associated with being 150, I believe 180 is more often referred to as the threshold to stay below. It’s hard to tell a lot from just one meal. Most of us don’t have a perfect ICR/Basal set up because there are too many uncontrollable variables, but if your ICR works for the meals you eat most often then it’s all good.
What did your endo give you for a target BG? I hate to throw out a number because I think? you are still honeymooning and docs like to play conservative at this stage, you know?
Above 140 is the usual number given where damage occurs.
I agree with Gerri, and some of us work on being tighter than that. 180 is an outdated number that the ADA is still touting (and thus many doctors and dieticians are echoing it) despite damage starting to form at 140.
The problem with staying at 150 between meals is that it gives you nowhere to go. If you start your meal at 150 you are automatically going to be too high. If this is a post prandial number (2 hours after a meal) I would look at the I:C ratios. If it is a number you remain at between meals (up to time for the next meal) than I would address your basals as well.
Some of us, imho are too cavalier with taking more and more insulin to suit food whims. But others of us hesitate to take more when it is clearly indicated. I find myself in this category at times and have to remind myself that if I’m getting consistently high numbers at a given time I obviously need more insulin (or to take it earlier perhaps if its basal).
180 is from the Dark Ages & risky.
Low doses are preferable, but normal BG is far more preferable.
Some folks like me could make only a .1 adjustment strategy to a basal or bolus and end up with a 30 mg/dl between meal result instead of a target 100. Everyone has to decide where their mind and body is comfortable. If you want it lower, just take your body there (slowly) with minute adjustments, log-booking, more frequent testing, and experiment. It’s really interesting to see what blood sugar does by the hour (even half hour!) if one can devote a day to finger gouging. Diabetics who are used to a post meal sugar at 150 would feel really low and awful at 90. Just take the adjustments slow and experimentally and patienly–easy does it–and it’s okay to strive for perfection (even if you don’t get it)! There is always more at stake going on in the body than just food, carbs, and insulin–that’s just the superficial stuff that we try to control from the outside good luck–i think 150 is a great start!
That’s my problem - I am always scared to take more insulin, especially when I’m at work. I am afraid of going low (and gaining weight!) My endo wants me closer to 120 after eating and the CDE felt that 150 wasn’t too bad considering I’m T1.
I understand. Not being able to function at work is awful. Taking higher doses translates into weight gain if there’s excess insulin circulating, but if the dose is accurate to need that’s not a big problem. One thing you can try is eating less carbs for lunch to keep doses low hopefully without a spike. Make changes in small increments. Timing of insulin can make a huge difference. Taking part of your dose before meals & the other a bit later to head off the high.Takes experimenting & lots of testing at 1 hour, 2 hours & 3 hours.
The attitude that 150 is good enough for a T1 is wrong. Glad you have a good endo.
Interesting on the 140. Have you seen studies that come to this conclusion? I’m not disputing it, just wondering if there is something I haven’t read. Does Bernstein refer to 140?
Blood sugar ALWAYS has a spike point after meals–even in non-diabetics-- and it is unrealistic to expect yourself to time everything perfect EVERY day-- insulin and metablolism running a perfect paralell race together!! ha ha–in our dreams!!! I hate having lows after meals too so I feel your pain. Your CDE is probably taking your personal variables into consideration, and making a smart choice of targets with you!!! When I used to work, a short walk after eating lunch helped me speed up my bodily usage of the 3 hr insulin action dose I took with meals. Don’t know if your job or circumstance permits that, but it’s a (weather perimting of course) thing-- that can help some people.
Yep, there are studies showing renal threshold & BG levels. Dr. B advocates normal BG for diabetics. He thinks 140 is too high.