BS post dinner elevation

Hello all, I am having difficulties lately (past 2 weeks) with post prandial BS. Type 1 and insulin at meals 3x day. Low dosage of 3.0 units premeal. Insulin ratio 30:1. Has been working fine now lately my BS come down nicely to around 100 or even at times in the 80s -90 1 hour after meal. Then for some reason, 2 hours after meal it rises to around 200 or 210 and stays there for next 2 hours or more. Timing with meals and possible fat content in meal may play a factor. Question is can I take only 1/2 insulin dose at meal then another 20 min later or so during the meal take the other 1/2 dose ( 1.5u pre and 1.5u during) Will this correct my later BS rises? Any thoughts or experience in this is appreciated

Depending on what I’m eating, I sometimes find it beneficial to spread out my bolus. I may pre-bolus maybe 1/2 20 minutes before eating, 1/4 to 1/2 when I start eating and any remaining 20 minutes or so after starting the meal. High protein and high fat meals both go better for me when I do that.

Experiment! Maybe save just a little for later to see if that has an impact and adjust from there.

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True. If I am eating a higher fat or protein meal, may delay the absorption of food and hence a rise later. May need to balance my CHO with protein and fat more. I am not on a pump only injections 3-4 times daily. May try more plant based proteins vs animal proteins as well. Frustrating though. Quantity matters.

I have found that my postmeal spike often won’t happen until as late as 2-3 hours post meal so I will sometimes split the dose and take the second a full hour after I’ve started eating. The only problem is that dinner tends to be a higher fat meal than breakfast and lunch for me so this is when splitting the dose is most beneficial but I don’t always like to take the second dose so late as I go to bed a few hours after dinner and I don’t like to have much insulin still active at that point.

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Wanting to split your doses is akin to “faking pumping” and may very well help. Give it a try and see how it works

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Are you finding this elevation happens with any meals in particular (or in general, since diabetes is so wonky!), and other meals it isn’t? If so, what differences are there between those meals?

Your overall reasoning sounds like a good path forward, and yes, timing and fat/protein content can definitely have a significant impact.

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It sounds like a pump would really make your life easier, however you could also try an intermediate insulin like NpH
You can mix the 2 or buy a premixed that’s way you get the initial bump and then a coverage for later.
It saves you another injection.
I did things like that before pumping.
I was taking so many corrections and little blood spots on my clothes I switched to a pump.

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Hi awesome group. My post BS were managed pretty well for a while with splitting insulin doses pre meal and then pos-st meal however now I continue to have elevations 2-3hours after meals 180-200. Way too high and very frustrating. Really tests your patience and progress. At times is so hard to continue to strive for good control. Thanks to this group and support system. One last thing, my amylase and lipase enzyme levels are still ok, on the low end but still functioning. Would it be advisable to consider taking these? I have a high metabolism and have lost weight recently. Not trying as I am 6’1" and weigh 160#. Would like to gain weight however can see my muscle losses. How would one recommend to gain back the weight. Between meal snacks are mostly protein and good fats for added kcal.
Any thoughts and recommendations would be very helpful.

Fast-acting insulin is mostly out of your system in 2 hours so try taking an extra dose 1 1/2 hour after meal (figuring it takes about 25 minutes for your insulin to kick in). Want to add weight in a hurry. Try buying a 3 lb bag of almonds at a big box club and mix 1/4 cup of almonds with a couple of tablespoons of peanut butter. Do that 2-3 times a day and you should be amazed how fast you can gain weight.

Thanks a bunch. I am a Registered Dietitian and one would think I can figure that out. Problem is will I get a CHO numb from it and would I need coverage. Would need lots of fluids after and would my kidney function be compromised due to the protein load? Thanks CJ is