OK so maybe somebody can help me figure this out. With dinner time if I have a good 1hour number I always go low at 2 hours and if I have a high 1 hour number my 2 hour number is always good. how do I fix this? Suggestions? Thanks
Are you still taking your fast acting and waiting 20 minutes to eat? You might try experimenting with how you take it. I know 15 minutes is kinda the standard rule of thumb, but I'm sure you are becoming aware that there really is no standard treatment for diabetes. It's something we all have to customize to fit us. Maybe experiment with your fast acting and eat sooner after taking it. For me, I almost never wait to eat. I bolus and go, lol I'm weird If I wait 15 min to eat, my 2 hours are going to be higher than I want them.
Also it might be what you are eating. Foods high in fat and protein, tend to slow the carb response down...so maybe if you are eating a lot of protein and fat, its slowing the carb impact down, then the fat and protein are hitting later.
What are your 2 hour blood glucose reading?
good question
You may find that your insulin requirements are lower in the evening hours. My dinner I:C ratio and correction factor equal about 25% less insulin when compared to my morning requirements.
Note: you should weigh your food to calculate carbs even if one serving is called out on the package. This will also help you judge portions and you will have better luck when you eat a restaurant meal.
define high ? What do you consider a "good" 1 hour number or a "good" 2 hour number ? and what do you consider low ? There are people here who have targets of 70-130 before and 70-180 after. But at the same time there are others here who would cringe if their post dinner was even near 180 so it's hard to give a fix if you don't know the parameters.
Well example the other day my 1 hour number was 160's and 2 hour number was 120's soo 2 hour number to me was good, 1 hour number seemed not extremely high but high enough. Ok now example number 2 yesterday my 1 hour number was great 91 but then I didn't even get to get to the 2 hour mark because at 1 and a half after I was 56. I've been waiting 15 minutes before eating..maybe I should try waiting 5 to 10 minutes instead. Example of a meal.. Slice of meatloaf, 1/2 cup of squash, and small salad with only 2tbsp of dressing and almonds in it. I don't really thing that's really a high fat meal? I don't know.. My 3 and 4 hour number still have been going high after dinner like today 1 hr was 115 2 hr was 123 so tonight seemed great with first 2 numbers but now my 3 hr number is 169... :-/ so guess i'll increase my morning basal...since moving it up and taking it an hour later hasn't helped like I hope... I really hope this gets at least a little easier...because right now its just so frustrating....
my basals after dinner are set pretty high, maybe you need to increase them a bit.
I dont know if its so much your I:C ratios are off, or your basals, or the fact you havent started adding a correction factor. For me, my target range is 80-110 premeals. If Im over 110, and of course Im on a pump so the pump makes smaller corrections, but pre pump for every 30 over 110 I was I took 1 unit of humalog. 160 1 hour after eating is NOT bad, and 120 2 hours out, esp if on the downward side REALLY is not bad at all. Me personally I would not be too alarmed with 56, I might not even treat 56, but just continue to monitor it. You may fairly quickly start coming back up on your own as food starts hitting your system. There's a lot of variables to take into consideration.
Your morning basal has little to do with your dinner numbers and is just what is needed to control fasting BG when you have no active bolus insulin. Your numbers will be different every day for every meal even if you eat the same food every day. I only worry about it staying in my target range and if I can do this 70-90% of the time...life is good.
I would consider the meatloaf a high fat food and would consider delaying bolus insulin.
Denise relax your doing a great job...;-)
And also with the meatloaf, a lot of times it has a tomatoey base to it, which will up the carb count as well. May actually have some hidden carbs floating around in it with any kind of "bread" that is sometimes added to meatloaf. But I agree Denise you ARE doing a great job. This is not easy by any means, and even those of us who have been dealing with it for years, still have days nothing goes right, and we are struggling all day.
I made the meatloaf there was no tomatoes in it . It's been 4 and half hours since i've ate and my blood sugar is now 220. :( But John question... I thought the basal was for between meals so wouldn't it have to do with what my bs is 3 hours after a meal? I take half in morning and half at night. I was told if I'm going high 3 hours after a meal I should increase basal?
Is it even safe to go to bed with it this high?
Most "fast" acting insulins still act over a pretty long period of time. I take Humalog and it has a duration of action of 5 hours. I only look at my 2 hour number. If I am low at 1 hour I am almost assured that I have overbolused. And in most cases, if you are back to your preprandial or lower at 2 hours, you will still have as much as half the insulin still waiting to take effect and a low in your future.
Counting the carbs in your food is a "skill." Even those who have done it for years still struggle and we all make mistakes. And then, even with an accurate carb count, there are so many variables that you never get things exactly right.
Your first order of business is to work towards getting good at carb counting and figuring out an accurate dose. Your 2 hour number should be "in target" (I use < 140 mg/dl) and your goals is to restore your blood sugar to your normal preprandial number at 3-5 hours with no lows and no need to correct. After that, all the rest is details.
It is not "unsafe" to go to bed with high blood sugar; not in an immediate sense like it is unsafe to go to bed with low blood sugar. Nothing will happen to you during the night with blood sugars in the 200's. However, that being said, the more time you spend at high numbers the more you accumulate possibility of complications and 8 hours is a long time to stay in the 200s. One night won't hurt you but you don't want to do this on a regular basis. That's why we correct. Some people say don't correct before bed, to make sure you don't go low. I agree with this for now because you are still trying to determine your ISF. But I always correct before bed now when my nighttime ISF is very sure and conservative so I don't spend the whole night high and then have to deal with highs at breakfast. One habit I've gotten into is not waiting until bedtime to do my last test. I always read in bed for awhile so I test when I go to do that. That way if I'm high - or even worse low - I can correct and still be up for awhile to see how I'm doing.
Yes, 3 or 4 hours after a meal is considered "between meals" and is influenced by basal. So if you are consistently high at those times you need a bit more basal. The only exceptions for this would be if you were high at your pp test (2 hours) and didn't correct. Then your high could still be from your meal. Or if you eat something high fat where your spike could be later. But if you are in range at your pp (I think you are confusing things by testing at 1 and 2 hours -pp should be at 2 hours)and then go high at 3 or 4 hours or later that could be a basal issue.
So would this mean if I'm high 2 hours after a meal do the correction then? or wait until 3 hours after?
I always correct if I'm high at my pp. But you do need to take into account the IOB when you determine your correction dose.
Seriously I'm so frustrated with dinner time... My bs was 134 at 1 hr great so I went to the store was only there for like 15 minutes or so walking then went home... 20 minutes before 2 hours I was 70 so I decided to wait it out I waited 20 minutes to see if it would go up... It went down to 62 so I treated with 1 lifesaver 15 minutes later it's a;ready 98...and I know it's not done going up :(. I waited when I saw the low because I was thinking it always goes up after 2 hrs but when it was still dropping that's why I treated... Now I fear I'm in for another long night of high blood sugar.I just can't figure out why my 1 hr is either high or normal and I still go low 2 hours?
Could you possibly have problems with gastroparesis? A lot of diabetics do. Do you often feel really nauseated or throw up after eating? Gastroparesis can really effect management because your food's being absorbed MUCH more slowly than it should.
I don't know how many grams lifesavers have, but I doubt one will make you high. Again, the two hour is the time most of us check for post prandials; so if you are consistently low at two hours then you are taking more insulin than you need and should reduce your I:C. You are just confusing yourself with the one hour check imho.
However, don't underestimate the effect of even a short walk. I used to always go low when I went grocery shopping.
I've read some about it and I don't throw up...but my stomach has became extremely swollen like bloated looking the past few weeks...It definitely doesn't seem normal. I actually go to the doctor on Tuesday so maybe I should ask her about that.