My doctor and dietitian both told me to test at 2 hours but by that time, my BG has gone back to normal. They said that means it’s OK to eat those foods. But if I test at an hour, my BG is 140-180 if I eat more than 10g carb. Since my fasting BG is 80-90, this is a huge swing and makes me feel terrible. I still have some of my own insulin (I have LADA) and that kicks in and sends me low. I’m going on the assumption that it is better not to go high, even if it’s only for a short period of time. I think I read somewhere that you should test to find the highest point, whether it’s at one or two hours and use that number to make decisions.
What do you think?
I test my blood sugar 6 times a a day sometime more than that… Fasting, 2 hours after I eat breakfast, lunch and supper. Plus before lunch and supper and before I eat breakfast… I do fasting when I get out of bed… So really I check 7 times a day… It depends on what my mood is… What I mean… I can’t tell if I having a low or high blood sugar… meaning NO SYMPTOMS!!! My children and my future husband can tell… so they tell me to check my blodd sugar… I slur my words but to me I’m talking normal…
Most of the time I test at two hours, but sometimes I just don’t feel right so I will test sooner, and if I am really high I bolus a bit more. Sometimes I am too low due to overbolusing for my food and then eat a few more carbs to bring it in range.
Answer is, it all depends, but sometimes I can test at two hours and be fine and then the 3 hr. mark I am sky high.
Once again it all depends as some fatty foods will make my bgs go high much later.
Typically if you’re very high at 1-2 hours, you simply underbolused. However insulin has about a 4 hour active insulin time, so it takes 3-5 hours for the insulin to full work and affect your blood sugars. If your blood sugars goes up after you eat and you test too soon and then take insulin, you could go low because you are “stacking insulin” - you are bolusing before the insulin in your body has a chance to work. My CDE, Gary Scheiner, recommends testing no sooner than 3 hours after eating, unless of course you know something is amiss and need to fix it. If you grossly underbolused and are at 400, your pump might say to bolus, but it will often tell you to bolus less than what you normally would because it’s taking into account the active insulin I mentioned.
Does that make sense?
Typically, I check around 2 hours after lunch, which is my main meal of the day, and dinner. (I generally use my pre-lunch check as my post-breakfast check as I eat little, late, and almost 0 carb in the morning). I’m also a grazer around midday so it’s hard to figure out when 2 hours is. But anyway, the other day I checked around 1 hr pp and I was unhappy. I went from 115 to 279 in an hour. What I had eaten was some cherries. I had bolused accordingly, even though I had just exercised and was hoping I was a little bit more sensitive than usual. Plus cherries are supposedly low glycemic - GI of 22 or something. Apparently not for me. But it was back down to 134 at 3 hr pp, so it makes me wonder what huge spikes I am missing. Lately I am trying to do more 1 hr pp’s now, and also watch fruit more closely.
I usually test at two hours. For me Humalog has a very noticable peak at about an hour and a half, which means I could be 15 at one hour but down to 8 (my target for two hours after a meal is under 10) by two hours. If I tried to correct after one hour I would end up low. The only time I test earlier is if I feel low and have overbolused, or feel extremely high (like high teens or twenties is when I usually feel it) and have probably underbolused or even forgotten a bolus, in which case I will add on a bit more.
It does frustrate me sometimes that “rapid acting” insulin is so slow, though. I try to bolus a short time before eating to make the spike less extreme. It’s even worse when I correct a high and have to wait hours for it to come down.
When I am in “laboratory mode” - meaning I’m trying to figure out how a particular food is affecting my blood sugar - I test one hour after, then again two hours after. It’s my understanding that this would be the peak of the blood sugar curve.
Before I did this, I couldn’t understand why my A1C was high, even though post-meals were more normal. The culprit was the spike after one hour.
Leslie,
This was exactly my problem: the one hour spike. So do you adjust your insulin or carbs to prevent it?
Even though I get told that it is acceptable, spikes of more than 30 points make me feel terrible that day and hung over the next day.
I actually test at both, but then again I am on Symlin, and it does strange things to my curve. I am usually steady or drop some for the first hour, then go up by hour 2.
I would say test when you peak. You are trying to avoid peaking, so test when it is the worst. But the information at 2 hours is important too, in your case, because it shows you that you are going back down by that time. For that reason, I personally wouldn’t mess around with the dosage as much as the timing of your insulin. If you take a lot more then you are going to start having lows at 2 hrs, which isn’t good either. It looks like your food is getting a head start over your insulin, then your insulin catches up and brings you down to where you are supposed to be. I don’t know when you are injecting, but you might trying moving it up a little bit if feasible to make the insulin action peak match the food absorption peak.