Should I hold off on dinner if my blood sugar is 144 still? I'm still in a learning process so I don't do corrections.
I'd usually take the dinner bolus and wait. If you can spare the test strip(s) it may not be a bad idea to try 15 min, test and see what it is. I always think of doing it that way but, as I'm the chef and making educated guesses about MrsAcidRock's battles w/ traffic on the way home, it doesn't always work out. I'd rather wait 15-30 minutes to eat than have to spend several hours chasing highs on the back end? It usually seems to work better for me that way although, if you are easily distracted while cooking, watch out as sometimes the tactic can hit quickly. That's why another couple of tests can help see if it's working?
I usually bolus and wait half an hour if I'm high ... but I consider "high" to be over about 10 (180). Of course, if I have time I will wait until it's lower, but I am high and eating on the run enough that if I never ate when I was high I'd end up skipping half my meals.
Who said 144 is high ? There are plenty here who think 144 is a pretty good number. It depends I guess on your perspective and also on your targets and whether you're on a pump or not too many variables to actually offer anything useful except if I was hungry and my blood sugar was 144 I would take some humalog to cover my meal and correct 1 unit for the "high" and then eat dinner. But that is just me, you're regimen will vary.
Since you can't correct, and are still working on your basal (so don't know if the 144 will come down on its own), I would bolus and then wait 15 minutes to 1/2 hour before eating Without doing an actual correction you can round your insulin up a bit. For example using your 1:15 ratio you can bolus your one unit (or two if you eat 30 carbs) and then only eat 12 or 25. That will give you a tad towards the high you're starting with.
Re Clare's reasonable "who says 144 is high?" question, I believe that the DCCT (link) suggested that BG > 140 will increase one's incidence of complications? I wouldn't call it "bad" or "good" but if I hit that at the same time 3 or 4 days in a row, I usually will tweak my pump to fix it?
I also think there's a difference between a 144 after a meal and a 144 before a meal. If 144 was the highest I spiked post prandial there would be dancing in the streets at my house! But if I have 144 before a meal and don't add a correction I know I'll look at going higher. My guess is, Clare, you don't disagree because you said you would add a correction for a 144 before you ate.
A BG of 144 won't cause me to hold off on eating. I would simply let my pump calculate both the insulin I need for a meal and the correction. I might give my bolus a little sooner than usual, just to give it time to kick in. I would also avoid eating anything too high in carbs if that 144 had been preceded by other higher-than-usual numbers. I will delay a meal if my BG is over 200, however, because I know from experience that eating a full meal when starting out at over 200 is just a recipe for higher numbers to follow.
What is your target range?
I was just put on my insulin the other day and I am still trying to figure out my carb ratio. I guess I don't have a target ...yet anyway just trying to get everything figured out, learning as I go. I took my novolog, then waited 15 minute, then ate. After I went and walked around walmart for an hour to see if it would help some. my 2 hour number was 159...hoping it doesn't go up to much more. It seems to keep going sometimes :-/. Thanks for all the advice.
I don't disagree at all, in fact my comment was really directed at the impression that 144 is "high", while my pre-meal targets are 70-130 my post meal targets are 70-180 so I wouldn't freak out at 144 regardless, I would just correct for it but like I said if I was hungry I would eat.
They should probably have given you some target numbers to work with. For the most part and it is fairly individualized depending on the situation, the ADA recommendations for diabetics is 90-110 before meals and 90-180 after meals but to be honest you would have to be pretty spectacular at your control to hit those targets. My targets are 70-130 before and 70-180 afterwards which for me are a bit more attainable. Zoe has different targets from mine but that just reflects that fact that we are different people. Don't get too bogged down in the details, it's great that you are checking you blood sugars and keeping track, and 159 2 hours after a meal is not a bad number either.
I should add that I will pre-bolus for all meals, if I have time. I find even if I'm not high to begin with, pre-bolusing by half an hour helps a LOT with my post-meal numbers.
Some of us believe that the ADA does us a great disservice when it tells us 180 is a reasonable target. Since studies show that complications begin to accumulate at significant time spent above 140 that is a better post prandial target imho. Do I make that target all the time? Nope. But I do promptly correct any highs over that level. I think we all make different choices - some people seek to be under 120 after meal. But too many doctors follow the outdated ADA standards and I believe that is expecting too little of us.
unfortunately my hope for it to not go to high was a fail..... :( Now 4 hours later I'm at 180. I really didn't have much fat in my meal. So maybe it was protein from chicken? I don't know. Today was a disappointment for me... Guess I'll just take my Levemir and go to bed. Good night everyone hoping for better success tomorrow. If after tomorrow I still having highs then I'll make adjustments since tomorrow is day 3 of trail and error with this ratio.
Protein is unlikely to make you high, Denise. Please don't consider high numbers at this point a disappointment or a failure. You are still trying to figure out your doses. if you are consistently high after using a 1:15 ratio for a couple days then it's time to try 1:13. It's all useful information. Also if you are considering numbers 4 hours after a meal then you need to look at your basal. It's important to have your basal right first.
Well I had lowered my basal to 5units since the first night I had dropped to 62, I take it at night. I feel like maybe when I do go back to the doctor maybe I should ask her if I should split a dose and do it in morning and at night, maybe this would help? Because I don't want to go low over night and my fasting this morning wasn't bad when I put it at 5 it my fasting was 110. But my during the day between meals does seem to be a bit high 3 or 4 hours later. So I don't know...I'm lost...
140 but I also ate a piece of string cheese because I had to take another med with food, so I ate the cheese because it had no carbs.
the first night I took the levemir is when I had the 62. I went to bed at 181 took 6units of levemir... 5:30am was 62. Next night went to bed at 140 took 5units of levemir woke up at 110.
I'm with Judith on this. T2 has different options, but the same concerns. I can actually bring my blood sugar down with some exercise, but since I can't walk very well that's not helpful. Have to just stay as low as I can all the time. If I was 140 I wouldn't eat until it was lower, and then it would have to be a really low carb meal.
AR: The average BG in the DCCT (a Type 1 study) tight control group was ~150-155 mg/dl (that's where the "aim for 7 or less" A1c came from). The 140 mg/dl is heavily promoted on the BloodSugar 101 site, but every single study referenced for that "damage occurs above 140" was done on Type 2s.
If I were 144 mg/dl before a meal, I would just bolus and delay eating a bit. Not a big deal, IMO.