Nope, not usually.
So, I did uber low protein last night with a salad and piece of cracker bread (low carb). I sat at 130 from 9-1am. Ha! Again bolus with no change. What could my body be up to?
To boot, this morning I had an episode of dawn phenomena! Spiked to 160 for 2 hours about 20 min after I woke up. Luckily had the Dexcom on and noticed the elevation.
Tonight Im going to try low protein again and see what happens.
Did u try with a different bolus profile for ur dinner?? I have had the same experience and most of the time i do not correct as long as it does not cross 200 late night. But my fasting BS get back in the range wit out any correction!! So never bothered to pay much attention to it.
Thanks for the reply Emmy. Carbs are minimal. For instance tonights dinner was 16g carbs, 14g protein and 12g of fat. So not a large meal. Also, this only seems to happen from 9pm to 1am. This is the only meal this happens with or only time as I dont know that its based on dinner.
Initially, tonight was totally off. I had LBS twice, then come 9pm I was 130 stead. Now its 10:45. My next step is to skip dinner and see what happens. I can have a good sized lunch, then a snack at 5ish and see what happens.
Is that after each meal Emmy?
I know what you mean. Its starting to frustrate me as the rest of my day is 90-120. I thought I had it down for the day then this pops up. Arg! =^)
chris, are your meals high carb? Mine does the same, with a higher protein dinner its 160 from 9-1am. If its a high fat dinner its 130 from 9-1am. Then back down to 100 in each case. I have been correcting though to see if I can get it down. Ive been using square waves or extended dosing.
Tonight’s experiment has gone awry from LBS at 8.15. Come 9pm I was up to 130 and have been there since. Im going to try fasting tomorrow. Then I think the answer might be a bolus over 4 hours of 1-2units an hour starting at 8:30 or so.
You are right on when u asked that question. Mine are definitely high carb (but definitely not high fat)!!! The lady from Disetronic said that it could be because of digestion pattern or some thing like that. I mean i tried with various types of bolus profile and they did not help me.
I have heard a lot of people raise similar concerns (on TuD) in the last 6 months or so. Also there is no definite pattern.
My reasoning:
Since i am a white rice person and this thing has high GI and so i believe i end up having a BS spike which my bolus isn’t able to catch it. Further when i test 2-2.5 hours after dinner even though my meter tells it is 220, but i have body symptoms that are clearly indicative of low BS (which i believe indicates a fast falling BS) . I believe there is some kind of lag between the actual spike caused by the white rice and the time it is shown in my blood (finger prick). with our any correction the morning sugars drop to 70 or so!!! a drop of 150!!!
Please do let me know if u get any advice from ur endo!!!
Chris,
Have you tried testing at 1 hour to see how soon rice starts the rise? How high is it before bed to drop down that much?
Are you sure that you were recommended a high carb or were you recommended a simple carb. A mixed simply carb/complex/protein/fat meal can certainly result in complex digestion patterns. Simple carb on the other hand results in a swift glucose peak that is actually closer matched to a rapid bolus profile. Are you sure she said high carb? Does this work with you when you do complex high carbs?
That white rice is a bad one. I used to eat it as well and figured out that the only way to deal with it, was to measure the amount - say a cup, then bolus about 20min before with a dual (long lasting and instant) bolus. Usually quite a lot of insulin. Maybe 5-6u for the rice then 1-2 for whatever else (curry, mobu, etc.)
As for me, I think its something different as the more I change eating patterns (more protein here, less there) the highs change as well. For instance, yesterday I had less protein at breakfast, a 3 hour 130 spike came around 3pm. 9-1 I was 70 and then this morning I was 160 from 4am-8am.
Chris,
i don’t remember the exact value but thing at +1Hr weren’t bad in the sense hovering around the same as at 2-2.5 Hrs. The values at 2-2.5 Hrs (i.e. right before bed time) are around 220ish.
My grandpa is T2 diabetic for like 25 years. He has been facing the same stuff in the last 1 year.
I am from India. My doctor (he is a renowned doctor and often considered the father of diabetes in India…He is no more though) has a view that in case of T1 since we administer external insulin the carbs should not really matter (i mean like white rice or wheat or some thing else…this doesn’t mean we should go after direct sugars) as long as we are able to compensate it with correct dose of insulin.
I do agree that rice has high GI but his opinion was that a high BS (like 200ish) for a short span of time shouldn’t matter much. I know this sounds like a philosophy. But his justification was such spikes cause no more than weight gain and since i am underweight anyway so weight gain is what i need!!!
I can see what you are saying about rice!!! It is probably going to be really tough to break away from rice for me!!! I got the data sheet for rice to insulin ratio from San Jose State University. I feel it is a pretty accurate estimate. I do the same way. But some how i feel it is just impossible to maintain 80-130 range 24*7 . So i don’t really bother even if they slip up to 160ish or may be 180ish.
Further with home made food i feel its just impossible to be accurate…i mean i tend play around a little bit with the ingredients and so i feel no point in trying to be perfect.
I actually find that homemade food is the best because I can measure everything precisely. Eating out, you never know what they put in stuff and you can’t weigh and measure things, although I’ve become pretty accurate at “eyeball” measurement.
You can drive yourself crazy worrying about transient levels, but if you aren’t achieving good numbers more than 2 hours after eating and your fasting numbers are off, then you need to make some adjustments.
I think it all has its place. Eating at home is great, but like the waffles I made this morning, I had no idea the count in them - made with WPI, almond and flax flours. I took a stab at 8g for 2 waffles and was good at a steady 105 or so.
On the other hand when eating out your right bsc. Youve got no idea what they put in there. I find I can only eat at places Ive tested or order super low carb meaning 0 carb meals.
Still another side is packaged food which is spelled out for me. That can sometimes take a load of pressure off having to make my “toss of this, toss of that” style cooking in to a precise science.
Ahh basmati rice is slightly different from the shorter grain white rice I was speaking of. The longer grain basmati (in my system) used to have a slower and softer spike than East Asian style rice. I am well familiar with masalas, curries, and chutneys. They are some of my favorite foods. I suppose the next Tiki masala I go with will be over cauliflower rice. Oh, now I have to figure out how to make a good naan for a low carb diet!
On the diabetic side, those fluctuations from 90-200 then back down arent good and should be avoided if possible. If you can make it a scientific test I would try to bolus 20 min before with 1/2 cup cooked rice. thats maybe 60 carbs and spread that bolus out over 1.5 to 2 hours. Test every 1/2 hour and see how that goes. Then you can adjust with the same amount of rice and increase / decrease the insulin as needed keeping the distribution time the same. Its a lot easier to type this than to do it, but it may be the way to figure out how to keep the numbers around 100 with some rice.
I agree with OneSaint about the fluctuations not being good. There have been studies showing that those glucose excursions are just as dangerous if not more than staying high all the time. That is why so many people now look at their standard deviation number as being just as important as average BS.
Yes!! I have the same problem! The later in the day it gets the higher my blood sugar goes it is soooo frustrating!! I’m guessing it has to do with all the protein and fat I eat during the day finally peaking at night.
Wow! so what do you do? How do you correct? Im finding that If I eat more protein / fat at lunch the nigh time highs are lower (130 vs 160).
If I eat a large protein breakfast, then I eat less protein for lunch. So the numbers at night seem to be higher. Im thinking Ive almost gotten it by doing a long lasting bolus at 8.30 or so. It seems to keep me around 70, so I think im going to easy up a tad and try to hit 80. Although, I seem to be getting morning highs now too. Go figure!
Lil Mama,
Many people are most carb sensitive/insulin resistant in the morning & evening. Since you’re T2, insulin resistance may be even more pronounced during these times. Afternoon seems to be our best time when we’re most active. Hardest time for me is after dinner.