This will be a long, agonizing process. But, it will probably work. Its best to have a few days of basal tests - like, 3 overnights and 3 basal daytime tests. Usually, I say a week, but you gotta bunch of work to do and time pressures, so let just get 'er done.
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The strange part is that the food I ate at 730 really had no carbs in it but this is my over night and I took my long acting Lantus at 9 pm. No insulin was taken at dinner because the food had no carbs
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Like your spread sheet! Wish I could make one like that. Not too talented on spread sheets but will try.
What did you specifically eat? What were the grams of carbs, protein, fat of each ingredient? Both fat and protein probably need insulin which could be why you are spiking.
3 gram of carbs. 6.2 grams of fat, 43 grams of protein. chicken breast and Half a cup of chopped zucchini. If you look at the time between eating it and the increase in blood sugar it is fast. Faster then if I ate bread. Now I could be completely wrong and have no idea what’s going on and how my body processes insulin and carbs at different times of the day. I understand there is some change through out the day but Iv never noticed that much.
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I’m at 10:1 i:c what would someone use to cover fats and proteins? And would you wait until after the meal? Also as you can see I had only taken my lantus after the meal and woke up with a low blood sugars reading.
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So you had about 3g in carbs. What is your Carb Ratio (how many carbs are covered by 1U of insulin)? 3g could be enough to produce that initial spike 7:30 - 8:30PM of about 30 or so points. Then you trend down and after a short gap of readings you’ve already spiked up at about 9:30PM. The gap in readings could be due to the sensor not being able to keep up with the spike. So it looks like you started to spike really at about 9PM, 1.5 hrs after you ate. This could definitely be due to the 43 grams of protein. You could try taking a bolus specifically for the protein perhaps after you’ve started eating to mimic the peak activity of your bolus insulin (eg., Humalog peaks at about 75 minutes). You’ll have to experiment to work out how much bolus you need. Many use 50% of their Carb Ratio (half the insulin you would take for a carb, so 20:1 in your case). But start out on a much LOWER amount just to see if it helps.
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Sorry, just seeing this! But my previous response addresses your first 2 questions.
I’m on a pump so I do not take a long acting insulin like Lantus. It looks like the Lantus dose is too large though if you are getting a low within 10 hours of dosing. What is your dosage, and is that just 1/day? How does the rest of the day look? Do you get lows between meals?
@mohe0001 mentioned it might be a good idea to do a basal test. I agree with her.
Interesting yeah. I’m pretty consistent with going low I’m the morning. Last few weeks Iv been lowering my Lantus. My normal before was 31 but I wasn’t checking blood sugar hardly ever and not using my cgm. My does now is 27. I tend to go low between meals sometimes but then at some points. I’ll be high and won’t come down between meals. Especially between lunch and dinner. That’s why I have been sometimes trying to eat very low carb dinners because they have been the hardest to control. I can’t help but get the feeling like food is sticking around in my stomach then when I eat the next meal it pushes some of the left over meal into my small intestines. I have also had some issues some days with getting low after a meal like it’s not all digesting fast enough for the meal time or pre Meal injection. But I guess if There is to much Lantus on board that could be doing it? Also I never knew people split their bolus until now.
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I am way out of the loop o have had diabetes for 20 years but have very haphazardly taken care…
I’m not proud but I just don’t want it to be too late. I have the pump now but waiting on training and a meter to connect to it.
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Its cool, @Rleb. You’ll get it worked out. It will get better. It just takes some time and effort.
You can split your dose into two doses. But, if that doesn’t do the trick, you will need the pump. These guys had me split my dose (Way back in the day) and it helped, but not quite enough. Today, I have 5 different basal rates and that works well for me.
Don’t worry about counting the fat and protein, yet. Lets get the basics down.
CGM data will help immeasurably. I would hook that up ASAP.
If you want to discuss gasteo and gut stuff more, you might talk to @Terry4, if he’s around here somewhere - usually is.
Yeah I’m on the fence with it being gastro or what not. I sometimes feel like it’s just a lack of knowledge and static thinking but there is so much that goes into it. Exercise and stress that I just have never accounted for and now I’m stressed to a point Iv never been to before and I’m barley moving all day. I’m trying tho I have thought about splitting my dose too I’m
Not sure if I should lower it again or just divide it into two
I have learned that my body takes its time metabolizing food. SO I would get into trouble if I followed the standard instruction to meal bolus 20 minutes prior to eating. The insulin would kick in, causing a low and the food would have its peak impact somewhat late. It isn’t gastroparesis, just a slower system, Been this way my whole life - even pre-T1D Dx. try logging when you bolus, when and what you eat and see if it is consistently “off”. I find giving the meal bolus at first bite to resolve a lot of the issue
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I’d keep lowering the dose until your running a little high in the morning - like 200 or 250 and then split.
People generally split the dose as a way of achieving a higher morning dose and a LOWER morning bloodsugar.
You end up taking one before bed and one in the morning, so you kinda get double the insulin the morning. There’s overlap from both shots.
People’s motivation for splitting is generally that they are high in the morning and they want to double down on that insulin.
Don’t split if your going low in the AM. Don’t split yet.
Your assignment is to:
1.) Hook up CGM and post the data - just to get reacquainted with it.
2.) Take a before bed and a morning BG with your BG fingerstick machine.
Write those down somewhere and start a record.
3.) Make a separate post where you try and walk us through what is stressing you out so bad. Maybe people can brainstorm and bounce some ideas around. You are not the only one, believe me.
4.) Keep dropping the basal dose until your not getting morning lows. Those lows might be giving you anxiety. I got really bad anxiety yesterday when my sugar was low. The two go hand in hand.
Oh, crap, my sensor says I’m 43 --> right now. I guess I should practice what I preach.
I dont trust that number. I’m gonna do a manual BG stick.
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Okay I can do that
The missing piece for me was learning that fat causes insulin resistance. I would get these mysterious highs HOURS after eating. Couldn’t figure them out, especially since I was on a low-carb diet.
Now I know these were delayed highs due to fat-induced insulin resistance. In other words, the fat itself doesn’t push blood sugars up, but it makes our cells more resistant to the effects of insulin.
I learned about this from the Mastering Diabetes guys. Here’s a link to one of their resources, if you’re interested: http://www.masteringdiabetes.org/wp-content/uploads/2017/02/Causes-of-IR-Opt-In-Bribe-FINAL.pdf.
Good luck!
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Thanks for this link. I experience highs hours after eating dinner as well. I’m a vegetarian and I eat little fat. I guess that is relative, but my scale measures a low body fat percentage - how accurate these scales are, I don’t know! 
I just read the Mastering Diabetes on insulin resistance that you posted. They mention …
in most cases diabetes is caused by excessive FAT intake.
Is this true?
Thanks again for sharing and I am so glad you found a way to reduce your spikes! I will definitely look into my fat intake in my own diet!
I’m trying to stay positive and do this stuff but it just throws me for a curve ball when my numbers are decent and then all of a sudden It seems like nothing makes sense. Getting low blood sugar after eating and stuff. Spikes 5 hours later or spikes in the morning after drinking water.
You will have this figured out in a couple months. Keep at it. It’s just all gotten away from you. You gotta play catch up, now. Its super frustrating, but keep at it. Little by little things will improve.
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