How do postprandial bg readings affect fasting levels?

Type 1 and LADA
1

I’m 34, newly diagnosed this year with type 1 diabetes, and am 3 months pregnant. Doc has put me on the tslim g4 pump, and I should be getting a dexcom cgm some time this week. Insulin requirements change during pregnancy, and my endo is adjusting insulin rates on my pump as needed. My sugar hasn’t been perfect, but not terrible either. I’ve had some highs (highs stay under 200) and several lows over the last few weeks, and my fasting levels are typically higher than my goal of 90, running 115 - 135 most days. I thought this meant that my basal rate needed to be adjusted, however, at my appointment last week, my doc adjusted my carb ratio because she worried if she adjusted my basal rate I would be have more lows. She said in stabilizing my post-prandial levels, that my fasting levels would come down to where they need to be.

So far, fasting bg is still running 115 - 135, and I honestly haven’t noticed a huge difference in post-prandial readings–those still vary anywhere from the 60’s to the 160’s.

I should add that I’m eating quite a bit more than I usually would because my Graves is in relapse (since beginning of the pregnancy) and causing my thyroid to be overactive, and therefore my metabolism as well. I haven’t gained any weight so far during this pregnancy, despite eating more of everything (including more carbs, which I got fussed at for doing at my last appointment), plus lack of activity from pretty severe fatigue the last couple of months. That being said, if I do any level of activity, even walking around shopping or being out in the heat, for an hour or two, my sugar drops too low. I do work full time, but at a desk so not a lot of activity during the weekdays. When I was on vacation a couple weeks ago, my sugar bottomed out more than ever because I was being more active.

My question is related to the insulin adjustment – does increasing the insulin to carb ratio (ie, more insulin per unit of carb) have any affect on fasting bg levels in anyone’s experience? If so, does anyone know why this is…seems very confusing to me.

Also, with ALL of the info above, are there any suggestions about how to stabilize bg a little better, and not having to feel like I’m starving all the time? I feel my my endo wants me to eat chicken and vegetables 24/7, but that literally lasts an hour and I’m hungry again.

With so much going on in my body right now, I feel so out of control and extremely frustrated. If I could at least get my sugars in my target range most of the time, I would feel at least like I have some control over all this.

Sorry for the long post – suggestions, feedback, tips are greatly appreciated!!!

2

Ok, here is the short answer.
###Yes.

When you have basically lost all your insulin production if you bolus too little insulin for your meal your blood sugar will be elevated for hours after your meal. Technically, this is the time that one should correct. Sometimes your basal can make up for it, if that happens you could “use up” some your basal for partly covering your meals. This can result in your fasting being elevated.

You should make sure you have proper basal levels set and then worry about your meals. And if you are actually eating chicken and veggies then you need to remember that this is a low carb meal and may be digested over 3-5 hours and will require adjustment to the timing of your mealtime bolus and possibly splitting or extending your bolus. It doesn’t matter if you bolus dose is perfect if you totally miss the timing.

3

Not talking about insulin, but if you are hungry you need to majorly increase the (healthy ie unprocessed And, naturally occurring) fats.

4

Your basal insulin just holds your blood sugar steady between meals and overnight. It’s not supposed to lower your blood sugar much, if at all. Wherever your blood sugar “lands” four hours or so after eating is where it should be the next time a meal comes around. So, as @Brian_BSC says, if you’re under-bolusing for meals and your blood sugar is not coming down all the way, then it will hover there at a slightly high level for hours until the next meal (which could be all night).

2 Likes
5

Thank you Brian. Your explanation about why incorrect mealtime blousing can cause elevated fasting bg levels makes sense.

I am still learning how to adjust the timing of my basal dosage based on what I’m eating, and it’s a work in progress.

The nurse who trained me on the pump said meals high in fat take longer to digest, but I didn’t realize protein also takes longer for the body to process. Like I said…work in progress!!!