How do you correct post meal spikes?

The pattern I see is once it trends towards the 180 mark it just keeps going up and stays high between 200-270 for 2-3 hours (sometimes 4 hours) and at that point I end up correcting a few times before it would come down.

I find that if I correct before it hits that high, it comes down quicker.

I don’t feel so great when my sugar is so high for a long period of time

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My key “trick” is to titrate the correction bolus depending on the bg. If I am 140-170, I’ll use 100% of my normal correction, 170-200 it’s 120% etc. I may also do a temp increased basal, keeping my eye on things to return the basal to normal or a reduced basal for a short period of time. <My range is barrow 70-120, and I do a lot of micro-corrections

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I have this issue too and it seems to get worse not better.
I have to time my insulin early enough but then I’ll bottom out before my carbs kick in. Otherwise I go high. So it’s a very fine line
I’m considering trying Symlin which is supposed to help with this exact issue. My type 1 cousin uses it and swears by it.
I’m not sure my insurance will pay for it because it’s not on formulary, but I’m going to ask at my next visit.

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Let me know how you go with that. I don’t think we have symlin here in australia yet but at least there is hope of it works!

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I agree 1000% - most of my ‘mistakes’ have to do with timing. Stacking, instead of waiting for the insulin in me to work is very frustrating, particularly, as in my case, where insulin takes anywhere from 15 minutes to 2 hours before the results show up on my CGM. And that the insulin inside of me has a life of 4 to 6 hours. And all this is complicated by the type of food (e…g. fats take longer ) your relative health that moment (e.g., not enough sleep the night before), and a million other things. I have learned over 35 years to take the amount of insulin I believe is correct, wait at least 2-4 hours, and then correct. For “emergencies” (sugars way too high and not descending) I keep a pen with FIASP and take a small dose of it for immediate results. But that can be dangerous and lead to low BG. Overall, I suggest taking the shot you think is right, and the the hardest part, wait for it to work

I for some unknown reason tried splitting my bolus at dinner time, biggest meal of the day. I didn’t think 2 hours was very helpful in stopping highs, but using a 1 hour extended time has really helped me cut down on the highs. I now use the 1 hour extended for every meal I eat.

I also seem to have an occasional high with no obvious explanation. I will sometimes realize that I’m not feeling 100% and that seems to be related to the highs. I never seem to run a fever but just feel off. In these cases, I SWAG an additional bolus that usually at least stops the increasing BG and I don’t seem to go hypo very often.

YMMV John

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