I’ll admit, as a recently diagnosed T1 (14MAY09), I’m still in the dark about how everything works, but I’m learning. I’m reading “Think Like a Pancreas,” and “Using Insulin,” (I’m on MDI, not a pump, yet). I test a minimum of 4 times daily - 0700, 1200, 1700, and approx 2100 hrs. More often if I start feeling hypo, which fortunately turns out to be in my head. My lowest low so far has been about a 72.
I started the Diabetes Education at the local hospital - all of three classes (I’ve taken the first one) to learn how to manage this disease for the rest of my life. We covered a little of everything in the first hour and a half class, and one of the things I’m trying to track is how my body is handling carbs after meals. I tested at lunch time, prior to eating, and had a BG of 98. I had seafood from Long John Silvers (admittedly not the best in the world, but I wanted to test something). No fries - I can’t stand them, but fish, clams, shrimp, cole slaw and hushpuppies. Going by an online source, it was about 72 grams of carbohydrate - should have just pounded my blood sugar - right? When I tested two hours later, I was at 96 - down 2 points from my pre-meal testing.
I take 15 units of Lantus in the evening, typically around 6:00, and then I’m on a sliding scale at my other test times. This morning, I was at 130, and had to take 3 units of Humalog - but both the Lantus and the Humalog should be gone at the time I ate lunch.
Is this part of the Honeymoon period I keep reading about or what?
Your meal was high fat, so the 96 mg/dl reading at 2 hours later may not have been your peak blood glucose in response to the meal. Your blood glucose may have continued to increase for another hour or two. That often happens with high fat plus carb meals.
Still, to figure out how foods affect your bg and how well you’re counting carbs and matching rapid-acting insulin doses to cover them, testing at about 2 hours after the first bite of food is recommended.
But sometimes I’ll test at 1 hour or 3 hours after I eat just to get more data.
Today, for example (I’m a longtime type 1 on a pump), I tested 138 mg/dl at 1 hour after 38 grams carb (yogurt and chili and my beloved Diet Coke), 152 mg/dl 1.5 hours later, and 137 mg/dl 2 hours later. That meal was moderate fat (lean beef and the high-fiber beans help even things out).
See, the more you learn, the more complex it gets! But after a while, it does get easier, or at least more routine.
It sounds like it could be part of the Honeymoon Period for you.
If you took no Humalog with your meal then it sure sounds like
the Honeymoon Period to me. Enjoy the Honeymoon it ends
so quickly. Maybe you should test a little more during this period
to prevent a low or possibly to lower your Lantus amount.
Good luck, keep an eye on your sugars, maybe have a snack before bed.
Kelly’s suggestion was most probably right on target. High fat meals are slow to digest & often take more than 2 hours to register with BG. High protein meals can do the same. You should test later to see how this type of meal effects you. It can take many hours to see the full impact.
You should not lower your Lantus given your fasting BG.
Please discuss matching your insulin dose to carbs with your doctor so you can graduate from the sliding scale. Hope this being covered in your class. The class I took never went over this because everyone else was a Type 2.
Yes, this does sound like the honeymoon period. My niece had no problems with food for about four to five months after diagnosis. She always has had problems with lows, though. During the honeymoon period you have to watch out for lows as your pancreas might kick in insulin. The lows will continue, though, after the honeymoon is long gone I think this is mostly because insulin does not match food digestion perfectly, or even well. Endo told us to check two hours after eating and adjust from there, which she did not have to do during her honeymoon. The way we figured out she was coming out of her honeymoon was her after breakfast numbers. We were told not to change her diet, she could eat anything she wanted. Breakfast cereal started spiking her into the 300s. During her honeymoon, no problems with cereal.
Doc said to take the Lantus around dinner time - I eat around 6:00, so that’s when I take it. Right now, I’m working through a couple different books trying to figure out the best way to go about taking the medication, so I can present it to the MD - right now, the amount of Humalog I take is so low, that it’s almost negligible - I’m not going to say that it is negligible, but it’s close. I only take Humalog if any one of my four daily tests is 121 or higher, and I’ll go a few days at a time where I don’t have to take any of it. Usually I only have to take 3u, rarely 6u. Looking at the meter, my averages are 111 over the last 7 days, 109 over 14, and 106 over 30. I know the end of this is coming, just don’t know when, and don’t know how bad it will hit when it does. And I’m pretty certain it was the fats. Last night at 9:00 when I tested, I was at 173, so had to take 6u.
It’s all a huge learning curve for me at this time.
Great that you’re doing the research! Diabetes is a YMMV (your mileage may vary) disease. So consider these suggestions, but most of all consider what your body is doing. So far, so good from what you’ve shared with us. And, hey, we know how tough it is to master that learning curve!
In addition to your humalog sliding scale, do you have a carbohydrate target for meals, as Gerri suggested? That’s something you’ll eventually want to learn as your body starts to produce less insulin (since it sounds like you’re producing some right now). You may want to see a registered dietitian 'cause most MDs don’t provide many specifics on the food side. Like with the insulin dosing, however, listen to the dietitian, do your research, and still take into account your body.
I think this is mostly because insulin does not match food digestion perfectly, or even well. Endo told us to check two hours after eating and adjust from there, which she did not have to do during her honeymoon. The way we figured out she was coming out of her honeymoon was her after breakfast numbers. We were told not to change her diet, she could eat anything she wanted. Breakfast cereal started spiking her into the 300s. During her honeymoon, no problems with cereal.