Keeping blood sugar under 140

So I’ve read that to have tight control you should keep your BS under 120 after eating and never above 140. Since I want to get pregnant soon I’ve been trying to perfect my diabetes management but this still eludes me. I am usually pretty good at keeping it low but sometimes I get a random spike and I’m not sure how to handle it. I will explain what happened today to see if someone has some insight.

I bolused the usual amount for my usual breakfast. I have a dexcom and I started to watch my BS rise. It kept going up past 170. I still had 1.9 units of insulin ‘active’ in my system (per my omnipod). Do I give myself more insulin at this point? I know that it will eventually come back down and I don’t want to load myself up with insulin and be fighting a crash later. Do I just wait it out?

What do you do to prevent these spikes or mitigate the damage once it happens?

As a side note, I think it spiked so much because I tried a new pod site on my thigh and I’m worried that it might not be a great site to use, absorption-wise, which makes me sad because I LOVE the placement and was hoping to use it in my regular rotation :frowning: I’m hoping it was just a fluke, fingers crossed!

I don't know anything about the Omnipod, but I assume it informs you of insulin on board. So I'm not sure when you got the 170 (I'm assuming you tested, didn't just rely on your CGM). But if it was at the two hour test and I was 170, yes, I would correct according to my ISF, of course with the IOB subtracted. if you don't ignore the IOB and your ISF is correct, why would you be "loading myself up with insulin and fighting a crash later?"

To TRY and prevent spikes I make sure my I:C is right, bolus 20 minutes ahead and try and keep my carbs reasonably low. If I do spike, which personally is inevitable, few of us can ALWAYS remain under 140, I just correct to reduce the amount of time spent at that high number.

Yeah I checked it with my meter and it was actually a little higher than the CGM. I hit 170 probably an hour after eating by breakfast and now at 2 - 2.5 hours later I am at 115.

I have a tendency to lose patience with the insulin, see by blood sugar rising above my limit and starting bolusing thinking that I am correcting it, only to have it all kick in a little later and then I’m at 65 and mass eating skittles to prevent hypoglycemia.

Sounds like you know your pattern. You might try bolusing a little earlier before your meal to see if you can prevent it spiking that high. Also, you didn't say what you started out at; if I'm anywhere over my target of 110 before my meal I always add in a small correction to my meal bolus, because if I start at say 130 I know I will spike a bit higher than I like before I come back down.